There are 3 main instances in which a graft warrants removal: When they are misplaced, when increased hair loss exposes them further, or when grafts are pitted/ prominent. In this presentation, we explore the removal techniques as well as the most common risks associated with each. Particular attention will be given to the Micro-incisional technique, and advanced technique for graft removal that decreases the chance of re-growth of hairs in the original removal site while also limiting the incidence of scarring.

1. Paul T. Rose , MD JD
Bernie Nusbaum, MD

2.  None

3.  Misplaced grafts
 Increased hair loss exposing grafts
 Pitted grafts/prominent grafts

4.  En bloc excision
 Punch removal
 Hand held punch or mechanized device

5.  Transection- inability to account for hair
angles
 Burying of graft
 Inability to remove due to tethering/scarring

7.  Use of custom made blades
 Blades can be cut to size attached to various
blade holders
 Depth can be set
 The incisions are directed AWAY from the
hairs
 Three to four incisions are made-these may
need to be joined, triangular or
square/rectangular wound

8.  Graft is lifted with forceps – at times two are
needed
 The blade can be inserted into the space
created to cut any fibrous strands
 Wound is allowed to heal via second intention
healing

14.  Decreased rate of transection- more hairs for
location to other sites
 Less chance of re-growth of hairs in at
original graft removal site
 Small wounds-limited scarring, second
intention helaing