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

    June 2004 in “ Dermatologic Surgery ”
    Dominic A. Brandy
    TLDR Mixing different sizes of hair follicles during hair restoration surgery can give excellent results, save time, and cause less damage.
    The 2004 study "The Art of Mixing Follicular Units and Follicular Groupings in Hair Restoration Surgery" presented a technique to minimize the time taken and limit damage to follicular units during hair restoration surgery. The method involved dividing a donor strip into one-, two-, three-, and four-haired follicular units and three- and four-haired follicular groupings under a microscope. These groupings were formed when two two-haired follicular units or a three-haired follicular unit and one-haired follicular unit were very close together. The grafts were then inserted into incisions that were 1.0 to 2.5 mm in length and arranged according to the patient's desired hairstyle. The technique yielded consistently excellent results, required less time, and damaged fewer follicular units, suggesting that using follicular units exclusively in hair restoration surgery can be counterproductive.
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