Graft Quality Index: A Morphologic Classification of Follicular Unit Excision Grafts

The document from 2018 introduced the Graft Quality Index (GQI), a novel concept for grading the quality of hair grafts in hair restoration surgeries, particularly Follicular Unit Excision (FUE). The GQI has four grades: Grade 1 grafts have no transections or damaged follicles and a smooth regular border; Grade 2 grafts are similar to Grade 1 but have less perifollicular tissue; Grade 3 grafts have extreme iatrogenic splay, with the lower third to half of the follicles being denuded of surrounding tissue; Grade 4 grafts contain transections and damaged follicles, and the graft margins are irregular. The GQI can be used to predict the difficulty of graft placement, guide the best implantation technique, and relate graft morphology to the results of surgery. The document also discussed the application of GQI in strip harvest procedures and its limitations.