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Face Lift and Hair Transplantation as a Single Procedure

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Frequently, when a face lift procedure is performed, several pieces of healthy scalp are discarded as waste unless a pre-hairline incision is used.

In selected cases, such as patients with hair loss, these pieces of scalp may be used to create micrografts (grafts with I to 2 hairs) and minigrafts (grafts with 3 to 4 hairs) and transplanted to the areas of need in the same session.

Over the past several years, as I have become more familiar and efficient with the use of micrografts and minigrafts, I have been combining hair transplantation with various other aesthetic procedures, such as rhinoplasty, blepharoplasty, otoplasty, CO, laser resurfacing, and face lifts.

I have found this to be very rewarding, particularly the combination of face lift and hair transplantation, because patients who need both procedures benefit immensely by having them done together. This way, the pieces of healthy scalp that normally would have gone to waste are recycled, making micrografts and minigrafts and then transplanting them immediately to the areas of need. These patients would have otherwise ended up with a somewhat depleted, more limited, or insufficient donor scalp to undergo hair transplantation at a later date.

Orentreich described “the donor dominance" concept, which is key for successful hair transplantation. He states basically that each hair follicle contains its own unique genetic makeup. When transplanted to another site, its original genetic properties are preserved regardless of the transplantation site (enabling the hair to grow at the recipient area for as long as it was going to do so at the site of origin). This is a most encouraging finding.

The occipital area is the most desirable donor site for hair transplantation (as it usually is genetically programmed to grow hair for a lifetime); it is also precisely the main area of scalp to be discarded during a face lift. When appropriate and if feasible, we must recycle it.

Scalp from the temporal areas can also be used, because it, too, is genetically favorable for transplantation.

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