Robert S. Haber, M.D.
CASE School of Medicine, Cleveland, Ohio, USA

SUMMARY of Dr. Haber’s Abstract from his presentation at the International Society of Hair Restoration Surgery, 2005 – Sidney, Australia

Harvesting high quality donor strips with minimal transaction remains an elusive goal for many hair transplant surgeons, particularly beginners. Hair restoration techniques that involve the use of scalpel blades demand the greatest skill and may cause significant transection. The Sandoval Score and Spread technique showed that non-traumatic dissection during hair transplantation is possible using a blunt instrument, but this technique is limited by poor ergonomics and the potential to cause tissue damage.

A new instrument for blunt dissection had been developed that is easy to use and is able to separate tissue along the natural planes of cleavage that causes minimal damage to hair follicles. This device has four sharp, staggered prongs aligned centrally and long handles developed for hair transplant procedures. This design utilizes the strong forearm muscles, as opposed to the weaker hand muscles, and distributes the spreading force over a larger area, minimizing trauma. A minimum depth scoring incision is made with a double-bladed scalpel to a depth of 1.5 mm. The device is inserted and expanded at intervals along the incision.

Fifty consecutive patients whose donor strip was harvested utilizing the device for the hair transplant were studied. It was found that the device works well for hair transplantation, producing virtually transaction free strips in approximately 90% of cases. The instrument was ineffective when the patient has very rigid tissue that did not yield to the force of the device. Standard scalpel blade excision was used in these cases.

When performing a hair transplant, there exists a natural dissection plane within the donor scalp that can be used to obtain high-quality strips with blunt dissection. This newly developed instrument is ergonomic and easily used by both experienced and beginner hair restoration surgeons.

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