信恩美醫診所植髮部落格

本診所張衍爐醫師於會中發表論文"於手術顯微鏡下施行微創毛囊擷取術的臨床報告"

Surgical microscope-assisted hair transplantation   

Yean-Lu Chang MD.  

a part-time hair transplant surgeon, private practice for 20 years,

ISHRS member since 1995

Toyoung plastic surgery clinic, Taipei , Taiwan  

在手術顯微鏡高倍放大影像下,做微創腿毛毛囊擷取術,之後再將毛囊移植作植眉整形.
ABSTRACT:  

Back ground:  

Magnification is a very important factor related to the quality of technical precision and incidence of hair follicle injuries during the hair transplantation procedures. Additionally, ergonomics is essential to prevent fatigue and repetitive strain injury especially for the beyond middle-aged hair transplant surgeon who need to withstand the long lasting follicular unit extraction procedures.

After obtaining the “follicular unit extraction” concept from Rassman’s FUE article published in 2002 and visiting Wood’s website in which Woods recommended microsurgical FUE, called “Woods’ technique”, we soon tried to apply operating microscope in FUE procedures in 2002. Initially, we use this device in scalp FUE and later, in body hair FUE, and other procedures. 

雄性禿,髮際線後退明顯                                      微創植髮術後當天  


微創植髮後10個月,毛髮密度之後還會進一步改善


Objectives:
The retrospective study of personal experience in microsurgical hair transplantation is to investigate the advantages and disadvantages of the application of surgical microscope in hair restoration. 
 

Materials and method:  

We review patients who received microsurgical hair restoration with the aid of Carl Zeiss OPMI pico operating microscope (Carl Zeiss Meditec, Inc,) during 2005 and the current date. The indication of using this optical magnification device include scalp hair FUE, body hair FUE and high-density graft implantation.

  

雄性禿,髮際線後退明顯                                   微創植髮後10個月

Result:  

The OPMI Pico operating microscope can effectively provide comfortable viewing, ergonomic convenience at the workplace and keep the operator in upright comfortable sitting or standing posture. It is also very helpful for enhancing the visualization of the surgical field so that high surgical precision can be achieved.  

Regarding the disadvantages of using surgical microscope, its cost is more expensive than loupes’ and a short learning curve is needed. 
 

Discussion:  

Un-ergonomic positioning during operation are the primary risk factors for musculoskeletal disorders that can affect surgeons. Especially for a beyond middle-aged hair transplant doctor, the long lasting, exertional follicular unit extraction procedure seems to be a tough operation comparing with the conventional strip procedures. However , by using surgical microscope, we can change this situation for the better. 
 

In terms of surgical precision, with the adoption of the optical magnificator, we can upgrade our technical accuracy more efficiently while doing follicular unit extraction or high-density graft implantation such as in patients with cicatricial eyebrow in which by using microsurgical single-follicle grafting techniques, the lost eyebrow hairs can be restored in a natural and undetectable fashion..



顯微鏡下施行第二代微創植髮術,取毛囊處不剃髮術後當天


顯微鏡下施行第二代微創植髮術,取毛囊處二週後
 

Conclusion:   

In summary, based on our limited experience of the microsurgical hair transplantation that was proposed by Woods, we believe that the operating microscope can play an important role in follicular unit extraction procedures and high-density graft implantation.     

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