Page 2 :
General Overview of Hair Restoration Surgery

Finally, the width (height) of trimmed hair is such that we harvest what we trim, so that when a person leaves our office, work done in the donor zone is imperceptible (meticulously camouflaged). We recommend that people leave their hair growth (in the donor zone) to at least 1 centimeter in length. If we plan on harvesting a donor strip with a width (height) of 12 millimeters, we will trim the hair in the area to a width (height) of 14 millimeters. When we suture (close) the area that was harvested, 1 millimeter on each side of the suture line will have trimmed (short) hair that simplifies the work of closure and yet is completely hidden by the surrounding (at least 1 centimeter long) hair.

After the donor zone hair is trimmed short, the scalp will be cleansed with an antiseptic solution and the skin will be “frozen” with a local anesthetic (lidocaine and bupivacaine). This “freezing” is a medication that is similar to a product that dentists typically use. We inject the freezing with a device named a “Dermojet” which is an instrument that allows the injection of substances through the skin without the need of a needle. Many “third-world” countries who vaccinate throngs of children will use such a device for quick and relatively pain-free attributes.

The “Dermojet” is approximately the length of a pen but several times it’s circumference. The liquid (in our case, anesthetic) that is placed within its chamber is infiltrated through the skin because it is ejected under pressure. The sensation is like that of a fly bite, but it is so brief that people find this device to offer skin anesthesia in a very comfortable fashion.

Once the skin is frozen, Dr. Wallik will remove the donor strip with a traditional single-bladed scalpel, by making two parallel, horizontal incisions that are separated by a distance of 10 to 15 millimeters. If you do any further research in regard to hair transplantation, you may come across some information describing scalpels that are fitted with more than one blade (multi-bladed scalpels). The quicker the donor strip is sliced into “slivers”, the quicker the procedure is completed. Multi-bladed scalpels are designed to speed up the preparation of the grafts, but undermine the accuracy and thus quality of the work. Needless to say, they are not part of the equipment that is used at our clinic.

The donor strip, once released, will be given to the technicians who will immediately place it into chilled saline. One of our staff will then take portions of the donor strip and subdivide it into tinier sections termed “slivers”, that can easily fit and thus be manipulated on the microscope’s stage.

Our technicians will then commence the task of microscopically subdividing the slivers into the tinier “grafts”.

During this process of graft preparation, the donor site will be closed with either sutures or staples. The edges of skin where the strip was harvested are pulled together to leave a fine, hairline scar.The method in which the donor area is closed is very important, with a good closure healing more quickly, feeling more comfortable, producing a finer, smaller scar and preserving the maximum amount of hair for future transplants.

We have found that sutures tend to be more comfortable and they can be either of the dissolving or removable variety. You are usually offered the choice of using a suture that dissolves in the skin and thus eliminates the need of having to return for stitch removal. The closure we undertake is termed a trichophytic closure.