Dilators
This technique is not performed by NHI.
Dilators were first introduced by Dr. Emanual Marritt of Denver Colorado in 1988. As the surgical sites for smaller grafts became smaller, Dr. Marritt had difficulty locating the holes after he made them. Once he found them, he had difficulty inserting the grafts. He came up with idea that he should use a toothpick-type device, placeing them in the small holes as he made them. By doing this, the holes were stretched and became larger. This made them easier to locate and it also made the grafts easier to place. As he removed each dilator, he kept count and was sure that every hole was filled.
As Dr. Marritt built experience, he found that he did not need the dilators. He was also concerned that the stretching may have caused more damage to the scalp. The dilators also required wider spacing than he thought he could accomplish without them. Eventually he gave up using them completely.
Dilators are still used by a few doctors during a hair transplant to help them find the recipient sites once they have been made, and to stretch them open to make it easier to insert the grafts. They are also used by these doctors to help provide hemostasis.
One of the benefits of Follicular Unit Transplantation is that the "snug fit", produced by the proper sizing of the follicular units to the recipient sites, ensures that the grafts will be held securely by the elastic tissues of the skin. This will promote rapid healing and allow the patient to resume normal activities, such as shampooing, as soon as possible. More important, it permits easier oxygen flow into the grafts and maximizes the growth of the transplant. Dilators stretch out the skin and loosen this fit; negating one of the great advantages of using properly-sized follicular units.
With the very small recipient sites used in Follicular Unit Transplantation, hemostasis is not a problem during, or after, the procedure. Our staff uses magnification during placing, and experienced placers can easily see even the smallest recipient sites and know which have been filled with grafts. Dilators just add an unnecessary step and slow down the procedure. A final issue is that dilators run the risk of increased pitting or delling, a problem not encountered with Follicular Unit Transplantation.
It is always surprising to us that some doctors resort to dilators rather than mastering the basic techniques of small-graft insertion. After all, an experienced placer should easily be able to find the recipient site and see if it has been filled with a graft. Dilators make it difficult, if not impossible, to place grafts closely and to produce the subtle changes in hair direction that give the transplant its most natural look.
The above photograph shows dilators in use during a hair transplant (from the text "A Color Atlas of Hair Restoration Surgery" by Swinehardt).
© 2008 New Hair Institute. www.newhair.com |
 | 
