Reply to Expert Comments - A Study of Donor Area in Follicular Unit Hair Transplantation

Dear Editor,

We appreciate the concerns raised by the author[1] in our original article ‘A study of donor area in follicular unit hair transplantation’[2] and would like to address it one by one.

Due to space constraints for an article in the journal, not all 30 pictures could be published in the article. Hence, we had included one high-quality digital image for each of the four different types of closure.

Our study is a retrospective evaluation of donor area in 30 patients who underwent follicular unit hair transplantation from March 2012 to February 2013. We had mentioned in future directions to conduct prospective studies to compare different types of closure, and we had conducted one in our institute to compare single vs. double trichophytic closure.

The issue of aesthetically gratifying result in recipient area is an entirely different issue where multiple factors, such as storage media, duration of surgery, temperature and density,[3] come into play and it is beyond the scope of discussion of our article.

We do agree that taking a narrow strip yields lesser grafts and hence less satisfying results. However, for example, given a choice between taking a strip of dimensions 10 cm × 1.5 cm or 15 cm × 1 cm, we would suggest choosing the latter, which yields exactly the same number of grafts but a cosmetically acceptable scar.

In our opinion, we should opt for a camouflage technique such as trichophytic closure[4] that is done along with hair transplantation in the same sitting rather than subjecting the patient for beard or body hair transplant later to camouflage donor area. Hair direction post-trichophytic closure in the donor scar is rarely a source of concern in hair transplant patients.

Hence trichophytic closure and smaller strip width gives a better aesthetic donor scar.