{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,7,20]],"date-time":"2022-07-20T08:40:09Z","timestamp":1658306409642},"reference-count":18,"publisher":"Georg Thieme Verlag KG","issue":"03","license":[{"start":{"date-parts":[[2019,8,26]],"date-time":"2019-08-26T00:00:00Z","timestamp":1566777600000},"content-version":"vor","delay-in-days":1089,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Indian J Plast Surg"],"published-print":{"date-parts":[[2016,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Follicular unit extraction (FUE) is one of the widely practiced minimally invasive follicular harvesting techniques employed during hair transplantation. FUE technique has an advantage of utilising lower occipital area and supra-auricular region as a safe donor area described by Unger, in addition to the standard occipital donor area used in strip method (follicular unit transplant). Despite its potential advantages such as rapid recovery, minimal scarring and reduced post-operative pain; its widespread acceptance is limited due to various factors in variable contribution like steeper learning curve and potentially higher follicular transection rates (FTRs). The main practical drawbacks in harvesting FUE from lower occipital donor region that lie inferior to the standard donor area, is its acute angle (10\u00b0\u201315\u00b0) of emergent hair from scalp skin, higher variance angle (15\u00b0\u201335\u00b0) between hairs below the skin and hair exit angle above the skin and comparatively loose scalp, preventing to provide stable platform for punching. Hair transplant surgeon faces difficulty in aligning and engaging the FUE punch leading to very high hair follicle transection rate, and therefore, it is not a preferred site for harvesting follicles in FUE. Authors description of modified technique using reverse rake scalp elevator helps in negating the acute angle of the hair follicles exit from scalp skin and reducing the variance angle between emergent hair and hair below the skin in lower occipital region thereby reducing FTR. Furthermore, an added advantage of reducing the overall operative time and surgeon fatigue, improve donor area healing, availability of a comparatively larger donor area which increases the confidence of the beginners. This method will be of help as it is easy to duplicate and follow by novice hair transplant surgeons and also for those who are routinely doing mega hair transplants sessions.<\/jats:p>","DOI":"10.4103\/0970-0358.197227","type":"journal-article","created":{"date-parts":[[2016,12,30]],"date-time":"2016-12-30T11:01:46Z","timestamp":1483095706000},"page":"390-396","source":"Crossref","is-referenced-by-count":0,"title":["Innovative modified hair follicle harvesting technique with reverse rake scalp elevator for lower occipital donor area in follicular unit extraction hair transplantation"],"prefix":"10.1055","volume":"49","author":[{"given":"Chandrakant Rambhau","family":"Gharwade","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Grant Government Medical College and Sir J. J. Group of Hospitals, Mumbai, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2019,8,26]]},"reference":[{"key":"key-10.4103\/0970-0358.197227-1","first-page":"463","volume-title":"Autografts in alopecias and other selected dermatological conditions","author":"Orentreich","year":"1959","journal-title":"Ann NY Acad Sci"},{"key":"key-10.4103\/0970-0358.197227-2","first-page":"239","volume-title":"Delineating the safe donor area for hair transplanting","author":"Unger","year":"1994","journal-title":"J Am Acad Cosmet Surg"},{"key":"key-10.4103\/0970-0358.197227-3","first-page":"52","volume-title":"Hair loss.What causes it and what can be done about it","author":"Burke","year":"1989","journal-title":"Postgrad Med"},{"key":"key-10.4103\/0970-0358.197227-4","doi-asserted-by":"crossref","unstructured":"Bicknell LM, Kash N, Kavouspour C, Rashid RM. Follicular unit extraction hair transplant harvest: A review of current recommendations and future considerations. Dermatol Online J 2014;20. pii: Doj_21754.","DOI":"10.5070\/D3203021754"},{"key":"key-10.4103\/0970-0358.197227-5","first-page":"797","volume-title":"Current practices and controversies in cosmetic hair restoration","author":"Williams","year":"2013","journal-title":"Dermatol Surg"},{"key":"key-10.4103\/0970-0358.197227-6","unstructured":"Rassman WR, Bernstein R. Hair Loss and Replacement for Dummies. Indiana: Wiley Publish Inc.;2008. p. 201."},{"key":"key-10.4103\/0970-0358.197227-7","first-page":"76","volume-title":"Follicular unit extraction hair transplant","author":"Dua","year":"2010","journal-title":"J Cutan Aesthet Surg","ISSN":"http:\/\/id.crossref.org\/issn\/0974-2077","issn-type":"print"},{"key":"key-10.4103\/0970-0358.197227-8","first-page":"162","volume-title":"The safe system: New instrumentation and methodology to improve follicular unit extraction (FUE)","author":"Harris","year":"2004","journal-title":"Hair Transplant Forum Int"},{"key":"key-10.4103\/0970-0358.197227-9","first-page":"97","volume-title":"FUE Megassions: Evolution of a technique","author":"Bernstein","year":"2004","journal-title":"Hair Transplant Forum Int"},{"key":"key-10.4103\/0970-0358.197227-10","doi-asserted-by":"crossref","unstructured":"Rassman W, Pak J, Kim J (2016) Follicular Unit Extraction: Evolution of a Technology. 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London: Informa Healthcare; 2011, p. 291-6."},{"key":"key-10.4103\/0970-0358.197227-12","first-page":"337","volume-title":"Donor hair follicle preservation by partial follicular unit extraction.A method to optimize hair transplantation","author":"Gho","year":"2010","journal-title":"J Dermatolog Treat"},{"key":"key-10.4103\/0970-0358.197227-13","first-page":"233","volume-title":"The donor area","author":"Knudsen","year":"2004","journal-title":"Facial Plast Surg Clin North Am"},{"key":"key-10.4103\/0970-0358.197227-14","first-page":"306","volume-title":"Micrografting in extensive quantities.The ideal hair restoration procedure","author":"Rassman","year":"1995","journal-title":"Dermatol Surg"},{"key":"key-10.4103\/0970-0358.197227-15","unstructured":"Barusco MN. The no shave technique for FUE. Hair Transplant 360 Degree Vol. 3. New Delhi: Jaypee Brothers Medical Publishers ltd.; 2014. p. 238."},{"key":"key-10.4103\/0970-0358.197227-16","unstructured":"Zontos G. How the Outgrowth Angle of the Hair Follicles Influences the Donor Area Injury Using FUE \u2013 A Mathematical Approach to the Problem. Available from: http:\/\/www.haarklinikken.dk\/cgi-files\/mdmgfx\/file-896-418802-25165.pdf. [Last accessed on 2014 Oct]."},{"key":"key-10.4103\/0970-0358.197227-17","doi-asserted-by":"crossref","unstructured":"Bertram NG, Damkemg P. Follicular unit extraction: Experience in Chinese population. Hair Transplant Forum Int 2009;19:14. Available from: http:\/\/www.forhair.com\/pdfs\/CIT%20 info.pdf. 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