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"Blind" Graft Production is On The Rise - Beware!
Blind Graft Production occurs when doctors try to cut corners in the graft harvesting process. It comes in two forms: The first is with the use of the multi-bladed knife to remove the donor tissue from the back of the scalp. This technique is popular because it is quick and produces thin slices of tissue that can be further divided into smaller pieces depending upon the size the surgeon wants i.e. the term "mini-micrografts" cut to size. The problem is that the multiple blades pass through the scalp without direct visualization or control by the surgeon (i.e. "blind") and cause unnecessary damage to the donor tissue by cutting into hair follicles and breaking up naturally occurring follicular units. There is no way for "blind" knives to adequately compensate for the random distribution of follicular units in the skin, or the normal variability in the direction of human scalp hair.
This damage is so significant that many doctors have abandoned the use of this multi-bladed harvesting technique. When a microscope is not used, the damage that is produced is not readily apparent to the surgeon, and he may even report that it does not occur. Unfortunately, the damage is seen much later on, when the amount of growth from the transplant is far less than expected.
The second, and potentially more serious, form of blind graft production is the "mechanized" cutting of the individual strips of donor tissue. In this procedure, the thin sections produced by the multi-bladed knife are placed on a grid-like cutting block, and then, all at once, chopped into tiny pieces (like Sushi). In this method, not only is the tissue removed from the scalp in slivers that are cut "blind", but then these slivers are cut in mass into smaller bits of hair bearing skin without individual control by the surgeon or staff. By using this method, not only is there a very high incidence of follicular transection (damage), but most of the naturally occurring follicular units are broken up. Needless to say, it is impossible to perform Follicular Unit Transplantation with any type of "blind" graft techniques.
To contrast this procedure, let's look at the way graft production is carried out at NHI. First, the donor tissue is carefully removed as a single strip. Next, the strip is divided into smaller pieces by a process called "slivering". In slivering, complete microscopic control is used to avoid breaking up follicular units or damaging follicles. The thin slivers are then further dissected into individual follicular units under complete microscopic control. This is the "ultimate" in direct visualization and ensures the best possible results.
With all of the negative aspects of "Blind Harvesting," one should ask why doctors perform it. The answer is that its is faster and cheaper for the doctor. Lower costs for a surgery can create the illusion that as the cost goes down the value goes up, but the value of the procedure, hair for hair, is actually more expensive when one takes into account the destruction of hair. Unfortunately, the patient won't see the results of the decreased yield for at least 4-8 months: long after the bill for the surgery is paid in full, and the lost donor supply can never be recovered.
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