Micrograft size and subsequent survival.

BACKGROUND: Micrograft survival rates in hair transplantation have been frequently described in private conversations by hair transplant doctors as variable at best. References in medical literature may grossly underestimate the prevalence and magnitude of poor growth. This is probably because most hair transplant surgeons are concerned that publication of a significant incidence of poor growth would reflect negatively on their practice.

OBJECTIVES: The purpose of this research was to study micrograft survival rates using microscopic dissection techniques. The author also presents a hypothesis regarding the relatively poor survival rates reported by hair transplant physicians.

METHODS: Two different groups of micrografts were prepared. One group, mainly single-haired with tissue trimmed close to the hair shaft, was planted into one test patch in the bald crown of a patient's scalp. Another group of intact follicular clumps, prepared with more dermis, subcutaneous fat, and intact sebaceous glands, was planted into another test patch. These test patches and their growth were documented with close-up photography.

RESULTS: The micrografts prepared as existing follicular clumps had a much higher survival rate (over 100%) than the micrografts cut as slender single hairs.

CONCLUSIONS: Extremely high survival rates of micrografts are obtainable by transplanting intact follicular clumps with protective tissue around the micrograft, and preserving the follicular clump's sebaceous gland. These survival rates were not achieved when micrografts were produced by splitting individual hairs away from a naturally occurring follicular clump.