Linear grafting using a modified slot method. Introducing the linear punch.
BACKGROUND: As the field of hair transplantation changes radically almost month to month, one goal remains essentially unchanged-satisfy the patient. Mega sessions of only one to three hair grafts either by slit or laser produce a natural but thin result, while the more traditional circular punch grafting can produce a thicker but unnatural result. OBJECTIVE: To introduce a new type of recipient site that has the width of a micro graft but can vary in length. When linear grafts are placed into these new recipient sites, they produce strips of hairs that heal quickly and naturally. When using the multiblade knife for donor strip harvesting, the shape of grafts change from the traditional round grafts to a narrow linear strip of hair. Current methods of slit receptor sites accommodate these grafts better than circular punch sites when grafts with a small numbers of hairs are used. Unfortunately, with either larger slit grafts or later densification, slit grafts often tend to compress creating a pitted or tufted appearance. It is the authors' opinion that by creating a slot incision and removing some tissue, a more dense, natural appearance can be created for the patient obviating the problems with slits, lasers, or circular punch grafting. METHODS: One-year study on 100 hair transplant patients. CONCLUSION: The linear punch creates recipient sites that avoid compression and allows for more hairs per graft without compromising naturalness. Healing is comparable to micrografts alone. It is the authors' opinion that a linear or elongated slot incision accommodates grafts created from donor strip harvesting more naturally than slits, small round incisions or punctures. The linear graft created is the precise size and shape to the recipient slot incision to which it is placed. This technique helps us avoid the old adage, "Trying to fit a square peg into a round hole." As stated by Unger, a slot incision created by a Ultrapulse laser produces superior results to those seen with conventional slit grafting (Dermatol Surg 1995;21:759-65). This approach is cost efficient and cosmetically appealing to the patient without the fear of the old "cornrow" appearance.