Skinny OR Chubby Follicular Unit Grafts?

follicular unit graftsQ:

Dear Dr. Mohebi,

What follicular unit trimming technique does your practice employ? Is there a survival rate difference between the different trimming techniques (chubby vs skeletonized)?

Are there any distinguishing characteristics of the follicular units, once they are grown out, between the chubby trimmed versus the skeletonized trimmed follicular unit grafts?

Dr. Mohebi, is there a size difference between a a follicular unit containg one hair and a multi-hair follicular unit?

Thank you for sharing your expertise and opinions.

Sincerely,

A:

These are great questions and we will use them for blog posts too. Here are the answers to your questions:

We are committed to the gold standards of hair restoration in our hair transplant procedures. We perform exclusive follicular unit transplants to maximize the natural appearance of the hair while increasing the survival of hair follicles. We only skeleton single hair follicular units that are needed to be used for frontal hairline to minimize the chance of growing anything but single hairs which mimics a normal hairline.  For anything else 2s, 3s and 4s we use chubby grafts to maximize their viability.

Chubby grafts can result 100+% result because of the growth of hidden hair follicles in telogen phase.  They also have more supportive tissue to support the follicles.  It has been studied and documented that chubby grafts have a higher survival rate than skeletonized ones (proven in two different studies done by Dr. Beehner 2010 and Dr. Seager 1997).

Even transplanting two single hair follicular units in one site have higher survival rate in comparison to two individual single hair that are transplanted separately.  That is why we combine the single hairs with other singles in one site to increase the final density and also enhance survival of hair grafts.  The only exception is for the single ones that we have to use the way they are on hairline area to minimize the chance of growing more than one hair on the hairline.

  • So here is my recommendation for hair transplant surgeons: Make the hairline single hair grafts skeletonized and the rest keep them chubby for the best result.

For more on that please read the Skinny Vs. Chubby follicular unit transplants article on our website.