Punch Grafts and Incisional Grafts in Scarring Alopecia
Presented in 2009 ISHRS annual meeting by Mojtaba Amiri, MD
Comparative Results in Patients with Cicatricial Alopecia Using Incision and Punch Graft Technique
This study on cicatricial alopecia is done by Drs. Amiri and Sayad and presented in the 17th annual meeting of International Society of Hair Restoration Surgery in Amsterdam. The Cicatricial Alopecia, also known as scarring alopecia, is permanent hair loss caused by inflammatory disease processes (scar tissue) or other forms of trauma (i.e. burns, cosmetic surgery, accidental injury, etc). Using hair transplant for the patient who lost hair due to cicatricial alopecia has been one of the controversial subjects. Prior studies showed a variety of results in surgical restoration of hair in these patients. Since no medical treatment can re-grow damaged hair, the only viable solution is hair restoration through transplant surgery. There are many hair transplant techniques but only two will be compared with and against each other for esthetics and density: Incision Grafts and Punch Grafts.
In this study a panel of 100 patients, 38 male and 62 female (median age of 27 years), within a 7 year period have been studied after undergoing hair restoration surgery using one of two or both techniques. Larger area scars were treated using a combination punch and incision grafts, eyebrows and hairlines received incision grafts, and any other scar type received either incision or punch type. All techniques showed satisfactory results in most patients within the first procedure and achieved best results by their second surgical procedure.
The advantage and disadvantage of each procedure is as follows:
- Punch Grafts: PROS
- Replaces scar tissue with natural skin tissues
- Adds more volume in single session treatment
- Punch Grafts: CONS
- Decreased cosmetic results
- Incision Grafts: PROS
- Increased cosmetic results
- Incision Grafts: CONS
- Less hair transplant volume in single session treatment
The presenter concludes that both hair transplant methods helped achieve a high level of satisfaction in most patients within the first treatment but each had to sacrifice one of two features before achieving their best results: Esthetics or Volume. Based on patient satisfaction, however, incision grafts in scarring alopecia is still best overall compared to punch grafts due to the higher esthetic quality of the work done and completed. Obviously more precise controlled studies are needed to prove the growth rate of hair transplant in the patient who suffer from cicatricial alopecia.
|
