Hair Transplant Surgery - Scientific Papers

ULTRAFINE SINGLE HAIRS
TO CREATE A REALLY NATURAL HAIRLINE
5 YEARS EXPERIENCE

Antonio Ruston M.D.

INTRODUCTION: The obligation of any surgeon performing hair transplants is always to create the most natural results. To do this, we must be creative, perfectionistic and knowledgeable of all available techniques. One of the greatest challenges is achieving a really natural looking hairline. The correct distribution of single hairs is not enough to achieve this. We must also use the correct type of hair to create a natural, degradee and “feathery” aspect of the very first lines and the only type of hair that makes this possible is “ultrafine single hairs”, a term the author has coined to describe the finest single hairs taken from the donor area.

OBJECTIVE: In this presentation, the author will discuss “ultrafine single hairs”. He will explain what they are, how they can be obtained, how they should be transplanted and distributed and most importantly why they should be used.

MATERIALS AND/OR METHODS: We have observed even in patients with the thickest hair that there is at least a small number (from 8 to 15 % of the total amount of single hairs) of very fine single hairs distributed randomly in the main donor area. This, of course, varies from patient to patient and depends on the type of hair. Patients with thick, course hair tend to have fewer ultrafines than those with thin, fine hair. However, all patients have some ultrafines.

In the last four years we have introduced to all of our patients the practice of separating these ultrafines from the others to transplant to the very front lines in order to imitate nature and create that natural , degrade and “feathery” aspect of the very first lines.

It is very important to know how to distinguish between a regular single hair of average thickness, a medium single and an ultrafine hair which is considerably finer. Here below you can see three types of single hairs taken from the same patient. Note the difference in thickness among them. The very finest hairs are the ultrafines, the second we call “ medium fine” and the third we call regular single.

There are basically two different strategies for distributing the ultrafine single hairs, depending on the number available. First, if the triangle front line design is used, the ultrafines must be transplanted to the most external line. If there are not enough ultrafines to fill the entire external line, we use them just on the tips of the triangles, which are the most visible areas.

We have been using the medium fines to fill the internal triangles and regular singles for the base.
Second, if a triangle design is not used, for example, when there is still some hair remaining in the frontal area, we randomly distribute the ultrafines in front of the first hair line already transplanted at the end of the procedure. In this case they are usually the last hairs to be transplanted so it is vital that they be carefully preserved in saline solution throughout the procedure.

DISCUSSION/RESULTS: Since initiating this practice, we have noticed considerable improvement in the front lines, even in patients with very thick, course and dark hair.
With this small refinement we had a huge improvement in our hairlines. The front lines acquire the “feathery” appearance found in a natural hairline.

CONCLUSION: The use of ultrafine single hairs in the front lines is highly recommended for creating a really natural appearance. This is especially true for patients with thick, course and dark hair.