Comparison of Different Instruments to Make Recipient Sites: Needles vs. Blades

David Perez-Meza, MD, Melvin Mayer, MD

SUMMARY of Dr. Perez-Meza’s Abstract from his presentation at the International Society of Hair Restoration Surgery, 2005 – Sidney, Australia

There have been great advances in hair restoration surgery over the past decade. New surgical techniques, instruments and medications have been developed to treat patients with hair loss. Some surgeons use needles to create the recipient sites and others use blades – both groups obtaining great results. There is some controversy, however, about the “ideal” instrument to make the recipient sites.

The objective of this study was to evaluate three different blades and three different needles used to make sites in the recipient area and to compare the wound healing and hair growth after the hair transplant.

Recipient sites were made using the following instruments: 18-, 19- and, 20-gauge needles, Sharpoint 22.5º, Minde 1.3 mm and Custom blades. Each instrument was used to make sites at a depth of 4 mm and at an angle of 30-45º. Two-hair follicular units were placed in pre-made incisions.

We evaluated intra-operative bleeding from the recipient sites (bleeding makes it more difficult to place the grafts). We also examined the patient at 10 days post-op for redness, swelling and scabbing, and at 6 and 12 months for terminal hair counts.

The results showed that there were no differences between the two groups with respect to intra-operative bleeding and, at 10 days, there was similar healing for each of the instruments. In addition, at 6 and 12 months, the hair counts were similar.

Our conclusions were that all of the instruments produced similar hair growth and survival. None of the instruments produced cysts, ingrown hairs, pitting or cobblestoning. There was similar naturalness, quality of hair and cosmesis. In sum, if one uses very small instruments in the hair transplant, similar results will be observed regardless of the specific type of instrument used.

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