If you are just beginning to explore your hair restoration options, you’ve doubtlessly encountered the term “hair graft.” But what exactly is a hair graft? The sources you may turn to for information could assume that you possess more background knowledge than you actually have. There is nothing wrong with that. As we at Tempus Hair Restoration always say, knowledge is power. The more you know about what a hair transplant involves, the better able you’ll be to find an ethical practice dedicated to providing the best possible result for your individual situation.
Dr. Marco Barusco – Founder and Chief Medical Officer at Tempus Hair Restoration – answers this fundamental question in an episode of his YouTube channel series, Hair Loss Medical Advice. Also known as a hair implant or follicular unit, a hair graft is a cylinder of skin and hair that encompasses the hair follicle, the sebaceous gland (which secretes sebum – a lubricating oily matter – into the hair follicles to lubricate the skin and hair), the arrector pili muscle (a microscopic band of muscle tissue which connects a hair follicle to the dermis), and the papilla – or bulb – of the hair, which is an important stem cell reservoir. A hair graft includes all of these structures. Each follicular unit graft can contain one to three (or even four) hair follicles.
How Are Hair Grafts Harvested?
The type of hair transplant procedure you have will determine how the grafts are harvested. For the Follicular Unit Transplantation (FUT) method, hair follicles are harvested from the donor area of the scalp as strips. After harvesting, each strip is divided into smaller sections until ready for transplantation. For the Follicular Unit Excision (FUE) method, follicular units are extracted individually from the scalp.
As you now know, each hair graft is a complex structure that must be harvested carefully so that it remains intact. And this is the point at which Dr. Barusco cautions against the increasingly popular use of robotic devices in hair transplantation. Many hair clinics that utilize such robots promote this as a selling point. The website for one such practice proudly states that “The physician does not actually harvest the donor grafts; the harvesting step is completed by the [brand name redacted] robot.”
We invite you to read Dr. Barusco’s insightful article on this topic, in which he shares his experience in treating patients whose original hair transplant procedure was botched by robots operated by non-licensed, non-medical personnel. Although the subject has been covered in some of our previous blog posts, unfortunately, it still bears repeating.
The Issues With Robotic Devices
The following excerpt from Dr. Barusco’s article explains the situation from his insider’s perspective.
“My practice has always been very busy with patients coming in for repair of procedures performed by other doctors. But in the last few years, I have seen a sharp increase in patients coming in for me to repair or replace hair transplants that were not done by experienced hair transplant surgeons, but by robots and/or by unqualified people under poor or no supervision of a qualified physician. In some cases, patients did not even know the name of the doctor they chose, but they knew that they had a robotic ‘procedure’ or the new FUE device ‘procedure.’
“Many doctors have also bought a robotic device that assists in FUE procedures. A robotic arm makes incisions in the skin to remove follicles from the donor area. The new version also makes recipient incisions and places the removed hair grafts. But robots are machines, and if the person behind the controls does not know basic rules of hair transplantation, the results may be bad. Sometimes, the robot can’t see the hair very well (the best case for the robot is dark, straight hair against light skin) and the surgeon has to switch mid-procedure to a manual extraction. Well, what if the surgeon does not know how to do this?
“In non-ideal patients, hair follicle damage (transection) rates can be higher than manual extraction done by an experienced surgeon. Also, manual extraction and an experienced surgeon allow the use of very small diameter punches (0.8mm or smaller), which creates very small incisions. The robotic device uses a two-step punch (a sharp punch scores the skin, and a slightly larger, dull punch dissects the hairs). This limits how small the punches can be. Bigger punches create larger incisions, which in turn create larger scars. Finally, a robot is a machine, and cannot provide the constant small adjustments needed to create a natural-looking transplant, which is the outcome you’re looking for.”
An Important Fact About Hair Grafts
Once a graft is taken from the donor site, hair will never grow there again. This is yet another important reason to research the credentials of any hair transplant surgeon and/or practice that you consider to perform your procedure. Only an experienced, skilled surgeon can harvest grafts without creating “patchy” areas that are missing hair, or leaving scars that cannot be concealed by new hair growth. And, only such a surgeon knows the proper alignment when implanting the grafts to the receptor site to achieve the effect of natural growth for an aesthetically pleasing result.
Keeping Hair Grafts Viable
Taking the proper steps to keep hair grafts viable after harvesting is just as essential as the harvesting procedure itself. Improperly treated grafts quickly die, and will not grow in the recipient area – resulting in a failed transplant. Poor quality control conditions include dehydration, warming and oxygen deprivation.
During your consultation with your (potential) hair transplant surgeon, ask how hair grafts are treated and prepared for transplantation after harvesting. An ethical surgeon will readily answer this – and any other – question you may have. If the surgeon wants to know why you want to know, or hesitates or offers a general “answer” – such as the practice follows industry standards (without explaining what those standards are) – continue your search.
By the way, the person who performs the actual consultation should be the surgeon him/herself – not a technician, nurse, associate or salesperson. Our blog post – “The Importance of Consultation Before Hair Restoration Treatment” – covers the process step-by-step, including questions a good hair restoration surgeon will ask each patient, and the examination of hair and scalp to make an accurate diagnosis in order to determine the appropriate treatment. It also contains a link to Dr. Barusco’s video on this topic. As most people have no experience in how to evaluate the practices and clinics with which they’re about to schedule a consultation, this is critical information for protecting yourself and achieving your hair restoration goals.
Now That You Know, Choose Your Surgeon Wisely
The hair graft is the foundation of every hair transplant procedure. From how it is harvested, prepared before transplantation and finally implanted to achieve the effect of natural hair growth, the graft must be in the hands of an experienced, skilled surgeon at each step. Dr. Barusco’s long list of accomplishments, his notable artistic ability and his successful surgical team make Tempus Hair Restoration a renowned practice. Contact us to schedule your free virtual consultation. Dr. Barusco conducts every consultation himself, giving you the opportunity to learn your options in the comfort of your home – or any location, on any internet-enabled device.
Dr. Barusco conducts consultations in English, Spanish and Portuguese. For your greater convenience, Tempus Hair Restoration offers a two-night complimentary hotel stay to out-of-town clients who travel 100 miles or more to our Port Orange, Florida, surgical center. No matter how far the distance, we welcome the opportunity to help you on your hair restoration journey!