Hair Transplant Procedure Information

1. “Micrografts” are obtained by slicing the donor tissue into very small sections,
   regardless of whether the naturally occurring bundles are kept together or not.
   These types of grafts are called, “grafts cut to size”. Microscopes are not usually
   employed when creating these grafts but instead the grafts are cut without keeping the
   natural integrity of a follicular unit in tact. Some surgeons feel that by cutting through
   a FU can damage the valuable hair follicles. Dr. Cotterill agrees with this and
   USES MICROSCOPIC DISSECTION TO OBTAIN FU,s ON ALL GRAFTS.
   Naturally occurring 1-3 hair bundles, as seen best with a dissecting microscope are called
   Follicular Units. The new techniques available today enable patients to wear their hair in
   virtually any style, even combed straight back. It should be pointed out that if an area
   is totally transplanted, without any pre-existing hair remaining, then the one way the hair
   may not be able to be worn is parted straight through the middle.

2. “1 – 4 haired Fus can be used in a “½ to 1″ wide zone in front of slightly larger 3-7 haired
   FU Families , to produce a natural looking hairline with gradually increasing density, or
   alternately may be used (in approximately 85% of our patients) for the entire recipient area.
   They are also used in areas such as the crown which does not need the density of larger grafts.
   FU,s and multiple FU,s are important new resources for those patients who only want (or need)
   lighter coverage, have or will have very large bald areas, or have very little hair in the
   donor areas; a limited supply of donor grafts can cover a greater surface area because these
   smaller grafts produce a sprinkled type of hair growth that is far more natural looking than
   the “pluggy” or “barbie-doll” look that may be produced by larger grafts, until such time as
   the area is densely transplanted.

   This type of graft is especially useful for patients who have fine textured and/or light
   coloured hair, and those who have (or will have) sparse temple hair in whom densely
   transplanted frontal hair would look unnatural.

3. “Standard” grafts, are grafts which contain 8-30 hairs. These are the traditional grafts that
   up until about 15 years ago were the standard grafts employed by all hair restoration surgeons.
   These grafts are placed into round holes made in the recipient area, with a small punch.
   The holes are placed approximately 1 graft apart, in a “checkerboard” fashion, to leave a
   surrounding blood supply. The result however was a very “pluggy” look. As a result “Standard”
   grafts have come into disfavor and are very seldom, if ever, used any more. There is no reason
   that with today’s techniques that with even 1 session on a bald area for the appearance to look
   “pluggy” or “like a transplant”. Therefore I only use single or double follicular units in all
   new patients.

In general FU,s and multiple FU,s produce more natural looking results than an equivalent amount of donor
tissue transplanted as standard grafts. However, because no bald skin is actually removed (hair is only
added), FU,s or multipleFU,s do not ultimately produce the same hair density as standard grafts or round
minigrafts – unless more donor tissue is used than would be for round grafts.

This is an important but seldom mentioned drawback of treating patients with only micrografts or single
one or two haired”follicular units” On the other hand “all micrograft” or 1-3 hair single follicular unit
sessions are ideal for treating individuals who are willing to do extra sessions for high density in
return for possibly less noticeability during treatment, or for those who are genuinely not interested
in high density. Lastly, FU,s and multiple FU,s are very advantageous in treating areas that still have
persisting hair – for example in patients who have relatively early MPB or female thinning. Slits and
needle holes can be placed between existing hair and none is sacrificed as occurs during the making of
a round hole for minigrafts and standard grafts. EACH CASE MUST BE CONSIDERED ON AN INDIVIDUAL BASIS.
There are a number of factors which influence the decision as to which type of grafts will be used and
where they will be placed; these include the texture and colour of hair, hair density, the size of the
donor area, the size of the site to be transplanted, and patient goals. In many individuals, a combination
of two or more of the graft types will be used, and in others only single FU,s will be utilized. You will
be shown photos of what you can expect from each. No one type of graft will provide “the best of all
worlds” for all patients