Hair Restoration, Hair Transplant, Hair Loss Treatment Clinic

Survival Comparison of FU Grafts Trimmed Chubby, Medium, & Skinny

This well-researched article is the result of another study from Dr. Michael L. Beehner, which was presented at the 17th annual meeting of international society of hair restoration surgery in Amsterdam, Holland.

In this study the author explores if there are survival differences in FU grafts when they are trimmed "chubby," medium, or “skeletonized.” It will look at this premise with both 1- and 2-hair FU grafts. The author reviews some previously done work in this area. He summarized that In 1997 and 1998, Seager and this author in separate studies compared skinny vs. chubby grafts. Seager found 113% growth in the chubby ones and 89% in the skinny ones. Beehner found 133% growth in the chubby grafts and 103% in the skinny ones.

The objective of this study is to add additional test grafts to the work that has been done in the past, to see if there is a compromise to follicular survival when the grafts are trimmed in a skeletonized fashion. The trimming of the "skinny" grafts in this study is even more accentuated than in the Seager/Beehner studies.

Five study boxes were created by the investigator in the rear mid-scalp region in a hairless scalp. The 3 boxes on the left, which looked at 2 follicular unit grafts. were each 1.2cm x 1.2cm (total of 1.44 square cm of area) and the 2 boxes on the right, which looked at 1-hair FU grafts, were each 1.1cm x 1.1cm (total of 1.21 square cm of area). Each of the study boxes were composed of:

Recipient sites made with tiny lateral slit blades, the grafts necessarily have to be trimmed slimmer and slimmer to the edge of the follicles. This study looks at comparing three levels of trimming, to see if there are advantages or compromises to any of them. The obvious advantage of placing a very tightly trimmed graft into a very small site is that more of these sites can be placed within a square cm than if they were trimmed chubby. Also, the smaller each site is, theoretically, the less vascular damage is done to the scalp in order to deliver that given graft.

The advantages of the chubby graft are that hidden telogen hairs go along for the ride and may give a 100%+ growth rate. Also, the grafts are much less vulnerable to trauma and can be easily grasped without damaging the follicle itself or the bulb. The disadvantage to this level of trimming is that a larger recipient site is obviously necessary and less can be placed per cm2 than with a skinny FU graft.

Dr. Behner emphasizes that the study by itself is not statistically significant and can only be considered anecdotal, but does give a glimpse into the questions and comparisons drawn above. Added to the two previous studies mentioned above, it will either further confirm the earlier studies or possibly give another result altogether.

The end result turned out to be that this small I-patient study seeks to give further evidence as to whether or not there is compromise in trimming grafts too closely and if there are extra advantages to leaving an extra amount of tissue around the graft.