Micrografting - A guide to Hair Transplant Surgery

This is a type of hair transplant surgery in which a small drill (electric punch) is used to remove hair grafts from the donor hair (the fringe of hair around the back of the head) which are then inserted into the recipient area (bald area of the scalp).

The problem with this is that it left large circular scars on the back of the head and often unsightly looking ‘corn rows’or tufts of newly grown hair on the scalp. However this has been largely replaced with the following graft preparation method:

• An incision is made in the donor area
• A thin strip of skin, complete with hair follicles, is removed from the donor area
• This strip of skin is divided into several smaller grafts
• The grafts are inserted into the recipient area

Micro or mini graft?

A micrograft contains 1 to 2 hairs

A minigraft contains 3 to 4 hairs

This method has become less popular due to follicular unit transplantation (FUT) and/or follicular unit extraction (FUE) but is still available.

Micrografting will insert larger grafts at the back of the scalp and progressively smaller grafts towards the front to give a natural looking appearance. Minigrafts are usually inserted in the centre of the scalp.

The micrograft procedure

Your surgeon will have given you a set of instructions on what to do before and after your surgery. These include massaging your scalp beforehand and stopping certain medications such as beta-blockers or anti-inflammatory drugs.

Our section entitled about hair transplant surgery contains useful information on pre-operative and post-operative instructions.

On the day of your surgery you will be given a local anaesthetic to help numb the donor area. This can be painful although the surgeon may freeze the area beforehand with a special spray and/or give you a mild sedative.

The surgeon makes a linear incision in the donor area (the back of your head) and removes a thin, horizontal strip of skin which contains follicular units.

He/she will close this incision using staples or stitches.

This strip contains numerous hair follicles and is cut up into smaller grafts. These are either micro or mini grafts.

He or she will anaesthetise your scalp before making a series of small circular holes using a micro-needle (or micro blade). These are very tiny 1mm incisions so there is unlikely to be any bleeding. They are made in a definite way so that space is left between each incision and in a pattern which conforms to the way your hair naturally grows.

The grafts are then inserted into the scalp via micro tweezers or an ‘implanter pen’. They are fully inserted into the incisions, about a few millimetres in depth.

This procedure can take from two to eight hours depending on the number of grafts to be inserted. The surgeon will place this so that larger grafts are surrounded by smaller grafts to give a natural look.

This is preferable to the old large scale grafts or ‘plugs’which resulted in a ‘toothbrush’ effect on the scalp.

Is a micrograft painful?

It can be but the degree of pain will vary between patients. The most painful part is usually the local anaesthetic but many patients find that the procedure itself is painful.

You can also expect some discomfort in the form of bruising and/or swelling around the forehead after surgery but applying an ice pack will help.

The swelling can be noticeable so it can be a good idea to take time off work until it has eased.

Direct Hair Implantation Technique

This is an innovative form of hair transplant surgery which is based upon follicular unit extraction (FUE). This technique is available at clinics run by the Direct Hair Implantation (DHI) Medical Group and aims to speed up the procedure by reducing the time between harvesting the donor hair and implantation.

They also promote a ‘no touch’ version of this technique in which the follicular units are inserted with a special pen implanter which limits the amount of handling and reduces the risk of damage.

Another factor is that hair transplant surgery is a time consuming process, which is tiring for both the surgeon and the patient. This technique aims to reduce the duration of the surgery whilst increasing the chances of successful grafting.

In other words, the less friction and time spent with the hair follicles the greater their chance of sprouting new hair growth.

So how does direct hair implantation work?

The preparation, day of surgery and aftercare are very much the same as for the other hair transplant procedures.

Have a look through our about hair transplant surgery section. This will give you an overview on what to do before surgery, what will happen on the big day itself and what to do after surgery.

With this procedure, each individual follicular unit is removed from the donor area (back of the head) and inserted into the recipient area (scalp).

The surgeon doesn’t have to make an incision or punch small holes on the top of your scalp as with other techniques as these units can be directly implanted using the pen device. This means that the units are not handled by an assistant which reduces any stress upon them. This also means that the patient receives high quality units.

This is an important factor as hair follicles are delicate things which can be easily damaged. If they are then this can affect their ability to sprout new hair.

Less anaesthesia and painkillers are required as the patient spends much less time undergoing this procedure. This is good news for both the patient and the surgical team.

So how does this differ from follicular unit extraction? (FUE)

Their ‘no touch’direct implantation technique differs from FUE in the device they use to insert the follicular units. They have pioneered a DHI Pen Implanter which is as the name says. This slim device enables the surgeon to insert single units without having to use forceps which reduces the risk of follicle damage.

It also removes the need to have a technician or assistant handle the units –as happens with micrografting. In that procedure a strip of skin with follicular units is divided up into smaller units before being placed in the recipient area.

The problem with touching or handling the follicular units is that they can become damaged or broken which may prevent them from sprouting hair. If several of these are damaged then this will impact upon hair growth and your overall appearance.

The ‘no touch’method has a high degree of precision in that units are placed so that they mimic the pattern of your normal hair. They will grow in exactly the same manner as the hair in the donor area. As a result of this they can rebuild certain areas of the scalp such as ‘widow’s peaks’ and bald patches using a light anaesthetic. This reduces any pain or post-operative discomfort and enables the patient to return to work or other activities the day after.

This surgery can take from three to six hours which appears to be quicker than other procedures.

Hair Transplant Surgery Methods Guide Index:

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• Hair Transplant Surgery Methods Intro
• Follicular Unit Transplantation (FUT)
• Follicular Unit Extraction

• Micrografting
• Comparison FUT with FUE

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