Hair transplantation. The use of hairbearing compound grafts for correction of alopecia due to chronic discoid lupus erythematosus, traumatic alopecia, and male pattern baldness.

In this study 8 patients with alopecia due to chronic discoid lupus erythematosus (CDLE), 10 patients with traumatic alopecia (TA), and 12 patients with male pattern baldness (MPB) were treated with the punch graft method (PGM). Stastistical evaluations of the results and factors influencing the results were careied out. The mean survival rate of hairs was 72% in CDLE, 97% in TA, and 104% in MPB. The mean number of hairs in a 4 mm graft before transplantation in 30 patients and 752 grafts was found to be 18.2. This is far more than the number reported in previous publications concerning PGM owing probably to the difficulties of counting several hairs simultaneously emerging from the same pilary canal when the hair is cut to a length of 1--2mm preoperatively. For this purpose the author has developed a special photographical magnifying system. The number of hairs surviving transplantation in MPB in a 4 mm graft was about 19 hairs per graft, which is superior to previous reports. This is possibly due to some modifications of the procedure made by the author. In a control series done with the same technique as that often seen in the literature, about 50% inferior results were obtained. These results were however similar to those reported in the literature. Consequently the modifications of the procedure have been successful. Only one article with a series of 12 patients with TA treated with PGM was found in the literature. The hair survival results of the author exeeded the reported results by about 100%. The size, hardness, and elevation of the scars of the donor holes were checked statistically after various treatments. It was found that the diameter of the scar is the same regardless of type of treatment but that a signifcantly greater risk of hard and elevated scars is taken if the bald grafts are put back in the donor holes. No complications were seen in this series. PGM is a safe method that gives good hair survival results on transplanted hairs in MPB and TA, but the results vary in CDLE. In spite of the good results with PGM the author emphasizes that, although the therory of the method is simple, both the preoperative judement and the performance with its practical difficulties and many cosmetic problems is complex and requires a lot of psychological insight, practice and experience before correct preoperative judgement and a maximally good cosmetic result can be achieved.