Dense Packing E Attecchimento

[homer]

Ciao, stavo rovistando HTN per capire se la % di attecchimento diminusce con la densita'. Ho trovato delle interessanti considerazioni del Dr. Feller e di altri forumisti:

 

I don't think it is a matter of how much density is achievable. Both methods can give the same overall density. The question is which is the best strategy for that particular patient, as NW clearly pointed out in his post.

To me, whatever works best in the long run is the way to go. Whenever you go back into a previously transplanted area you run the risk of hurting not only the hairs you already transplanted, but the new ones as well. This is especially true if you are going to a different doctor.

[....]

Doesn't it make sense that transplants want virgin skin? Surely all you guys must see that? There is certainly no ADVANTAGE to replanting into the same area.

Of course one may replant into the same area. I've done it for years with success. But how much better would these patient's have looked if I did it the "dense pack way"?

As a surgeon doing this every day you get a "feel" for what is right, and dense packing with horizontal slitting is it. Whether I'm doing a strip case or an FUE case I'm sure of the "rightness" of this approach.

 

There is no longer a question as to the survival rate of grafts packed at 45 grafts per CM2. They grow without a problem. I believe most of the doctors claiming it didn't work were those who simply could not do it because it IS much harder technically.

 

Al che alcuni utenti hanno replicato:

However if one is a Norwood 2 with some thinning and receding, dense packing might just cause shock loss of existing hair and be counterproductive might it not? Also, how would one use a lateral slit technique and dense packing between existing hairs without increasing the risk of transection? It would seem that densepacking is fine for open,bald areas but what about areas that have only some thinning? For that I would think that high guage needles might work more accurately.

 

I agree density issue should be addresses on case to case basis. I my case with diffused thinning all over higher density would prove counter productive. Dr. Cole packed in about 20/cm2 on front and top in between my existing thin hair with supposedly utra thin needles (to minimise shock) and at 2 months I still am suffering significant shock. I don't know how I will look when it all grows in but I am won't be surprised if I end up with net loss in cosmetic value. I can't imagine what would have happened with much higher density. So for people with some hair left on their area in question, it's better to wait and watch rather than play all your cards at once.

 

P.S. se qualcuno ha bisogno, posto anche una traduzione sommaria. :okboy:

[homer]

Poi mi sembra interessantissima anche questa risposta del Dr. Seager:

 

I use chubbier grafts than most other physicians, and put them into a slightly larger (but still very small) recipient site than is necessary to achieve 60 follicular units per cm² and I hardly ever exceed a density of 45 follicular units per cm². This gives two benefits. Firstly, the invisible Telogen follicles are spared by using chubbier grafts. Secondly, I believe that when EXTREME dense packing is performed into very small recipient sites, the grafts get traumatized and damaged more, and one is liable to get both lower survival, and thinner hairs growing. We are able to place more than 45 follicular units per cm2 using our technique but deliberately decline doing so as to produce optimal results.

 

When I invented the "one pass technique" and started advocating DENSE PACKING entire Megasessions in 1997, I started a new era in hair transplantation. Many other practitioners, I'm glad to say, are now trying to copy my techniques. However, they also try to improve on it by significantly increasing the number of follicular units per cm² they plant. Although they may produce equally (but no better) great looking results, it is very wasteful of precious, non-renewable donor hair.

 

Lastly, there is the issue of why not do it in two sessions instead of one. As I have mentioned before, after each session (in most patients to a greater or lesser extent - some patients a much greater extent) one gets Micro Scarring around the grafts, impairing the blood circulation, and therefore impairing the growth of a second session in between these grafts. In other words, the first session always grows the best and the second session usually gets reduced graft survival. These are some of the reasons why I originated and developed the “One Pass Hair Transplant” or – “Single Session Result”.

 

Quella di prelevare graft piu' "cicciute" per non tralasciare i follicoli in telogen, se e' vera, e' un colpo di genio... o no?

Anche il discorso sul micro-scarring intorno ai capelli trapiantati e' un punto fondamentale.

Cioe': mettere dei graft intorno a dei capelli nativi alla prima passata non e' come mettere altre graft intorno ai capelli trapiantati in precedenza.

Allora la % di attecchimento nella seconda passata e' < di quella nella prima, ma e' vero che la % di attecchimento totale in 2 passate e' < di quella della singola passata in dense packing! :o

Sara' vero? :blink:

[homer]

E infine ci mette bocca anche Hasson: :o

 

Several posts recently have discussed the ideal density of transplanted FU grafts. In a previous thread I had posted that the ideal density in an individual would depend on many factors including- hair texture, hair colour, balding pattern, area of the scalp and patient expectation .Most importantly the balance between coverage and density must be achieved without compromising the naturalness of the result.

 

Some individuals may ( based on some threads) think that I routinely pack at greater than 60 FUs/cm2. This is incorrect – packing at this density is the exception rather than the rule. As Dr Seager has stated the desirable density is usually between 40 and 50 FUs/cm2, and this is usually my goal.

 

Dense packing at greater than 50-60/cm2 is possible with one pass. While many surgeons now claim to be transplanting at this density, I have yet to see the end result.

 

Pero' non dice nulla (conferme/smentite) sul discorso del telogen, sul micro-scarring e su come trattare l'applicazione del dense packing a casi di diradamento diffuso.

Conferma soltanto che va applicato con criterio caso per caso.

[homer]

Una riflessione del Dr. Limmer:

 

I do not think it makes a major difference whether you do2 sessions of 20 grafts per squared centimeter or 1 session of 40 grafts per squared centimeter in the final product. The advantage of 1 session dense packing is that you do not need to go back to that area in many cases for additional density. The disadvantage of very dense packing is that you cover a smaller area with the initial session if doing the same total number of grafts.

[homer]

Infine questa fantastica discussione tra Feller, Cole, Hasson e Parsley:

 

http://hairsssssssss-restoration-info.com/ev...1861#5566051861

 

:wacko: