The final stage of a hair restoration procedure is the actual placement of the grafts into the recipient area of the scalp, which Dr. Gabel oversees and helps to perform personally. Once the donor hairs are properly trimmed using stereo-microscopes, they are categorized into the 1-hair, 2-hair, 3-hair, and 4-hair follicular units. The follicular units are held in a specialized solution called HypoThermosol biopreservative which has shown to increase the survivability of the grafts. Grafts are further maintained at an appropriate temperature, around eight degrees Celsius, which has also been shown scientifically to improve the longevity of the follicular units.
Dr. Gabel and his staff at the Gabel Center use specialized loupe magnification that has been custom fit for each of his staff for use during graft placement. This high magnification allows Dr. Gabel and his placing team to easily visualize the grafts for proper grasping, and to also easily visualize the graft openings for a smooth, non-traumatic insertion of the graft. If the grafts are damaged during placement, they may not grow, making this delicate process crucial to the final outcome of a procedure.
Although most hair restoration physicians do not place grafts, Dr. Gabel is always involved throughout the entire procedure, placing grafts with his highly trained and experienced staff and monitoring graft placement progress. Dr. Gabel and his staff also each use specialized 0.12 mm tipped forceps, which allows for them to be absolutely precise with the handling of grafts and avoid trauma while placing the grafts into the sites.
In the creation of a frontal hairline, the finer 1-haired follicular unit grafts are placed, followed by the thicker 1-haired follicular unit grafts. Approximately 1-cm behind the hairline, the 2-haired follicular units are place, and in the central tuft, the larger 3-hair/4-hair follicular units are placed. This technique allows the hairline to develop in a gradient fashion, which is what ultimately gives the most natural appearance to the frontal hairline, and provides the greatest appearance of density for the scalp.
Graft placement is a surgical technique that must be carried out with extreme precision and accuracy to achieve the best results. It requires an individual with years of experience to do it correctly or risk graft damage and poor growth.