Follicular Unit Simple Talk: Hair Transplant Terminology
Author: Robert M. Bernstein, MD, FAAD
The follicular unit was defined by Headington in 1984. FU which he described as a composite of two to four terminal follicles, and one or rarely two, vellus follicles, sebaceous lobules, and insertions of muscles … arecteurs a follicular unit is limited by stromal investors the perifolliculum. He added that "the normal density of follicular units, or about one per square millimeter." (1)
In first paper on Follicular Unit Hair Transplantation, published in 1995 (2), Bernstein and Rassman used this definition of Headington. Limmen, who has referred to these groups that occur naturally as micrografts stereoscopically assisted "(3) and Seager, he called the" follicular packages "(4) begins to use the term follicular unit as well.
Limmen using a stereo-dissecting microscope, the backbone of the follicular unit transplantation is required expensive equipment, technical expertise and was very strong workforce. For this reason and because many doctors at that time did not understand the importance of dissection microscopic, or even using the follicular unit hair transplantation, other, easier to perform the procedures have been completed.
Interestingly, because the increase of the Internet, follicular unit transplantation has become a fashionable hair loss discussion groups faster than it has been accepted by their doctors. (5) This caused a significant pressure on the hair restoration surgeons to learn more about the new procedure and to adopt its technology. While many quickly adapted their practices to FUT, others simply changed their marketing – advertising that performs follicular unit transplantation, even prior to the purchase of microscopes.
Partly in response to false, but to science in 1998, a group of 21 hair transplant surgeons, including Bob Bernstein Bill Rassman, David Seager, Ron Shapiro, Jerry Cooley, O'Tar Norwood, Dow Stough, Mike Beehner, Jim Arnold, Bobby Limmen, Marc Avram, Bob McClellan, Paul Rose, William Blugerman, Marcelo Gandelman, Paul Cotterill, Bob Haber, Roy Jones, Jim Vogel, Ronald Moy and Walter Unger joined forces to write "Standardizing the classification and description of follicular unit transplantation and mini-micrografting techniques. "(6)
In his words, the purpose of publication is "to provide the hair restoration surgeons with guidelines for … facilitate communication among physicians, stimulate research, increase the accuracy of the procedures hair transplant that can be represented to our patients and ultimately improve the quality of care we offer.
In the paper, were arrested the following:
Follicular Unit – The unit follicular adult human scalp is a natural entity that consists of 1-4, sometimes 5, terminal hair follicles, 1 or rarely 2, vellus follicles, sebaceous lobules, the insertion of arecteurs muscles, brain and vascular plexus, and the fine adventitial collagen that surrounds and defines the unit (the perifolliculum).
Follicular unit graft – a graft that is obtained by dissection of the individual, natural follicular unit. This also is mentioned as a follicular implant, a term which implies that (unlike the majority of transplants), the proportion of hair / skin is greater in the follicular units implanted in the donor and that some carriers will not cut their hair after the surgical dissection.
Micro – A hair transplant 1-2. Of course, May is one or two hair follicular units or derivatives of the major units, which are subdivided.
Minigrafts – A hair transplant 3-6 derived from a single follicular unit, multiple follicular units, or multiple partial follicular units. As suggested by Walter Unger To be classified in the small hairs minigrafts 3-4 and 5-6 wide minigrafts hair.
Slit rootstock – a hair transplant of two 3-6 by several follicular units, follicular or partial multiple units where the technique dissection, in particular the attempts to produce a linear arrangement of the follicles, or follicular units. This can also be ordered in small grafts cleft of 3-4 hairs, and the great opening-grafts of 5-6 hairs.
Follicular Unit Dissection – A technique in which of course, the follicular units are dissected donor tissue that was removed in a single group (rather than a multi-blade knife more than two pages) to keep intact follicular units. Some do not wear their hair tissue is removed to reduce the implant. Stereo-microscopic dissection is necessary.
Cut Micrografts mini grafts or slit size – a technique dissection in which the donor is subdivided to produce grafts banda dimensions as defined by the number of hairs they contain and / or size of tissue that is placed in a container. The removal of excess skin is not necessary. The dissection can be performed with or without an increase, and the donor tissue can be removed with a knife or banda multi-blades.
Follicular Unit Transplantation – A method of hair restoration is hair transplant surgery when their only natural units follicular. Harvesting and single-band stereo microscope dissection is necessary. Grafts must be placed in small incisions recipient.
Mini micrografting – A method of transplanting hair grafts used in groups of 1-6 hairs that are not necessarily natural follicular units. Websites of the beneficiaries in May or incisions, divisions (tissue), or both.
Two Terminology Ends: Scientific vs Marketing
Shortly after publication, Seager suggested adding another term, "family Follicular Unit. "(7) To paraphrase Dr. Seager:
When the dissection of follicular units, it is sometimes unclear from the appearance of unity "errant" hair belongs. In other words, sometimes it is not entirely clear that a follicular unit ends and we begin to side. When an attempt to create a higher density, a stray hair including a (very) close by, large follicular unit, which contains perhaps three hairs. This technique of creating a hair into four, when there were four in May all units bristled. It should find two separate entities that are close enough to almost go hand in hand. "If the two adjacent units are chosen correctly, the result can be very difficult or impossible to distinguish from a natural follicular unit.
The key to success in this endeavor is the concept of "follicular unit family. "If someone (not family), two follicular units randomly doubled, the result will be the Secretariat of the size of a minigrafts, instead a microphone. That require greater recipient site to avoid the dense packing due to technical limitations of the plantation and the deterioration of the vasculature of scalp. However, if despite its large size, are forced by the minute size of the micro-receptor sites were traumatized during insertion attempts.
Although the term "follicular family unit" was introduced to take into account the variability of the anatomy of the follicular unit and take advantage of these variations of the surgery, other conditions are not necessarily based on purely scientific considerations.
Blatant false statement of the concept Follicular unit was "follicular unit Coupling – The role of the slot in the hair transplant grafts. (8) In this, he joined the new term slot for the method of transplantation. This is a technique used slit grafts harvested with a knife blade, cut into fine pieces and placed in large areas of skin with a rectangular punch. The term is new and has a marketing campaign, but the technique is the same as the original, without any attempt to use or retention, the follicular units.
Between these two extremes is the continuing struggle to describe what we do in a clear, precise – against any development of concepts and techniques, and an increasing number of conditions. The issue before us is to be able to distinguish between what is amount of science that are all that blur.
Making Sense of FU Salad
The opening of the list of acronyms used in all the recent reunion ISHRS, it seems that we still need to take a step back and consider the new conditions, to see what ideas or techniques that may be superfluous. The following is a first attempt to go to court six terms that we believe are the most confused, and have the most overlap. They come in two groups: the first coupling link FU FU, double FUS (DFUs) and multi-FUS (MFUs). The second group includes WAS and FIT.
Regarding the first group, we believe there are two different situations a doctor trying to communicate with these terms. The first is the technique of place two separately dissected follicular unit grafts in a single receptor site. This is different from that used term "double-up" that many doctors use to refer micrografts two in one site. Our suggestion is to use the term FU party to refer to the technique of placing two follicular units isolated in a separate single destination site. We suggest you throw the term coupling as erroneously FU has been associated with cleft grafting procedures in the literature and its use confusion.
The second situation occurs when a doctor places two (or more) the follicular units, which were not separated in the dissection, in a hole. In our opinion, this clearly is not the follicular unit transplantation. The reason is that the main advantage of WAS is that the isolation of FUS in the elimination of some non-carriers of the skin between the hair FUS, decreasing the mass of the graft. This, in turn, would allow the doctor to use a small target site, less cree injuries, safety can transplant more grafts in one session, etc, etc. Using several non-dissected follicular units, in our view, creates more injuries and carry none of these objectives.
We do not pretend that doctors should abandon this technique. Some excellent transplant surgeons to integrate these in its procedures. We are simply suggesting that it is not known FUT. Well what we call? Our response is to draw what they have always been called, ie, micro-grafts, mini-grafts and slit grafts. If one believes they are now different due to the use of stereo, we agree. In this case, the grafts must be delivered microscopically dissected micro transplants, mini-grafts and slit grafts to communicate the fact that follicular transection can be prevented. But even this is not the follicular unit grafts, no more than a pedicle flap is follicular unit transplantation. To avoid confusion, we suggest you remove the words DFUs and MFUs.
Then, What should I call the eyebrow transplant? Depending on the technique used by most surgeons restore hair, which only share banda Donor hair, should be called a dry micrografting. Using the contra-lateral donors to eyebrow hair, it can really be considered as FUT.
FUE and FIT
Raising transection FUE harvesting techniques using a sharp punch (compared to a single strip harvesting and dissection stereomicroscopic) Some doctors immediately the question of whether this should be classified as a type of follicular unit transplantation. (9) With the introduction of the technique of dissection Roma Harris, much of the damage reduction of follicles and increased preservation of follicular units, the argument for classification as a FUE FUT rate is much higher – but certainly not bullet proof – because in some cases transection remains important and in others not all follicular unit can not be captured. (10)
Follicular isolation technique (FIT) is a term used by Cole and Rose, which refers to a technique that was used with a punch to a stop limit the depth of penetration. While these authors and other doctors questioned the need for a cessation of deep mining technology, FIT is perhaps an better word than if the unit is not the whole WAS taken into account. In our view, when the objective is to extract the hair, rather than follicular units intact, the FIT is preferable term.
Conclusion
In sum, these authors suggest that the four terms and definitions are added to the initial classification.
Follicular Family unit for almost two adjacent follicular units are dissected as a transplant, so they can enroll in the same size as the largest recipient natural follicular unit used normally the procedure.
FU The technique of placing two units matching follicular isolated in a separate receiver.
FUE donor direct extraction processes, where the goal is to extract all the follicular unit. If a depth stop is used, it must be indicated.
FIT procedures for extraction Direct intention is to remove the hair or smaller than the whole of the follicular unit. (In other words, the direct extraction of micro-grafts). If a cap depth is used, it must be indicated.
Micro-grafts, mini-grafts and slit grafts, which were reduced under the microscope to prevent follicular transection be referred to just that, ie micro microscope dissected grafts, mini-grafting and cleft grafting. These authors do not feel that these procedures should be classified as a type of follicular unit transplantation. We also propose that the terms coupling FU, DFUs MFUs and confusion and should be abandoned.
References
1. Headington JT: Transverse microscopic anatomy of the hairy scalp. Arch Dermatol 1984, 120:449-456.
2. Bernstein RM, Rassman WR, Szaniawski W, Halperin A. Follicular transplantation. Int J Aesthetic Restorative Surgery 1995; 3: 119-32.
3. Limmen BL. Elliptical donor stereoscopically assisted micrografting as a more refined in hair transplantation. Dermatol Surg 1994; 20:789-793.
4. D. Seager binocular stereoscopic dissecting microscopes: should we use? Hair Transplant Forum Int 1996; 6 (4): 2-5.
5. Bernstein RM: Microscopophobia. International Forum of hair transplantation. 1998, 8 (5): 23.
6. Bernstein RM, et al. Normalization of the follicular classification and description of the unit transplantation and mini-micrografting techniques. Dermatol Surg 1998; 24: 957-63.
7. D. Seager dense, low donor site of transplantation hair – introducing the "follicular family unit." Hair Transplant Forum Intl 1998; 8 (1) :21-23.
8. Bernstein RM, Rassman WR, Marritt E, Seager D, et al: A niche market timing under another name. Forum International Hair Transplant 1999, 9 (6): 175.
9. Rassman WR, Bernstein RM, McClellan R, Jones R, et al. Follicular Unit Extraction: Minimally invasive surgery for hair transplantation. Dermatol Surg 2002; 28 (8): 720-7.
10. Harris JA. System security New instrumentation and methodology for improving Follicular Unit Extraction (FUE). Hair Transplant Forum Intl. 2004, 14 (5): 157, 163-4.
About Author:
Dr. Bernstein is one of the pioneers of the restoration of hair and many hair transplant techniques. The Bernstein Medical – Center Hair Restoration in Manhattan is dedicated to treating hair loss using the Bernstein the state of the art of hair transplant techniques. For more publications on hair transplants, visit target = "_blank" href = "http://www.bernsteinmedical.com/."> Http: / / www.bernsteinmedical.com/.
Article Source: ArticlesBase.com – Terminology "> Follicular Unit Simple Talk: Hair Transplant Terminology
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