An advantage of noting the calculated density of a particular technician is that it allows a rapid assessment of their efficiency. If a technician’s dissection results in a lower than expected calculated density, the technician has fractionated the natural follicular groups or had a higher than expected waste. If the technician produces a higher than expected calculated density, they have produced grafts larger than natural follicular groups.

It remains to increase the sample size for the extremes of calculated densities (very high and very low calculated densities) in this study. We should also begin to look at the pre-operative calculated density and determine the ratio of one, two, 3, 4, 5, and 6 hair follicular groups prior to dissection. This sample should be evaluated carefully with a microscope. The hairs in each follicular group should be inspected manually with a pair of fine jewelers forceps to determine the actual number of hairs in each group. The results of this inspection should be compared against the aforementioned findings to assess their validity.

Last year I explained to Dr. Devroye an idea for assisting in the counting of grafts. The idea was to create a computer program that would record the number of grafts, the rate of production, the total number of hairs, the calculated density for each technician, and summarize the data. The results were to be compared to the predicted results based on a series of calculations I previously devised and the projected ratio of graft sizes based on the pre-operative calculated density. Using this data we could measure the output of hair, the efficiency of our staff, the speed of our individual staff members, and continue in our quest to maximize donor yield. I also desired to link the program to a voice recognition software package so that the technicians would have their hands freed to produce grafts. The act of writing the graft count takes away from productivity. Accordingly, it is our hope to incorporate a voice recognition program with this software to speed the graft production phase, improve the accuracy of the hair count and graft count. In this scenario a lavaliere microphone will be attached to the collar of each graft cutter. As they cut the grafts they will record the hair count of each graft. The Excel program will tabulate the total number of hairs and total graft count in a worksheet. At the end of the dissection the results will be printed and compared to the other members of the dissection team. It will be possible to keep a running record of the technician’s speed of production and efficiency of dissection based on comparison with both other technicians and expected results.

Dr. Jean Devroye cleverly introduced the a power point program designed to monitor the results of the dissection and to assist the tabulation of the grafts, number of hairs, and the ratio of various size grafts. The following is his description of this software.

When I discovered the world of the hair transplantation, I was very interested in searching the accuracy of the counting of grafts and hair. Dr J.Cole gave me the opportunity to develop this subject and I would like to thank him.

Beginning with the existing database, I built an excell programming to be able to calculate the number of grafts and hair before and after cutting. The programming doesn’t only involve the estimations but gives the opportunity to compare the results of the cutting obtained with the theoretical expectations.

This includes the work of all the team or specifically of each technician.

For the ones who were in Hawaii, you can notice the modifications because the study is in progress and any comment is welcome.

Counting before cutting.

Compared to the old one, the new version is easier to use. In order to use the programming, the first step is to measure the strip surface and the hair density. I took the usual repartition of the different types of FU according to the hair density. (based on Dr Cole’s chart).

For example, if you base your FU density on 10 FU per 10 mm square, and you observe a hair density equal of 16 hair per 10 mm square, you will find 4 singles and 6 doubles.

Mathematics confirm the theory: 4*1 + 6*2 = 16 hair.

Each hair density usually follows the repartition of the graph above. But we are working on refining the database in function of different criteria (ethnical origins, etc...).

Example: After measurement, you will obtain this board.

Counting after cutting.

The second part of this programming is to study the results after the cutting.

Again, it’s very interesting to compare the theoretical goals with the results obtained.

Using another board, we introduce the results of the cutting (either the ones of each technician, or the ones of all the team together)

We also built a graphic pages which gives us a general view of the results.

Now, we have the project to use the speech recognition system.

Such a performing system will help hair transplant surgery to work fast and precise.

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    Arnold, James: Cyberspace Chat 7/4/2001

    Cey, Victoria: 2001 ISHRS Opinion poll

    Headington JT. Transverse microscopic anatomy of the human scalp. Arch Dermatol 1984;120:449-56.

    Whiting D: New York Hair Meeting 1999

    Bernstein RM, Rassman WR:Follicular Transplantation Patient Evaluation and Surgical Planning. Dermatologic Surgery 23:771-784, 1997 and Bernstein R, Rassman W, Szaniawski W, Halperin A: Follicular Transplantation. International Journal of Aesthetic and Restorative Surgery 3:119-132, 1995.

    Types of three hair grafts