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Open Access

Fifteen Steps to Pull a Graft

Mauro Speranzini
Hair Transplant Forum International May 2022, 32 (3) 73-82; DOI: https://doi.org/10.33589/32.3.73
Mauro Speranzini
São Paulo, Brazil
MD, FISHRS
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  • For correspondence: speranzini.mauro@gmail.com
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Figures

  • FIGURE 1.
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    FIGURE 1.

    A 6X loupe is used by the surgeon and 5X loupe by the technicians.

  • FIGURE 2.
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    FIGURE 2.

    We use a curved tooth forceps to pull the epidermis.

  • FIGURE 3.
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    FIGURE 3.

    A: An angled forceps is used to pull one graft at a time. B: Closed forceps. C and D: Forceps grasps one FU at a time.

  • FIGURE 4.
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    FIGURE 4.

    A: Forester forceps for sequential collection of dozens of FUs. B: Forester forceps with one graft. C and D: Forester forceps with dozens of grafts.

  • FIGURE 5.
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    FIGURE 5.

    A: Assistant is to the left of the surgeon. B: Assistant is to the right of the surgeon. C and D: Two assistants.

  • FIGURE 6.
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    FIGURE 6.

    Harvesting can be done at the same time the surgeon excises the FUs.

  • FIGURE 7.
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    FIGURE 7.

    A and B: The left hand holds a curved tooth forceps and the right hand holds either an angled extraction forceps or a Forester forceps.

  • FIGURE 8.
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    FIGURE 8.

    A: An assistant positioned on the left side can hold the curved tooth forceps with the right hand and extract the graft with the left hand. B: All team members hold forceps the same way.

  • FIGURE 9.
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    FIGURE 9.

    A to D: A graft is pulled in a single stage.

  • FIGURE 10.
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    FIGURE 10.

    A to D: A graft is pulled in two stages.

  • FIGURE 11.
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    FIGURE 11.

    A to G: A graft is pulled in three stages.

  • FIGURE 12.
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    FIGURE 12.

    A: On straight hair, the traction on the graft must be linear. B: On curly hair, the traction must follow the hair curvature.

  • FIGURE 13.
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    FIGURE 13.

    A to D: Ideally, we must follow an uninterrupted sequence of extraction to avoid wasting time. E: After harvesting 50 grafts, pools of blood can be removed for additional harvesting.

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In this issue

International Society of Hair Restoration Surgery: 32 (3)
Hair Transplant Forum International
Vol. 32, Issue 3
May/June 2022
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Fifteen Steps to Pull a Graft
Mauro Speranzini
Hair Transplant Forum International May 2022, 32 (3) 73-82; DOI: 10.33589/32.3.73

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Fifteen Steps to Pull a Graft
Mauro Speranzini
Hair Transplant Forum International May 2022, 32 (3) 73-82; DOI: 10.33589/32.3.73
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  • Article
    • Abstract
    • INTRODUCTION
    • STEP 1: USE QUALITY LOUPES
    • STEP 2: CHOOSE YOUR FORCEPS
    • STEP 3: DECIDE WHO WILL PULL THE FUs
    • STEP 4: DETERMINE NUMBER OF ASSISTANTS TO HARVEST
    • STEP 5: CHOOSE THE BEST POSITIONS FOR TEAM MEMBERS
    • STEP 6: DECIDE WHEN TO REMOVE THE GRAFTS
    • STEP 7: USE PROPER EXTRACTION TECHNIQUE
    • STEP 8: USE THE CORRECT NUMBER OF EXTRACTION STAGES
    • STEP 9: PULL WITH TRACTION IN THE CORRECT DIRECTION
    • STEP 10: GATHER EXTRACTED GRAFTS
    • STEP 11: REMOVE GRAFTS IN AN EFFICIENT ORDER
    • STEP 12: OPTIMIZE COMMUNICATION BETWEEN ASSISTANT(S) AND SURGEON
    • STEP 13: OPTIMIZE EXTRACTION SPEED
    • STEP 14: AVOID IATROGENIC GRAFT DAMAGE
    • STEP 15: USE PROPER EXCISION TECHNIQUE FOR ATRAUMATIC EXTRACTION
    • References
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  • Call for Co-Editors
  • President’s Message
  • Literature Review
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Keywords

  • excision
  • extraction
  • forceps
  • harvesting
  • pull grafts

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