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Background: Trichoscopy can be very useful for evaluation for hair transplantation (HT), helping rule out simulators of androgenetic alopecia (AGA). There are only a few reports about normal trichoscopic findings after HT. Objective: The aim of this study was to evaluate donor and recipient area trichoscopy after FUE in HT without complications in AGA patients. Method: A prospective study was carried out with 10 patients, for 24 weeks, with photographic follow-up, using FotoFinder®. Patients were evaluated from week 1 (w1) to week 8 weekly, then, at week 12 and week 24 post-HT. Results: Main results were perifollicular crusts, donor area erythema, recipient area erythema, perifollicular erythema, white circles, perifollicular whitish halos, repilation black dots, dystrophic hairs, folliculitis, yellow dots. We discussed the meaning of each of these findings in the period in which they occurred. Conclusion: Normal trichoscopic findings in post-transplant patients have not been well established yet. Our findings are an attempt to define a normal pattern. Future studies with a longer follow-up may be necessary to corroborate these results.
RESUMO
BACKGROUND: In follicular unit excision (FUE), the concept of depth control (DC) has been created to minimize the risk of hair follicle damage. AIM: To analyze DC variation in different parts of the safe donor area of scalp; to propose Boaventura's new DC classification for hair restoration surgery using the FUE technique. PATIENTS/METHODS: Thirty male patients underwent hair restoration surgery. The donor area was distributed into 14 zones, with the minimum depth required for at least three atraumatic extractions of the grafts. When the extraction was not successful, 0.5 mm was added until reaching three follicular units, determining the DC area. RESULTS: Approximately 2000 extractions were performed on each patient to determine DC. For some areas, greater depth (2.54 ± 0.10 mm) was necessary. Fifty-eight percent of follicular units were extracted with 2.0 mm DC, and 3.8% required 3.5 mm DC. Thus, according to Boaventura's new classification for DC, grade I ≥ 2.00 mm, grade II from 2.1 to 3 mm, and grade III > 3.0 mm. CONCLUSION: There is variability in the DC of follicular units within the different areas of the safe donor zone. Moreover, we have proposed a new DC classification, which would represent a valuable estimation of surgery demand.
Assuntos
Folículo Piloso , Cabelo , Humanos , Masculino , Cabelo/transplante , Folículo Piloso/transplante , Couro Cabeludo/cirurgia , Transplante Autólogo , Coleta de Tecidos e Órgãos , Alopecia/cirurgiaRESUMO
The technique of follicular unit excision for harvesting grafts for hair transplantation procedures has become very popular. This technique relies on the use of small punches to remove viable grafts. Many different punch shapes have been developed to accommodate the varying nature of skin and hair characteristics, resulting in hair transplant surgeons requiring a variety of punches to suit a wide range of patients, which can be overwhelming to the beginner when trying to decide on the optimal choice of a punch to suit a particular skin characteristic. We describe a novel multipurpose ring punch that can be used on patients with a variety of skin and hair characteristics, as well as for shaved and long hair FUE. Features of this punch include an octagonal ring that protrudes from the outer wall of the punch and functions to control the punch's trajectory into the deeper dermis during incision. Additionally, this punch has a dull, notched edge which allows for use in long hair and shaved FUE without sacrificing ease of incision through the epidermis. This punch is the first of its kind to have this breadth of versatility with a one-size-fits-all design.
Assuntos
Folículo Piloso , Cirurgiões , Epiderme , Humanos , Transplante de Pele , Coleta de Tecidos e ÓrgãosRESUMO
BACKGROUND: Follicular unit excision (FUE) is a popular hair transplant technique, but requires shaving the donor area. This is a deterrent for some patients wishing to keep their hair transplant discreet. The new long hair FUE technique avoids shaving the donor area, which appeals to a wider patient population; however, it has a reputation of being technically challenging and slow. AIMS: We review the tools and techniques developed for long hair FUE and present our experience using the Trivellini Long Hair System and Long Hair punch. DISCUSSION: With the new advances in tools and techniques for long hair FUE, this method is gaining momentum and has the potential to be the next trend in the hair transplant industry. There are a few different punch designs marketed specifically for long hair FUE (window/slotted, Trivellini Long Hair, and bi-pronged). Although this technique is slower to perform than shaven FUE, graft survival and final outcome are comparable. CONCLUSIONS: Innovations in technology have made the long hair FUE technique more accessible to hair transplant surgeons. It is important for hair restoration surgeons to keep knowledgeable about this technique in order to maintain a competitive business.