"Patients who already have Old Style grafts may want to take advantage of mini and micrografting, to enhance their hairline. Micrografts are especially effective for creating a more natural-looking diffuse hairline, even for those who had Old Style grafts placed years ago."

Old Style Graft Hair Transplants What they are | Benefits | Risks | Candidates What Old Style Grafts Are: 7-15 hairs: Old Style grafts are circular pieces of scalp containing from 7-15 hair follicles. They are the old-fashioned technique, and when used today are almost always combined with smaller minigrafts and micrografts. Since the 1970's through the 1980's hair transplantation with Old Style grafts, or "plugs" as they are commonly referred to, was the standard method of surgical hair restoration. Presently most hair transplantation is accomplished with minigrafts and micrografts alone, however Old Style grafts are still used in some procedures to achieve maximum hair density. Dr. Panagotacos uses Old Style grafts to create maximum density, allowing the hair to be cut short or to be worn long and combed straight back: Before After Old Style graft procedures Hairline close-up Another hairline close-up Maximum yield: Old Style grafts range in size from 4-5 mm wide, which is about the size of a small split-pea. Punch grafts smaller than this size range tend to have a lower overall survival rate, while the follicles in the center of grafts larger than this range sometimes fail to grow. The 4mm size punch graft has been determined to be the size that allows for the maximum yield of transplanted follicles, for Old Style grafting procedures. Old Style grafts performed by Dr. Panagotacos About three weeks after surgery Six months after Show both enlargements at the same time (216k) 50-100 grafts: In a typical Old Style graft procedure, about 50-100 grafts are placed. The quantity placed in a single session depends upon the size of the grafts, the area requiring coverage, and various characteristics of the patient. Adequate space must be allowed between the new grafts, or some of the grafts may not survive. The spaces between the grafts may make the grafts appear unnatural, like "dolls hair", until additional sessions with more grafts fill in the spaces. Today this procedure is rarely performed without also doing mingrafts and micrografts at the same time. Dr. Peter Panagotacos plans each procedure with consideration for how his patients will look far into the future. These photos illustrate the original hair transplantation technique used since the late 1950's. Despite the superior hair density achieved with Old Style grafts after all procedures are done, full size grafting is rarely performed today: About 2 weeks after the first Old Style graft procedure 10 years after Circular punch: Old Style grafts are typically harvested with a circular punch, one graft at a time. The hair follicles selected for transplantation are located on the back and sides of the head, because these hair follicles tend to continue to produce full size hairs over a person's lifetime. Old Style Grafts: Old Style grafts were state-of-the-art up until the 1980's, and required four sessions to complete. The main benefit of hair transplantation with Old Style grafts is safe and effective achievement of excellent hair density. For example, in just 3 Old Style graft sessions, a "brick wall" hairline can be constructed for those patients who prefer an extremely solid-looking hairline, in contrast to the gradually increased density of a hairline zone created entirely with micrografts. Usually however, procedures performed with Old Style grafts are combined with micrografts. The micrografts are used to create a natural-looking hairline zone with gradually increasing hair density, and the Old Style grafts are used on top to achieve a "solid head of hair" look. Old Style grafts combined with mini and micrografts performed by Dr. Panagotacos. About a week after surgery 11 months after Risks of Old Style Grafts: Unnatural appearance: Among the biggest concerns of those having Old Style graft procedures is the unnatural appearance one has following surgery. The individual grafts can be quite noticeable before they heal. Bandages, crusts from dried blood, and sometimes visible wounds with sutures can affect the patient's appearance for several days, to more than two weeks after the procedure. "Under construction": Even after the grafts have healed, the first few sets of Old Style grafts may result in an "under construction" appearance. There will be spaces between the individual grafts until additional procedures fill in the spaces with more Old Style grafts. The "dolls hair" look commonly associated with Old Style grafts is typical only of the initial stages of the treatment process. Full size grafts in particular will have an unnatural "pluggy" appearance if too large an area is attempted to be covered with inadequate donor follicles, or if the recommended number of sessions is not accomplished. When the entire set of procedures is accomplished, Old Style grafts are difficult to identify, even upon very close inspection. Patients who had all four sets of procedures done by Dr. Panagotacos in the 1970's still look good today. Limited results: Only limited results are possible with Old Style graft procedures, because no new hair is added. The goal of Old Style graft procedures, like all surgical treatments for hair loss, is only to create the illusion of having more hair. Additional procedures: Old Style graft transplant procedures typically were four sessions, three months apart, taking a full year to complete. Hair loss continues: Old Style graft procedures have no effect on one's genetic program for losing hair. After a hair transplant, hair loss due to inherited genetics will continue, and continued loss of hair may cause dense hair to become thin. Depending upon the design of the transplant procedure and the pattern of loss, further hair loss may eventually result in unnatural appearing "islands" of dense hair surrounded by thin areas. Candidates Past Transplant Enhancements: People who had Old Style grafts performed in the past may desire additional grafts to add density to thin areas. Follicular Unit grafts can be used to enhance past Old Style graft hair transplants. Adequate health: Adequate health for surgery is required, with no conditions restricting surgery such as pregnancy or severe cardiovascular problems. Realistic expectations: Candidates must have realistic expectations for the results achievable with Old Style graft procedures. Follow through: They must be motivated to follow through with the entire set of procedures recommended, if more than one procedure is indicated, and to carefully follow the surgeon's instructions for care after each surgery. Dense, curly hair: Those with dense hair along the sides and back will achieve a greater visual impact than those with less dense donor hair. Curly hair will generally appear denser than straight hair. Not scar readily: Those with skin that does not scar readily with surgery, or form bumps, will have better cosmetic results than those who do.