Lateral Incisions with Sapphire and Density

  1. If you have a lot of 2-3 hair in grafts, this method will give you the impression that you have more hair.lateral slit
  2. This technique can be used on Norwood 5 (for crown and top of head) and above.

What Are The disadvantages of Lateral Incisions with Sapphire?

Lateral incisions have demonstrated advantages but there are also some disadvantages.

  1. The technique itself is considered to be “counter intuitive”. The procedure does not come naturally to hair transplant surgeons that are used to creating sagittal incisions thus the learning curve is more steep.
  2. The potential for unnecessary trauma is greater than with sagittal incisions. Lateral incisions cut more blood vessels during the recipient site creation stage of a hair transplant and when inexperienced hands attempt dense packing excessive trauma to the recipient scalp can develop with some cases resulting in isolated necrotic formation.
  3. Density is achieved through dense packing and not through the number of hairs. Top lateral incisions practioners will sometimes sub-divide the grafts from three and four hair grafts down to single and double hair grafts. This allows for smaller incisions which helps naturalness but it means incisions must be placed closer together. This can lead to increased trauma and potential for infection. When performed properly the density is very natural but the graft count to achieve this density is elevated artificially.

lateral sagittal slit

What Are The Advantages of Lateral Incisions with Sapphire?

Some of the advantages of lateral incisions are:

  1. Some have argued that because of the more shallow nature of the incision made with lateral incisions compared to sagittal incisions that even with additional blood vessel damage the incision is more shallow thus the trauma is avoided.
  2. Better coverage over a given area compared to sagittal incisions due to the “shingling effect” that is created by the nature of the incision. Part of this coverage is also achieved by modifying each multi-hair follicular unit. When follicular units are harvested, via FUE , they can be round or oval in shape. By dissecting one side of the follicular unit the tissue spreads out and appears to be more rectangular in shape. This allows for a better fit into the incision and allows for a more natural appearance.
  3. The shallow nature of the incision can allow for the potential for slightly more natural results with less recipient site scar formation.

How many grafts should be the ideal density per square centimeter in hair transplantation?

shingled methodeThe ideal frequency in hair transplantation is to place a maximum of 40-50 follicular units per square centimeter. (In the congress organized by the European Hair Surgery Association in Brussels in June 2005, it was stated that hair follicle loss may occur at frequencies above this number.) We inject physiological saline under the scalp. In this way, more swollen scalp. Afterwards, it provides us the opportunity to make more hair transplantation in a narrower area.
Shingled Pattern incisions can be see more density too. We are using a shingled below pattern.

Dr.Caymaz's Pattern
Dr.Caymaz’s Pattern like this


Both Pattern (Shingled-Random Composed)





August 2020

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