47A Graft Placing Using Implanter Devices

Sungjoo “Tommy” Hwang

Summary

In strip harvesting, the grafts have tissue surrounding the entire length of the follicles. In follicular unit excision (FUE), however, the portion of the grafts near the bulbs is often stripped, which leaves them more vulnerable to both desiccation and trauma during removal, processing, and, particularly, during graft placing. With either type of graft, the implanter technique may eliminate or reduce the crushing, squeezing, bending, piggybacking, and over-manipulation that can potentially reduce the graft survival rate. The sharp needle implanter technique was developed in Korea in the 1990s and it was designed to make recipient incisions and place grafts without touching the follicle bulb. Since the surgeon harvests all the grafts in FUE and places all of them with sharp implanters using the “stick-and-place” technique, it can be exhausting and limit the number of grafts in a single procedure. In contrast, a dull needle implanter uses premade sites, allowing the physician to delegate the work of graft placement to assistants without the risk of graft angle change. A sharp needle implanter allows shorter operating time, less bleeding, and is appropriate for chubby grafts or thick hair (e.g., Asian), while a dull implanter allows delegation of graft placement and smaller incision, is less expensive, and has a shorter learning curve.

Key words

sharp needle implanter - dull needle implanter - intrapatient graft length difference - Choi implanter - Hwang implanter - EZ grafter - stick-and-place - FUE - graft rotation

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