Physician’s Hair Institute Techniques
Physician’s Hair Institute’s procedure
Dr. Keene uses the most advanced and effective techniques of hair transplantation in the world. We remove permanent hair follicles on the sides and back of the scalp that are not affected by androgenetic alopecia (often called male pattern baldness) and employ them as donor follicles. These permanent donor follicles are then transplanted in follicular units of 1-4 hairs (the way hair grows naturally) on the crown and front of the scalp. By using follicular units, as they appear in nature, we avoid producing unsightly “corn rows” or other unnatural effects associated with hair transplant surgeries using grafts of 6 or more hairs. We also utilize double follicular units (DFUs) limited to 3 to 4 hairs for added density with fewer incisions. This can allow us to place the grafts closer together. Grafts are placed very close together, since too much space between groupings looks unnatural.
Donor Removal Techniques
There are 2 ways to remove the donor, and Dr. Keene has offered both for many years. For optimal graft numbers, we have been utilizing a combination of the FUT and FUE donor removal.
Follicular Unit Strip Surgery (FUT or FUSS)
This donor removal method entails removing a linear excision from the permanent donor area. Dr. Keene makes 2 incisions, one above the area, and removes the donor in between. She closes the area using a double layer closure, both internal and external sutures. The internal sutures dissolve, and the external sutures are removed 1 week to 10 days after surgery. The grafts are dissected from the donor excision under high magnification into 1 to 4 hair grafts. Dr. Keene also uses a trichophytic closure which allows the hair to grow out through the incision to mask it further. The advantage to this technique is the regrowth rate is the highest available, up to 100%.
Follicular Unit Extraction (FUE)
With this donor removal method, each follicular unit graft is removed individually using a biopsy type excision. Dr. Keene has been doing FUE for over a decade. She currently utilizes a hybrid device that both rotates and oscillates a .8 to .9 mm punch to remove the follicular units (1 to 4 hair grafts) one at a time. The advantage to the FUE hybrid device (the WAW machine) for donor removal is that it helps to retain the tissue that surrounds the graft, so the regrowth rate using this FUE device is high. Advantages to FUE include: minimal discomfort; there are no sutures, and the excisions are tiny, so patients experience minimal discomfort. Minimal scarring; if you wear your hair in a buzz cut, the small dots that are left when donor is removed with FUE are typically not visible. We can also use this technique when donor laxity is not sufficient for FUSS due to prior surgeries.
Neither type of donor removal is scarless, but FUE donor removal can allow you to wear your hair even buzz cut without noticing a visible scar.
How does FUE compare to Neograft, or the Artas, or other FUE machines?
Neograft and Artas are machines used to perform FUE donor harvesting, not unique “techniques” for hair transplants. This can be confusing to patients since devices are sometimes advertised as though they are a unique type of procedure, rather than a surgical device. These devices do not work “automatically.” As with all cosmetic surgery, the success of the surgery depends on the skill and experience of the individual surgeon performing it. When you choose your surgeon, you should expect them to be the one who performs it. Be sure to ask your doctor for before and after photos of hair restoration procedures they themselves have performed.
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