14615 San Pedro Ave, Suite 210
San Antonio, Texas 78232
“A Long (Hair) Day”
A Day of Long Hair Follicular Unit Transplantation with Dr. Marcelo Pitchon
THE PITCHON METHOD
On February 4, 2008 , a group of hair restoration surgeons gathered in the Limmer Hair Transplant Clinic inSan Antonio to observe a full frontal restoration done by Dr. Marcelo Pitchon of Belo Horizonte, Brazil. Assisting Dr. Pitchon were his personal assistants Lourdes Souza and Luciano Angelo, and Dr. Limmer’s staff of Carole Limmer and Zhuling Reiter and Mary Ann Parsley of Dr. Bill Parsley’s staff. Attending the procedure and observing were Dr. Bill and Mary Ann Parsley and Dr. Mark Waldman Louisville, Kentucky, Dr. John and Marilynne Gillepsie of Calgary, Alberta , Dr. Jorge O’Campo Candiani of Monterrey, Mexico, Dr. Robert Haber of Cleveland, Ohio, Dr. Marc Avram and Dr. Nicole Rogers of New York City, New York, Dr. Dow Stough of Hot Springs, Arkansas, Dr. Walter Unger of Toronto, Ontario, Dr. Jerry Cooley of Charlotte, North Carolina, and Drs. Bobby and Bradley Limmer of San Antonio, Texas.
The group of doctors and technicians overseeing the case
Just moments before we got started....
Long hair restoration using plugs and minigrafts was described by Dr. Pierre Bohanna of Paris, France
, in 1989. During the plug and minigraft era (1958-1988) the long hair method did not gain a large popularity. In 2004, Dr. Marcelo Pitchon of Belo Horizonte, Brazil
, who had been doing follicular unit transplantation since visiting Dr. Limmer in 1992, began to leave the hair untrimmed during donor harvest and transplantation thereby giving the patient and physician both an immediate “preview” of how the transplant results are expected to look some 12-24 months later. Dr. Pitchon discovered that the patients not only accepted the immediate “preview” but did so very enthusiastically and generally incorporated their friends and relatives into their own enthusiasm, frequently resulting in consultations shortly thereafter.
Dr. Pitchon feels that there are major advantages to leaving the hair long. The first and most obvious is the positive reaction to the visual change and the enthusiastic acceptance of the “preview”. Secondly, the surgeon himself gets to view the results as he does the procedure which assists in the choice of distribution, density selection, and frequently reduces the number of grafts anticipated to accomplish a suitable cosmetic density and distribution. Harold’s total frontal restoration seen below required 1234 follicular unit grafts. Finally, the comparison of the results immediately postop and after regrowth to the same length gives both surgeon and patient some rough estimate of survival of the grafts placed.
The disadvantages of the procedure itself are perhaps less than one might anticipate. The technical handling of the grafts including dissection and implantation are very similar to standard follicular unit transplantation methods. Some additional assistant staffing is required (Dr. Pitchon works with 5 assistants.) Keeping the long hair shafts out of the way of the implanter is not as much of a problem as might be expected. Dr. Pitchon feels this aspect and other technical aspects work best using the stick and place method. Dr. Pitchon does all the implantation personally. The orientation of the graft and hair shaft is facilitated by having a single assistant place the graft in proper orientation on the glove of the implanter. To keep the hair shafts from becoming entangled, the grafts are placed in groupings of 10 in the holding solution with the hair shafts in parallel allowing groups of 10 to be picked up by the assistant and transferred to the implanter’s glove in groups of 10 or fewer, as desired. The grafts show little tendency to pull out during the procedure or during the healing process. Dr. Pitchon carefully washes the scalp and hair during and at the end of the procedure using an airbrush to gently spray cold saline and air dry as needed to keep a very clean surgical field. At the end of the procedure a standard blow dryer and wide tooth comb are used to dry and style the hair.
The one disadvantage to the patient is very obvious – it will be no secret to anyone that you have been transplanted for the first month after. This however may be much less problem than we as physicians suspect because the long hair covers the scalp and the placement sites thereby preventing the usual, even though typically minimal, micro-crusts and erythema visible in the usual short hair transplant. By the time the long hair is shed in 2-6 weeks, the tiny crusts and erythema have disappeared. From this prospective the long hair may disguise the procedure especially if other hair are present into which the newly transplanted hair can blend. The usual and customary shedding of hair shafts will still occur in the following 2-6 weeks and regrowth follow in the 3-12 months thereafter as is characteristic for all method of hair transplantation.