Hair Restoration, Hair Transplant, Hair Loss Treatment Clinic

Study of the Effect of 100% Transection on Hair Graft Survival

Summary of Dr Beehner's presentation at 14th annual meeting of ISHRS

There has been much debate and discussion over the years regarding the effect of follicular transection on the eventual outcome of survival of those follicles. Some studies have shown an increase in hairs produced, and most ha e shown a decrease. Most have shown a decrease in the caliber and overall quality of the hairs produced from transected follicles. This study attempts to look at hair yield in the face of transaction at one point in all of the follicles placed in the study recipient sites.

To see what percentage of hairs grow from follicles that have all been uniformly transected at one point along their length. In this study, the point at which that transaction occurred was at varying points along the follicle, due to the method whereby the cuts were made. All follicles have one transection and no follicles planted were intact and free of transaction.

Transected Slot-Mini grafts: Of the 213 follicles (hairs) planted, at 6 months 105 were counted, and at 12 months 95 were counted, for an overall yield of 44.6% survival at 12 months. Control Intact Slot-Mini grafts: Of the 175 follicles (hairs) planted, at 6 months 161 were counted, and at 12 months 124 were counted, for an overall yield of70.8% survival at 12 months.

Control Intact FU Grafts: Of the 169 (average of 166 hairs exiting and 172 follicles under skin), at 6 months 147 hairs were counted, and at 12 months 138 hairs were counted, for an overall yield of 86.9% survival at 12 months. This study by one of the two authors shows very poor growth in the transected grafts. It should be added that of those 105 counted growing from these graft sites, that 17 of them were extremely "stunted" and short or otherwise deformed as compared with the other normally growing hairs. 'This represents a 16.1 % abnormal appearance rate for the hairs produced in the transected grafts.

This study would certainly support the practice of removing donor strips and dissecting grafts in a manner that features the least possible transaction of follicles. In this study and in numerous other ones performed by one of the authors (MLB), the hair count at 6 months has been higher than the one at 12 months. The reasons for this are not clear - whether some of the follicles prematurely go into a telogen phase or are somehow "crowded" out of existence.

Survival of follicles in slit and slot-mini grafts which were deliberately transected resulted in very poor result, it must be recommended that transaction be kept to a minimum in hair transplant surgery if the follicles within the transplanted grafts are to survive at the highest possible percentage`.