Preview Long Hair Transplantation with Donor Harvesting Using the Follicular Unit Excision Technique

Abstract

Hair transplant surgery has significantly evolved in recent years with the advent of donor harvesting using the follicular unit excision (FUE) technique. The ultimate goal of any donor harvesting technique is to achieve undetectable surgeries, including in the immediate post-operative period.

Our goal was to develop a method that ensures that patients who choose hair transplantation using the FUE technique could also benefit from preview long hair transplantation (PLHT), a technique in which the donor hair does not need to be cut short or shaved and the grafts are placed in the recipient site with long hair. Although this is also possible with the strip excision technique, known as FUT, the resultant linear scar may be visible if the patient chooses to wear the donor hair short.

The concept is to maintain the same FUE dynamics used when trimming the donor hair. To carry this out, a new punch was developed that works with a function specifically created for long hair FUE in a multiphasic device (Trivellini Device). The results are highly encouraging even though the operative time is slightly longer than that required to perform FUE surgery with the donor area trimmed or shaved. However, with adequate training and improved tools, this surgery may become the first option for patients choosing hair transplant surgery.

Preview long hair transplantation (PLHT) is a technique where the key point is the aesthetic vision or preview of the end result is presented before the surgeon’s eyes at the time of surgery, and not the previously calculated mathematical hair density. With this approach to surgery, we are rationally using only the follicular units necessary to achieve a result that meets or exceeds the patient’s expectation while preserving grafts in the donor area for possible future surgeries.