How I do it: A simple do it yourself (DIY) tool to prevent tangling of grafts in long hair transplantation
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* Ng Bertram

1.  Ng Bertram, MBBS


1.  Hong Kong, China

Dear colleagues,

I earnestly invite you to share your surgical tips in this column. Please send your articles to me at bertram{at}hairtransplant.hk.

After Dr. Marcelo Pitchon of Brazil presented the concept of the Preview Long-Hair Follicular Unit Transplant at the ISHRS meeting in San Diego, we occasionally have patients requesting a long hair transplant procedure. Cutting and inserting the grafts, however, becomes difficult when the donor hair is excessively long. Dr. Pitchon recommended cutting the donor hair to a specific desired length (approximately 7cm) that is technically more comfortable to work with and also produces a beautiful preview result.

We performed the procedure on an MPB Class III transgender female who wanted to wear a feminine hairline in her wedding party, just 2 weeks from the day of surgery. The length of her donor hair was about 30cm long. The donor strip was marked, harvested, and slivered as usual (Figures 1, 2, and 3). Single follicular unit grafts were prepared under the microscope and collected on Petri dishes; however, the tangling of the long hair follicles in the dish rendered it very difficult in sorting for insertion (Figure 4). We immediately hand made a simple but effective tool to overcome this problem.

![Figure 1](http://www.ISHRS-HTForum.org/https://www.ishrs-htforum.org/content/htfi/19/4/133/F1.medium.gif)

[Figure 1](http://www.ISHRS-HTForum.org/content/19/4/133/F1)

Figure 1 
The selected and prepared donor site

![Figure 2.](http://www.ISHRS-HTForum.org/https://www.ishrs-htforum.org/content/htfi/19/4/133/F2.medium.gif)

[Figure 2.](http://www.ISHRS-HTForum.org/content/19/4/133/F2)

Figure 2. 
The harvested strip

![Figure 3.](http://www.ISHRS-HTForum.org/https://www.ishrs-htforum.org/content/htfi/19/4/133/F3.medium.gif)

[Figure 3.](http://www.ISHRS-HTForum.org/content/19/4/133/F3)

Figure 3. 
The sliver

![Figure 4.](http://www.ISHRS-HTForum.org/https://www.ishrs-htforum.org/content/htfi/19/4/133/F4.medium.gif)

[Figure 4.](http://www.ISHRS-HTForum.org/content/19/4/133/F4)

Figure 4. 
Tangling of grafts

### My DIY Tool

Material:

1.  A clean plastic comb

2.  A cigarette lighter

### Method

1.  The width of the Petri dish was first measured and then marked on the center of a clean comb, leaving equal length on both ends (Figure 5).

2.  A cigarette lighter was lit at a distance below the two markings. When the plastic was softened by the heat, the comb was bent to form the shape as shown (Figure 6).

3.  The recoil of the plastic made the comb sit steadily inside the Petri dish.

4.  Immediately upon cutting the FUs we stored them in the dish. The papillae were kept moist in the saline while the shafts hung over the comb teeth. Between each pair of teeth was a bundle of 10 grafts. 1-, 2-, and 3-hair FUs were placed at different part of the same comb.

5.  The assistant came and collected the bundles of grafts. Counting was simple, with all the grafts lying in the same direction ready for insertion.

![Figure 5.](http://www.ISHRS-HTForum.org/https://www.ishrs-htforum.org/content/htfi/19/4/133/F5.medium.gif)

[Figure 5.](http://www.ISHRS-HTForum.org/content/19/4/133/F5)

Figure 5. 
Making of the DIY tool

![Figure 6.](http://www.ISHRS-HTForum.org/https://www.ishrs-htforum.org/content/htfi/19/4/133/F6.medium.gif)

[Figure 6.](http://www.ISHRS-HTForum.org/content/19/4/133/F6)

Figure 6. 
How it worked

*Pictures courtesy of Dr. Damkerng Pathomvanich, DHT, *Bangkok, Thailand*.

*   Copyright © 2009 by The International Society of Hair Restoration Surgery