Hair Restoration Blog

In a standard hair transplant procedure (follicular unit transplant through strip technique), having adequate scalp laxity is crucial to avoid complications in the donor area. Doing so has required the individual judgment of an experienced hair transplant surgeon but still leaves room for human error. If the surgeon removes too wide of a strip, there may be issues with wound closure, a visible wide scar, telogen effluvium (hair loss around donor wound), and/or skin necrosis. Areas around the scalp most at risk are the mastoids or the area behind ears.

Laxometer has been designed to minimize hair transplant complications (in 15th annual meeting of International Society of Hair Restoration Surgery) by helping assess scalp laxity more accurately prior to a hair transplant procedure. After the first assessment, the patient then practices the scalp exercise to increase mobility and is then reassessed the day of surgery. The more laxity the patient has the higher the chances of increasing the number of grafts that can be transplanted in a single hair transplant.

We performed a study on 37 different patients to assess the success and functionality of laxometer. In all of these patients, half of the donor wound was closed during the procedure to evaluate the impact of donor excision on the laxity of the donor area. Three (3) locations of donor area were assessed before and after incisions were made:

I.    Right side
II.    Mid line
III.    Left Side

The laxity of the sides were measured approximately 10-15cm above the mastoid bone from the midline. The incision was made using a double bladed knife to insure uniformity.

After excising the first half of the strip, laxity was measured on the secondary section prior to full incision and excision. If laxity has been compromised due to the first excision and closure, then the second incision will be smaller. Out of the 37 patients that underwent follicular unit transplantation through strip technique, only six (6) patients required a smaller incision due to a lesser laxometer reading caused by reduction of laxity. Our study shows that wound tension:

I.    May increase on the secondary side in some patients (~16% chance)
II.    May not be an issue in most patients (~84% chance)

Laxometer helps determine scalp laxity before, during, and after a hair transplant procedure for optimal excision and closure. It helps determine the maximum amount of tissue that can be excised safely helping increase the chance of more grafts that can used a single session. This practice is best applied on patients undergoing a mega-session hair restoration in which over 2500 grafts are being transplanted in one hair transplant session.

I just gave a lecture on a new application for Laxometer in mega and giga session hair transplants in the annual ISHRS (International Society of Hair Restoration Surgery) meeting in Amsterdam, Netherlands.  As we presented the Laxometer in the prior hair restoration scientific meetings, Laxometer can make us capable of increasing the precision of strip removal method of follicular unit hair transplants while minimizing the risk of donor scar complications.

This year, I presented a new application for Laxometer for its use in patients who have limited laxity of the scalp due to prior hair restoration surgeries or for those who require a maximum number of grafts in one session (3000+, 4000+, 5000+ and so forth).  I performed a research in US Hair Restoration last year in which we removed the strip in sequences for hair transplant surgeries using Laxometer before and after removal of each section of the strip.  This method has increased the safety of the strip removal while decreasing the risk of donor wound complications.

The result that was presented in the ISHRS meeting indicated the effectiveness of Laxometer at increasing the number of grafts in a strip hair transplant while minimizing the donor complications of a hair restoration surgery.  Based on our findings, we now use Laxometer in our California hair transplant offices on a regular basis and obtain positive results consistently.