Needle holder fixation technique for assisting non-shaven follicular unit extraction hair transplantation

Problem

Non-shaven follicular unit extraction is a recently developed technique for hair transplantation.¹ This technique can prevent extensive shaving of the donor area. However, it is difficult to obtain an optimal visual field for harvesting follicular grafts while performing this procedure, especially in patients with long hair. Moreover, stretching the scalp to maintain tension is critical for graft harvesting during these procedures.

Solution

We applied a needle holder for assisting non-shaven follicular unit extraction during hair transplantation. First, the donor area was disinfected and anaesthetised with a subcutaneous tumescent solution. Subsequently, we used the dominant hand to stretch the scalp (traction) while holding the shank of the needle holder with the non-dominant hand, thus applying circumferential pressure on the target area using the ring handle (counter traction) for graft harvesting [Figures 1a and b]. We then used iris scissors to trim the hair as short as 1–2 mm in length and punched it with the dominant hand [Figure 1c]. Finally, the follicular graft was removed using forceps. This procedure was repeated until adequate follicular grafts were harvested.

Close

Figure 1:

(a) The ring handle was placed on the harvested area with firm pressure to fix hairs, (b) we used iris scissors to trim a hair as short as 1–2 millimetres in length, (c) we used 1 millimetre punch to harvest the follicular graft

Export to PPT

Needle holders are typically available in operating rooms and are easily acquired. Although artery forceps can be used as an alternative, we recommend using a needle holder during this procedure as its robust nature provides us with adequate tension support. The ring handle of needle holders can fix the scalp, similar to a tensioner during robotic hair transplantation surgeries. Briefly speaking, the ring of needle holders can give traction and counter traction with ease by a single operating surgeon. Additionally, the circumferential pressure applied using the ring handle of needle holders can also function as a haemostat and reduce intraoperative bleeding.