RHOMBOID MINIGRAFTS IN HAIR RESTORATION SURGERY

BACKGROUND. The transplantation of large numbers of three- to five-hai r minigrafts has superseded the use of traditional punch grafts in hai r restoration surgery. The minigrafts are usually designed and cut in a square or rectangular shape for implantation into the recipient slit s. Transplanting a large number of these grafts into the recipient sli ts can lead to a high frequency of complications, especially in cases in which there is a need for dense packing of grafts. The complication s include excess graft compression resulting in extrusion or retractio n into the slit. This in turn can lead to piggybacking or insertion of two grafts per slit with the resultant effect of cyst formation, cobb lestoning, and hypertrophic scar formation. OBJECTIVE. TO develop an o ptimal shape of minigrafts to match the recipient slits. METHODS. The authors have calculated the optimum geometric configuration for a mini graft in a linear slit and have developed the correct cutting instrume nt and preparation technique for its production. This rhomboid minigra ft design maximizes the graft stability in the slit and therefore its survival, and also minimizes the risk of complications. RESULTS. The d escribed technique shows that the transplanted rhomboid minigrafts rem ain well anchored in the recipient slits and results in an excellent c linical outcome. CONCLUSION. The rhomboid minigrafting technique (1.5 x 1.5 mm in size) seems to accommodate the grafts better into the reci pient slits than the standard shape rectangular minigrafts. It thereby better facilitates the insertion of the grafts in the slits and reduc es the frequency of graft extrusion as well as graft compression. (C) 1998 by the American Society for Dermatologic Surgery, Inc.