Experiments performed by the hair transplant surgeon Dr Seager in 1996 gave significant credence to the surgical technique of unit follicular hair transplant. Since these experiments had demonstrated that the survival rate of intact follicular unit was better than the single hair micro-grafts, the use of micro-grafts for hair transplant surgery was more or less dropped. Although the results of surgical hair restoration with the use of follicular unit transplants were sound and aesthetically pleasing, this form of hair transplant surgery suffered from drawback of requiring a long time period (6-8 hr) to complete a transplant session. It involved teams of highly skilled assistants for the hair transplant procedure of separating the follicular units. As the procedure required long time and much skill the procedure was proving to be very costly to the patient. The surgical damage caused to the follicle when two follicular units extremely close together were dissected apart, also started to affect the results of Hair Restoration Surgery.
A reduced success in follicular unit transplantation was more frequent in hair restoration surgeries that were being performed by hair transplant surgeons undertaking follicular unit transplant surgery only infrequently. The fact was of much concern to the professional hair transplant surgeon. The primary reason for a reduced success rate was that the assistants of the hair transplantation surgeon lacked the expertise and experience in correctly isolating single follicular units and dissecting them at a fast pace.
Ensuring that the follicular unit remains intact and is dissected and implanted into the scalp in the shortest possible is essential for increasing the chances of the hair follicles surviving the process and growing. But whenever an assistant was not able to take care of this important aspect, it affected the results.
For the above mentioned reasons, a technique that leaves the follicular unit intact but at the same time advocates the use of three and four-haired follicular groupings for surgical hair restoration was evolved by the innovative hair transplant surgeons. This procedure was found to have many advantages over follicular unit transplantation.
A single hair follicular unit does not necessarily comprise a single hair and may contain 2-4 hairs in a single hole. When the follicular units are found very close to each other in the donor skin sample it is not advisable to separate them as it can cause iatrogenic damage to them. Advantage of this fact is taken to form three-and four-haired groupings when 2 two-haired follicular units or a three haired unit and one-haired unit are naturally placed very close to each other. A group (of 1-4 follicular units naturally placed close to each other) transplanted as a single graft results in superior hair growth and at the same time lessens the surgical damage and trauma to the recipient site.
The hair transplant procedure of using natural groups for the hair transplant surgery has many advantages:
1. It results in much quicker hair transplant procedure as it saves time for separating each follicular unit and less time is required for their placement.
2. Hair transplant procedure prevents iatrogenic injury to follicular units during the dissection phase.
3. It lessens iatrogenic injury during placement phase because follicular groupings are not as fragile as follicular units because of more tissue attached to them.
4. As this hair transplant procedure proceeds at a faster rate, it allows the grafts to be left out of the body for a shorter period of time and increases their survival rates.
5. The last but not the least important advantage of this hair transplant procedure is that it reduces the cost of hair transplant surgery and is there for affordable to the patient.
Besides the above mentioned advantages, the technique of grouping of hair follicles can serve as a crucial tool in an expert hair transplant surgeon's hands to create wonders through the hair restoration surgery! Success and a natural looking hair transplant requires strategic planning! The grouping technique does not undermine the importance of a unit follicular hair transplant but actually compliments it by conserving more single-haired follicular units for the defining the hair line. The 2-haired follicular groups can be used for gradation in the area immediately posterior to the hair line and use of denser, but not bigger, 3 haired groups to provide the hair-density to the bald scalp behind. Besides saving the hair in the donor area for the future hair transplants this innovative technique of hair restoration surgery provides you the results which are just wondrous!
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The author is a hair restoration surgeon and runs a renowned hair restoration clinic