The Art of Mixing Follicular Units and Follicular Groupings in Hair Restoration Surgery

    May 2004 in “ Dermatologic Surgery ”
    Dominic A. Brandy
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    TLDR A hair restoration technique was introduced that mixes different types of hair groupings to reduce procedure time, limit damage, and potentially increase hair density, suggesting more hair can be transplanted than previously thought.
    In 2004, Dominic A. Brandy, MD, introduced a hair restoration technique that combined follicular units and follicular groupings to reduce procedure time and limit follicular damage. The method involved dividing the donor strip into one-, two-, three-, and four-haired follicular units and three- and four-haired follicular groupings, which were then inserted according to the patient's desired hairstyle. The study presented three case studies, transplanting 4920, 6215, and 4621 hairs respectively, and demonstrated successful results with strategic graft placement. The document also discussed "cherry-picking" grafts and "dense packing" techniques to potentially increase hair density. It concluded by challenging the estimate that only 25% of hair in the donor area is available for transplanting, suggesting more could be harvested without significant thinning in the donor area.
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