There are many closure techniques used by skilled hair transplant surgeons in strip harvesting hair transplant surgery for a minimal hair transplant scar. These include closure techniques such as sutures, staples and tricophytic closure to name a few. In Strip Harvesting, a strip of skin is removed from the back of the scalp (called the donor area), the follicular units are then dissected into individual follicular grafts, and then those grafts are transplanted to the recipient (balding) area. One area of the surgery process that is often discussed is the closure technique after the strip is removed, as well as the hair transplant scar that it will leave behind later on. The closure technique and the scarring are synonymous as the technique used for the closure is crucial to how minimal the scarring will be on the back of the scalp.
The debate about which technique is the best depends on the surgeon and the clinic. At Beverly Hills Hair Restoration, our surgeons have adopted both suturing and trichophytic closures for the back of the scalp. Suturing is optimal compared to staples because with sutures, they lay flat on the scalp so after the procedure, it is more comfortable for the patient when laying down at a 90 degree angle as the incision and recipient area heals. Staples are not intended to lay flat on the scalp and some of our patients have expressed that they are uncomfortable and even painful. Surgeons use staples because they are much easier and quicker than sutures. And while sutures are typically not ideal for large incisions, this technique is very beneficial for smaller wounds, such as with strip harvesting hair transplants.
Trichophytic closure is another technique for strip harvesting and a minimal hair transplant scar. In this technique, it involves overlapping the edges of the incision where one side of the skin is cut at an angle and then the other adjacent flaps are brought together to close the wound. So the skin flaps lie underneath each other, allowing the hair follicles grow through the wound to cover scarring of the incision. Tricho is a great option for patients who are ideal for strip harvest but also want the option of wearing their hair really short. With Trichophytic closure, the challenge of the technique is as much about the skill of the surgeon as it is about the elasticity of the patient's skin and if it is the right technique for the patient. Tricho closure is not ideal for every single person, so it's important the surgeon determines this first. Overall, no technique is necessarily "the best" since it all depends on what is best for the patient. At our Los Angeles clinic, we offer both suture closure and trichophytic closure for our patients.