implantation

• FUE

• FUT (stip harvesting)

donor• Time out of body

• holding

Graft

• Stick and place

• Premade

• Implanter

recipient

Survival

protection

naturalness

understanding of basic

principles

individualize techniques for each patient

satisfactory result

Potential risks

• size• transection• injury• dehydration

donor

• time out of body• temperature• solution• dehydration

graft• density• depth• orientation • size• transection• injury• dehydration• placing

recipient

respond to

• Does the harvesting method have any affect on implantation?• Are there any differences between FUE and strip harvesting grafts?

Hair follicle

FUE grafts

• removed directly from the donor

• time out of body

• less soft tissue surrounding the follicles• splayed follicles• bulbs of different length

more difficult to placemore prone to injury and desiccation

FUE grafts

• holding conditions•graft grasping techniques

• time out of body

graft placement techniques

•premade incisions•stick and place• implanter

Recipient site• vary in• size • shape• depth• width• direction• angulation • orientation

• techniques • sagittal to coronal incisions • chisel blades to needles

Incision Orientation

perpendicular

• perpendicular to the long axis of hairs • control of hair angle and direction

• improved hairlines• greater densities• better coverage

• vascular damage ?• faster healing• greater scalp coverage

parallel

• parallel to the long axis of hairs • easier to place • damage less of the surrounding hair• easier to get inbetween native hairs

Basic Principles For Graft Placement• maximize visualization • avoid dehydration• proper graft sizing• gentle grasping• maintaining appropriate rotation

of the natural CURVATURE • avoid multiple placing attempts• angle and directions of grafted

hair should match the RESIDUAl hair

grasping the graft

• Ideally at the fat• What about FUE ?• special attention• difficult to grasp in a bundle

formation

Graft Insertion into Pre-made Incisions

• Body/hand position

Graft Insertion into Pre-made Incisions

Stick and place

• sticker creates the site, and placer inserts the graft • less bleeding• no missed sites or piggy backing•more difficult to control the distribution of the grafts

Implanter

• the incision is made and graft is placed simultaneously • less bleeding • no missed sites or piggy backing• no time gap in which the recipient site is left empty and capable of

bleeding• less trauma• faster than traditional S&P

Implanter

Implanter

Trauma to hair bulb kinky hair growth

Desiccation poor growth or no growth

Incorrect position poor growth or no growth

pitting

compression

inclusion cyst

ingrown hair

grafty look

unnatural cowlick

Careless handling difficult insertion

irregular growth

popping

ingrown hair

unnatural result