Dr. med. Conradin von ALBERTINI Dr. med. Conradin von ALBERTINI A Fruit Hanging Too Low to be Seen? Preventing FUE Donor Damage with ‚Minimal Depth Control‘ Conradin von Albertini, MD, Switzerland ISHRS Annual Meeting 2014
Dr. med. Conradin von
ALBERTINI
Dr. med. Conradin von
ALBERTINI
A Fruit Hanging Too Low to be Seen?
Preventing FUE Donor Damage with ‚Minimal Depth Control‘
Conradin von Albertini, MD, Switzerland
ISHRS Annual Meeting 2014
Dr. med. Conradin von
ALBERTINI
Disclaimer
§ I have no relevant financial relationships or conflicts of interest to declare.
§ No photography please.
ISHRS Kuala Lumpur, October 10, 2014 2
Dr. med. Conradin von
ALBERTINI
Donor complications in Giga FUE
§ FUE = very low risk!
§ But: ‘Giga rat race’ = Shock hair loss & necrosis?
§ Personal relevance: 2000-3000 FUs per day (w/PCID®)
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Source: Harris (2014)
ISHRS Kuala Lumpur, October 10, 2014
Dr. med. Conradin von
ALBERTINI
Tissue damage in FUE donor sites
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How can we quantify it? A
How can we reduce it? B
ISHRS Kuala Lumpur, October 10, 2014
Dr. med. Conradin von
ALBERTINI
A – Quantify the damage: Wound surface „Perpendicular punch holes“ (simplification)
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2πrh + πr2 = = cylinder surface
circle area 90°
ISHRS Kuala Lumpur, October 10, 2014
Dr. med. Conradin von
ALBERTINI
B – Reducing the wound surface: Options
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Less grafts 1
Smaller punch diameter 2
ISHRS Kuala Lumpur, October 10, 2014
Dr. med. Conradin von
ALBERTINI
4 mm
1.2 mm
Smaller punch diameter: A classic
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- 35 % 16.2 mm2 10.6 mm2
0.8 mm
ISHRS Kuala Lumpur, October 10, 2014
Dr. med. Conradin von
ALBERTINI
A 3rd option for less donor damage ?
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Less grafts 1
Smaller punch diameter 2
Smaller depth ? 3
ISHRS Kuala Lumpur, October 10, 2014
Dr. med. Conradin von
ALBERTINI
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Source: Cole (2009)
2.3 mm
Minimal depth (e.g. PCID®) ISHRS Kuala Lumpur, October 10, 2014
4 mm
Full depth
Smaller depth : Minimal depth control
Dr. med. Conradin von
ALBERTINI
1.2 mm
4 mm
2.3 mm
Smaller depth
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- 40 %
ISHRS Kuala Lumpur, October 10, 2014
9.8 mm2
16.2 mm2
= Smaller wound surface
Dr. med. Conradin von
ALBERTINI
534 cm2
320 cm2
4.0 mm
2.3 mm
Giga FUE donor wound surface: 4000 FUs
Diameter: 1mm Depth:
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- 40 %
Dr. med. Conradin von
ALBERTINI
Equal above the bulge
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Histology:
ISHRS Kuala Lumpur, October 10, 2014
4.0 mm 2.3 mm
Dr. med. Conradin von
ALBERTINI
Less surface below the bulge
13 ISHRS Kuala Lumpur, October 10, 2014
Histology: 4.0 mm 2.3 mm
Dr. med. Conradin von
ALBERTINI
Intact “shiny layer”
14 ISHRS Kuala Lumpur, October 10, 2014
Macroscopic:
Dr. med. Conradin von
ALBERTINI
My conclusions
Do not underestimate the donor damage of Giga FUEs – e.g. limit grafts, wait > 4 months
15 ISHRS Kuala Lumpur, October 10, 2014
Minimal depth control = helps not only to avoid transaction, but may also further reduce the donor wound in FUEs
A
B
Dr. med. Conradin von
ALBERTINI
Dr. med. Conradin von
ALBERTINI
Is the Fruit Hanging Low ?
‚Minimal Depth Control‘ to Prevent FUE Donor Damage
Conradin von Albertini, MD