We performed the advanced technique of follicular unit transplantation where naturally occuring follicular units containing 1, 2 or 3 hairs are redistributed over the balding area. This process follows the way our hair naturally grows on our scalp thus leading to the most natural looking results.

Follicular unit grafts with 1 hair are placed irregularly over the hairline area for a more natural appearing hairline. Grafts with 2-3 hairs are places behind the single haired grafts and further back for greater density.

Most patients prefer follicular unit extraction/ excision. This technique obtains individual follicular units at the donor area utilizing a motorized punch devise. Punches with very small diameters are used to minimize wound size incisions leading to lesser injury to the donor area with better healing times and a resultant donor area without linear scars.

There are some patients who request strip harvesting. The strip technique excises a strip of hair bearing skin to obtain the required number of grafts. And since every hair follicle is valuable we strive to decrease transection by following the open technique in donor harvesting. This open method allows the surgeon to visualize directly the hair follicles during the strip excision process thus minimizing follicular transection.

The decision on which the technique depends mainly on the preference of the patient as well as taking into account hair style and hair features and characteristics.

To trim the donor tissue into follicular units grafts we use binocular stereoscopic microscopes with a magnification of 10X to prevent the transection of follicles during this dissection process. The small size of the grafts allows the ability to achieve greater density over the recipient area.

On the recipient area lateral or coronal slits are made which allows for better control of the angle between the hair and the scalp thus resulting in transplanted hairs which follow the natural angle and direction of the patient’s original hairs. Follicular unit grafts placed in coronal slits also provide more coverage since the new hairs eventually fan out over the scalp.

Recipient slits are created by mainly using smaller sized hypodermic needles which closely match the size of the grafts thus allowing for a snug fit between the follicular unit grafts and the surrounding skin. This improves healing and survival of grafts.

Since eyebrow hairs usually occur in single haired follicular units only single hair grafts are carefully dissected under microscopes with 10X magnification. Follicular units that contain more than two hairs are longitudinally sectioned into one-hair units.

Insertion of the grafts in alignment with the axis of the brow is followed to ensure that the hairs will result in a natural appearance. Fine needle size gauge 23 or 24 are utilized for easy insertion and dense packing. Magnification loupes are used to perform simultaneous needle stick-and-place in flat angle and dense packing of grafts.

Just before finishing the procedure the patient examines the transplanted eyebrows to see if any adjustment is needed.