의느님답변📂ㅣ의느님답변 68회 포셉 슬릿은 수술시간이 오래 걸려서 간호사이식을 해야만 생착률을 높일 수 있다던데?

Hello, I’m Doctor Jaehyun Park at Dana Plastic Surgery. Today a patient who visited our hospital asked me Dr. Park, I want to get a hair transplant using the slit method but I heard that the slit method takes a long time And so, if the nurses don’t do the implant, it will be difficult. But I want a doctor performing the implant, is it possible?

I get similar questions like this and to make everything clear I would like to talk about this in detail. First of all, I will talk about the implant time. The amount of time a hair follicle has been outside the body Is called time out of body (TOB). For any kinds of transplant, it is better if the TOB is short as possible.

Bone, skin, liver, heart, kidney, and all the other transplants are included which is the fundamental proposition. So people might say that the longer the surgery the more devoted the doctor is towards the surgery. And if the time of the surgery is short, they might think that the doctor was not as devoted to the surgery.

This is not true. The shorter the time of surgery the better. Therefore the doctors around the world are trying to shorten this TOB through extensive research. Now I will talk about the typical method and the difference in time of each transplant method.

The doctor does the implant in the case of rainbow hair implanter. I will tell you the difference of each method using 3000 grafts as the standard. In the case of the rainbow hair implanter, the doctor is transplanting about 3000 grafts which is about 1500 hair follicles It will take approximately 1~2 hours, which

is not the whole process of hair transplant. It also depends on the doctor and the team’s workmanship And the type of scalp the patient has. But usually, it will take 12 hours for the implant. For the DNI (Dull needle implanter) it will take about 3040 minutes for making a slit When it’s 1500 hair follicles. And about

12 hours for the transplant if the doctor does it in person. In conclusion, it will take 3040 more minutes than the rainbow hair implanter. Because it takes that much longer to make the slit. Just like the rainbow hair implanter, the slit and implant process is all done by the doctor.

Forceps slit is a method of using the forceps to put in the grafts. And this method will take about 30 minutes for the slit And for the implant it will take about 3~4 hours. In other words, the rainbow hair implanter has the shortest surgery time. But it is possible to make a slit while pulling out the hair follicle.

Then it will shorten the time of TOB while making the slit. So in reality, there won’t be a big difference in time between the DNI and the rainbow hair implanter. Then does the implant time affect the survival rate of the hair follicles? I mentioned it on my previous videos. Doctor Limmer has reviewed and presented about this topic

and said that the survival rate will not be affected if the time is less than 6 hours. Generally, the rule of thumb is that 1 hour will decrease about 1% of the survival rate And this isn’t an exact data but the doctor’s in the field of hair transplant all agree that

The hair follicle of FUE method is a little weaker than the FUT method. That is why there needs to be an effort to reduce the TOB when using the FUE method and to find the fastest method possible. And this is the reason why the forceps method is not being used often And is changing to the DNI or the rainbow hair implanter.

Then is there a way to keep the survival rate while the time of surgery increases? There is a way. What kind of effort do we put in for this? If the hair follicle goes down below 0 degrees Celsius, a crystal will form which is not good for the hair. So keeping the temperature at 4℃

will increase the survival rate. Additionally, using a Hypothermosol solution is better than using a typical saline solution. our hospital also uses this hypothermosol solution and have used it for a long time. This hypothermosol solution is also used for transplanting the liver, heart, kidney

which keeps the cells alive outside the body for a long period of time. And of course, we are implementing this in our hospital. We have been using this for a very long time And I can’t even remember how long it has been. Hair transplant surgery takes a very long time and requires a lot of patience and is a labor intensive work.

Since the surgery time is so long How is it possible for only one person to do the surgery? Doesn’t the nurse have to do some of the process? Isn’t it impossible for the doctor to do it by himself? They ask me these questions frequently And I want to tell you that this is not true.

Since the surgery time is too long, how does the doctor do it alone? Isn’t it too strenuous? Won’t the concentration and endurance decrease which will make bad results? Therefore, the nurses have to do some part of the process? No, I don’t think that is correct. If the doctor is doing the surgery and it takes too long

it is fine if an expert helps, What I’m saying is that a nurse performing the surgery is not right. So, it is correct that the time of the surgery is long. And it is correct that it is difficult to do it alone. And if someone helps in some cases the result turns out well. But I’m pointing out the fact that it is not right

if the person who is helping is a nurse. That is why we need a doctor who is properly trained with the right knowledge and skills who can help to get the best results. To sum up, the rainbow hair implanter has an advantage because it has the shortest surgery time.

DNI is also fast and the forceps method has the longest surgery time. Therefore it will be better to use a faster method than the forceps method. And in order to withstand the surgery time we store it in 4℃ or other efforts in order to increase the survival rate. If we don’t put in these efforts does it make a big fuss? I can’t tell you for sure

But isn’t it better to put in every effort possible? And also, the false fact about the longer the surgery the better. The faster the hair follicle is implanted the better, and to shorten the TOB as much as possible for the best result. If it is too labor intensive, you could make a system where another doctor helps out with the surgery for better results.

Hair transplant surgery is an extremely labor-intensive work which requires endurance and patience. That is why the dissection of the hair follicle is done by the nurse. Then you may ask why is it okay for the nurse to do the dissection? In an ordinary surgery room, there is the residents and nurses who will help the doctor, but it’s like saying only the doctor is allowed in the surgery room.

there is a consensus among many doctors in other medical practices. And it doesn’t matter if the nurses do it if it’s a standardized process, However, the process of transplanting the hair follicle is not included. It is the main part of the surgery which the doctors should do. And if the result of the surgery is the same whether if it’s the nurse or the doctor you can say that again.

But there are other medical judgments that have to be made which will cause changes in the process. I will talk about this in more detail in the next video. There are both bright and dark sides in all kinds of surgeries. I'm going to talk about the bright and dark side of hair transplant.