blind techniques for quick donor harvesting which results in significant follicular damage from 5 to 37% transection rate as reported in medical literature. These damaged hair follicles usually have low growth rate depending on the level of transection and if they do grow they result in deformed and miniaturized hair.

In 1997 Dr. Damkerng Pathomvanich at the Stough clinic in Bangkok was the first to develop and pioneer the open technique in donor harvesting which results in very low transection rate of less than 2%. This technique was published in the Dermatology Surgery Journal (April 2000) and Hair Forum International (October 1998). We believe this open method to have the lowest percentage of transection compared to the other techniques reported in medical literature. This technique results in minimal wastage which means more grafts are available for transplantation and minimal donor scarring. Since then up to present this method is continuously being refined and improved to further decrease the follicular transection rate.

The donor area is closed by using running absorbable stitches and retention stitches. The addition of retention sutures will enable the surgeon to close without undermining which may lead to nerve damage, bleeding and follicular transection. Another advantage based on our experience is the almost undetectable post-op scar seen in majority of our patients.

The donor strip is then slivered over a tray specially designed by us to stabilize each strip for easy slivering into narrow segments with the least amount of transection and the strip is also partially immersed in normal saline to prevent dessication. In addition a high power loupe is used to decrease transection even more. The slivered strips are then further dissected under binocular stereoscopic microscopes into follicular unit grafts.

FOLLICULAR UNIT TRANSPLANTATION

Hair line design is a combination of science and art. The physician at the clinic will communicate with you to draw your new hair line to match your face. Sedation will be given orally to make sure that you are relaxed and calm before the injection of the local anesthetic. Then tiny lateral or coronal slits will be made at the balding area. These slits are oriented according to the direction and angle of the existing hair and arranged irregularly at the hairline area thus resulting in the most natural look.

In this clinic we do follicular unit transplantation which means we transplant only grafts made up of follicular units nothing bigger. Follicular units are hair groupings naturally occurring in the human scalp which may contain 1-4 hairs. The Stough clinic team is very meticulous in handling and inserting the grafts into the created slits. The follicular grafts are contained in special ring holders design by the clinic to prevent dessication and help the transplanter to select the appropriate graft size for insertion. This has the advantage of helping create a natural hairline because it enables the transplanter to selectively use all skinny 1 hair grafts in the front and coarse 2 to 3 hair grafts on back.

The clinic utilizes dense to ultra dense packing, mega session and all follicular unit grafts.