Follicular Transplantation

    September 1997 in “ Dermatologic Surgery
    Robert Bernstein, William R. Rassman
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    TLDR Careful planning and patient counseling can lead to excellent hair transplant results, often in one or two sessions.
    In 1997, Bernstein and Rassman published a paper on follicular transplantation, a method that transplants hair in its naturally occurring groups for hair restoration. The paper emphasized the importance of meticulous attention to transplanting intact follicular units, accurately assessing balding, and respecting the finite donor hair supply. It highlighted the advantages of follicular transplantation, such as a fuller look and natural results, and discussed managing expectations, especially in young patients with rapid hair loss. The document noted the variability in the growth cycle of transplanted hair, with most patients seeing growth at 3-4 months, but some experiencing delayed growth up to 18 months. It advised against attempting crown coverage in the first session and stressed the importance of patient education. The paper also discussed the planning and timing of a second session, recommending waiting at least 8-12 months before considering additional procedures. It addressed the challenges in treating patients with Diffuse Patterned Alopecia (DPA) and Diffuse Unpatterned Alopecia (DUPA), emphasizing the use of densitometry to assess donor supply stability. The authors concluded that with careful planning and patient counseling, excellent cosmetic results can be achieved, often in one or two sessions, and stressed the importance of understanding hair shaft miniaturization to predict future hair loss.
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