Sat 27 Feb 2010
The Stick-and-Place Hair Transplant Technique Vs. Pre-made Incisions
Category: Common Questions , FUT (Follicular Unit Transplant) , Graft Orientation , Hair Loss Blog , Hair Restoration Physicians , Hair Transplant SurgeryI’ve heard these terms used quite often, but what exactly is the difference between the Pre-Made Incision technique and the “Stick-and-Place” method? Is one better than the other?
This question was answered by Dr. Mike Beehner of Saratoga Springs, New York who is one of our recommended hair restoration physicians. Follow the original topic on our Hair Restoration Discussion Forum to also see expert replies from Coalition surgeon Dr. Cam Simmons and our managing publisher, Bill Seemiller (Falceros).
For myself, the one big advantage of the stick-and-place method, which I take advantage of in certain unique cases, is the fact that it allows the hair transplant surgeon to make the SMALLEST possible incision to place the graft in. This is because, at the instant you withdraw the needle or slit blade, you are immediately placing the graft into the opening before any elastic recoil or shrinkage can occur at the site. The benefits of this fact are two: One, you do the least possible damage to the vascular system of the scalp because of the smaller sites, and two, you can place grafts closer together, because the sites are smaller and more will fit into a cubic centimeter than with a slightly larger site.
The big problem with stick-and-place is that it is not possible for the surgeon to personally perform the whole hair restoration operation due to the time factor (time the grafts are out of the body) and the fatigue/exhaustion factor. He would be there for 16 hours (till the wee hours of the morning) and a lot of the grafts wouldn’t survive because of the time out of the body. So this task has to be delegated or shared with one’s assistants.
Creating a soft and natural hairline with surgical hair restoration should be addressed by the hair replacement surgeon during the procedure.
One of the most important factors that make a hair transplant look natural is a hair restoration surgeon’s ability to create a soft and natural looking hairline that mimics nature. Creating a natural looking hairline involves great skill, placement, artistic design, and hair density.
Most of the factors that we think have to do with “shock loss” of native hair following a hair transplant procedure all take place at the time of hair restoration surgery. The two most important things are: one, the VULNERABILITY of the hairs that exist on top, and two, the AGGRESSIVENESS with which the recipient sites are made. If a large percentage of those remaining native hairs are “miniaturized” (limited length and decreased diameter; ie: “wispy”) they are much more likely to be shocked than a strong terminal hair is. When recipient sites are aggressively made, whether it is the closeness with which they are made or the width, depth, or length of the individual sites, native hairs can be lost either by taking a “direct hit” by the instrument used or simply as a “shock” reaction to having all these cumulative injuries occurring so close to them.

