Strip Technique

The donor site density helps us determine the length required of the strip to be harvested.  Denser hair requires a shorter strip.  The donor site is taken from the posterior scalp which is hair that is genetically programmed to last longer than other parts of the scalp in general.  We do our best to protect the surrounding hair.  The strip itself is harvested and the donor site is closed bringing hair bearing tissue to hair bearing tissue, closing with sutures and/or staples which are removed in a week.

The strip is harvested with care to try and protect the hair follicles of the future grafts as well as the hair follicles near the harvest site. We try to angle the excision to protect every hair and every hair follicle. The strip is then placed into an iced sterile saline bath.

The strip is then cleaned of excess fat and divided into slivers or thin sheets one follicular unit thick, the entire width of the strip. This allows the follicular units to be seen clearly.

The slivers are carefully divided into minigrafts of 3 and 4 hairs and micrographs of 1 and 2 hairs, protecting the shaft and bulbs. Very fine pickups are used being careful not to traumatize each individual hair and graft. The grafts are kept on ice in sterile saline until ready for transplantation.

A team of experienced assistants help prepare the grafts allowing us to provide higher quality grafts in less time, giving you more hair faster.

We numb the scalp with a combination of a short and long acting local anesthetic. Recipient sites are then made with a small blade. Donor sites are made attempting to protect pre-existing hair and pre-existing transplants. Careful attention is paid to the direction of placement which determines the direction of the recipient sites. We have used a combination of different blades needles and devices for the recipient sites and favor especially made blades called Minde knives.

Grafts are placed with special forceps with angulation that allows placement into the slits. Singles and doubles are placed at the frontal hairline, and minigrafts are placed behind. Gentle technique and experienced hands improve survival.  We hope for 75-85% survival at a minimum.

After placement, the grafts are sealed relatively quickly by our bodies healing response which begins with sealing the grafts in a temporary clot. Our bodies then begin to keep the grafts alive by oxygen delivered via osmosis across the clot. Because the hairs are placed in very tight recipient sites, the amount of osmosis required is small. Survival is usually quite high as new blood vessels then have a chance to grow into the grafts over the next 2-3 days in a process called neovascularization.

Below is an example of a patient at the end of the procedure and one week out from hair restoration. The grafts are still somewhat visible, but healthy. It is very unusual for patients to be having significant pain or discomfort at this time.