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Objectives: Whether they choose the FUE or FUT technique, the hair surgeons always aim to minimize as much as possible the scars left by the harvesting process and select the most appropriate procedure for their patient. Sometimes, the best solution can be to combine both techniques.

Introduction: Although the FUE procedure is often presented as the "less invasive" harvesting surgery, macrophotography data has shown that it is, in fact, "more invasiveinvasive" than the FUT technique.

Materials / method: Mathematically, it is easy to compare the round scars of 1,000 x 1 mm left by the FUE procedure with the linear scar of 12 cm x 1 mm left by the FUT strip excision. Indeed, they allow harvesting the same number of grafts and macrophotography makes it possible to compare both scar areas.

Results: The results show that the FUE procedure leaves a scar area that is approximately 7 times bigger than the FUT one.

Conclusion: The mathematical approach is more and more used to evaluate the precise number of grafts that needs to be harvested now and in the future (according to the baldness expected evolution) with the least visible sequalae possible.

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Objectives: Introducing trichoscopy in the field of hair transplantation

Introduction: In recent years, the importance of trichoscopy in the diagnosis and follow up of hair diseases is definitely established.
In the field of hair transplantation (HT) trichoscopy can help hair surgeons before and after HT.

Materials / method: n this short presentation, we will successively discuss each of these benefits of trichoscopy and present some practical clinical cases.

Results: Before HT, it allows for the diagnosis of any hair diseases that may be a contra indication to HT (skin cancer, Alopecia Areata, Folliculitis decalvans, Nonstabilized Trichotillomania etc..), or on which there is not enough data in medical literature to guarantee a successful HT (Frontal Fibrosing Alopecia, Lichen PlanoPilaris, Cicatricial Central Centrifugal Alopecia etc...). Using sophisticated trichoscopic software, trichoscopy allow us global estimation of the number of grafts necessary to obtain a good aesthetic result
After HT, trichoscopy is useful in monitoring graft vitality

Conclusion: Like the preanesthetic consultation before surgery, the trichoscopic assessment before hair transplantation seems to be essential.

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Objectives: The most important stigma for a successful hair transplantation surgery is that no one will notice that this hair is a transplanted hair. Hence the naturalness of the operation is of utmost importance. Most important stigma for this naturalness is the natural hair line design.

Introduction: Hair line is not a line , it is rather a zone. This zone shape , location , feathering and being inconspicious need both artistic and scientific background. Hair line shape and location should take its time and be revised with the patient and all attendants several times before it is settled. Then during the implantation procedure the surgeon will use his artistic talent to create gradual and irregular appearance with special care for the direction.

Materials / method: The techniques for creating a suitable hair line will be explained in details with illustrating videos.

Results: The results of a properly designed and executed hair line during hair transplantation surgery cannot be ignored, it is on of the most important steps in a successful hair transplantation surgery.

Conclusion: One should take the design and execution of the hair line seriously durring hair transplantation surgery so the patient will be more satisfied.

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Objectives: Objectives:
As FUE is getting popular with every passing day, more and more types of punches are coming in the market. It is difficult for the doctors to choose between them. Most of the punches are promoted by the doctors who have a conflict of interest with one kind of punch. So as an unbiased and having no conflict of interest we thought lets determine the difference between the grafts yields using three different types of punches namely, sharp, serrated and blunt. There are other punches as well but we did not use them for this study.

Introduction: This was a prospective, randomized, study. Only the patients undergoing 1st session of strip harvest were included. The donor area was marked in sitting position. Three rows of 5 boxes were made on the occipital aspect of scalp with in safe donor area.
The row of selection for the type of punch was selected randomly, so that the area bias can be removed. Each horizontal row of 5 boxes were then harvested by same surgeon using one type of punch. The surgeon was familiar with all three different types of punches and had no personal preferences of the surgeon.

Materials / method: 3.5 magnification loupes were used to harvest each box. Although only three types of punches were used, but the surgeon was aware of other types of punches, namely funnel, flat punch etc.
these grafts harvested were then looked for transactions of hairs rather the transactions of grafts.
We only calculated the hair transactions as oppose to grafts transactions. Whether the graft had a total or partial transaction was not calculated but all hairs were counted and then the roots were seen for transactions. A partial transaction of 1 out of three hair graft was considered as one hair transaction

Results: In all 5 areas of harvest blunt punch had the maximum yield of hair per follicular unit. On an average blunt punch had the least transactions in total. The sharp punch had the maximum number of transactions and least yield of hair per follicular unit.
This clearly shows that a blunt punch is more forgiving in nature. The difference between the blunt and serrated was not significant. The central part of the scalp usually used for studies had less graft transactions as compare to the sides. This is usually due to the acute angle of exit from the skin and change in the skin character

Conclusion: So most studies showing the transactions are not true reflection of transaction rate, due to the non inclusion of these extreme areas. We did not calculate the fatigue factor on transaction rate when doing more than 2000 grafts surgery. This is an area which we will do a study by next year and publish our data.
in general, the punches with sharp edges on outer side, or a blunt punch, or a flat punch with outer rim as sharp are safer.

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