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I use a variety of needle gauges to make incisions for my single hair grafts. The reason I use needles instead of the scalpel for these incisions is for the staff to know where to place grafts of a specific size. I use the needle incisions to direct my staff, like a roadmap.
Needles cut a larger surface area than scalpels. The needle incision looks similar to the character from the game called Pac Man with his mouth open. A needle with a 1 mm diameter cuts a surface area of 3.14 mm. This is much larger than the surface area from a scalpel that is 1mm wide.
Another thing I don't like about the needle is that it can be more traumatic to the grafts to place into the needle site if the gauge is very small. We know that Dr. Woods likes to use 23 and 25 gauge needle sites for his grafts. We know that you will have much greater trauma, slower placement of the grafts, long time out of the body, and no advantage cosmetically. In fact, if the incision site is too small, the risk of compression increases.
We prefer to make incisions that are always custom made for the specific graft. We know that every individual has grafts that are of different size. Therefore, we must individualize the graft. Also, some individuals have very hard skin, while others have elastic skin that allows for greater ease of placement. More elastic skin expands and accommodates the graft better. Harder skin is not elastic. It does not expand and dial ate in response to the larger graft. Therefore, you will need a slightly larger incision for a larger graft in the individual with less skin elasticity.
Larger diameter shafts require larger incisions. If a person has finer hair, we can make smaller incisions. Again, all incisions must be customized to the individual patient.
We believe that a recipient site incision should allow ease of placement and provide for a snug fit so that the grafts are less likely to pop out during the procedure or after the procedure. Since each individual has a specific hair characteristic and specific skin character, all individuals must have recipient sites specifically tailored to their individual characteristics. I have several individuals on my staff who are very adept at placing grafts.