A Practical Guide to Hair Graft Placement Using the Sharp Implanter Method

Construction of a Hair Implantation Needle Using Injection Needles and Assessment of its Efficiency Compared with Other Planting Methods

INTRODUCTION

Hair transplantation surgery requires the efficient completion of hair follicles and thus appropriate hair implantation needles. The objectives of this study were to evaluate the effectiveness and feasibility of self-made hair implantation needles using injection needles and evaluate the speed of different hair implantation methods.

METHODS

Four patients were randomly assigned to four groups. A gem knife pre-punching planting method was used for the patient in Group A, while Group B received immediate implantation after punching with ordinary injection needles, Group C was treated with synchronized punching and planting using hair implanters, and Group D was treated with a self-made hair implantation needle. The speed of the different implantation methods for single and double hair follicles and the differences between the planting of single and double hair follicles were assessed.

RESULTS

Group D was found to have the fastest hair planting speed for both single and double hair follicles, followed by Groups C and A, with the slowest speed observed in Group B. Groups A and B were associated with significantly lower speeds of double hair planting than single hair planting, There was no significant difference between Groups C and D.

CONCLUSIONS

The self-made hair implantation needle is a novel and efficient tool for synchronized punching and planting. It has a faster planting speed and does not require assistance.

LEVEL OF EVIDENCE II

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Advancements in Graft Placement Techniques

For decades, the placement of follicular units (FUs) into incisions in the recipient area was exclusively carried out using forceps. In 1992, Dr. Choi introduced an instrument known as the "implanter," which had the advantage of simultaneously creating incisions and placing FUs without damaging sensitive parts. Its initial popularity was greater in the East, primarily due to the characteristics of Asian hair. Asian hair is typically straight and thick, with FUs mostly consisting of just one or two hair.With the description of the follicular unit excision (FUE) technique in 2002 and its widespread adoption nearly a decade later, the advantages of using the implanter also gained popularity in the West. The uniformity in the size of FUs provided by the FUE technique and the possibility of delegating the placement were key attractions in the use of this placement tool. In addition to the traditional Korean implanter with a sharp needle, other implanters and inserters have been described.The choice of implantation technique depends on individual adaptation and the advantages and disadvantages offered by each instrument. Although forceps allow for safe placement in the hands of well-trained teams, the increased fragility of FUs obtained with the FUE technique has led to the growing acceptance of techniques that employ implanters and inserters.

Post-Hair Transplantation Complication: Kinky or Severely Curly Hair

OBJECTIVE

To investigate the etiology and preventive measures of posttransplant kinky or curly hair growth after female hairline correction surgery.

BACKGROUND

Hair transplant surgery can be accompanied by various adverse effects, one of which is severely kinky or curly hair after surgery. Posttransplant kinky or curly hair is not well-understood for its cause or prevention.

METHODS

The study was targeted at a total of 980 patients who were confirmed whether they developed kinky or curly hair after female hairline correction surgery. Incidence, surgical method, degree of curliness, predisposed location, characteristics, hair caliber (thin, medium, and thick), and left-right differences were examined.

RESULTS

Among the total 980 patients, posttransplant curly hair (PTCH) was manifested in 38(3.9%) patients. None of the patients who underwent surgery at the present clinic developed posttransplant kinky hair; all 38 patients showed PTCH growth. In 36 cases, transplanted hair started to grow in curly patterns around 4 months after surgery. However, the remaining 2 cases showed no curly growth pattern when the transplanted hair was short at postoperative 4 months, but started to grow curly starting at 6 to 8 months after surgery as the hair growth direction was obstructed or compressed by the existing hair.

CONCLUSION

Familiarity with the cause, prevention, and management of posttransplant kinky hair and PTCH will be of great help to hair surgeons.