No abstract

Successful aesthetic treatment of earlier thinning of scalp hair in men and women has necessitated the development of alternatives to traditional punch grafting. The hair-bearing "serrated island" remaining between two parallel rows of round donor sites can be removed and dissected to yield a large number of "serrated island grafts" and single-hair grafts. These miniature grafts, along with half grafts from bisected plugs, can be placed, in one or several sessions, into dozens to hundreds of small "slits" between the remaining hairs in patients with early or advanced thinning on the crown, vertex, or anterior scalp--hence the name "slit grafting." The versatility of this technique is demonstrated by its value for patients with dark hair and light skin, in repair work, in patients necessitating extensive vertex coverage, or in combination with alopecia reduction and traditional punch grafting. The finely tufted progressive growth from hundreds of these carefully placed slit grafts can thus counteract further hair loss in a variety of different situations.

The results suggest that the incorporation of laurocapram in the formulation enhances the effectiveness of triamcinolone acetonide, without compromising its safety profile.

The superior yield from extensive scalp lifting has been detracted from by complications, including hemorrhage, scalp necrosis, and the need for greater anesthesia. Intraoperative unilateral occipital artery ligation, with extensive undermining to the nape of the neck on only one side, can minimize the risk of postoperative scalp necrosis or telogen effluvium. Careful hemostasis, extensive infusion of dilute anesthetic, and modifications in instrumentation can decrease the morbidity associated with this procedure. The advantages of the operation include removal of the large amounts of bald scalp, excellent intraoperative visualization, and lack of stretchback and asymmetry.