Sagittal vs. Coronal Incisions

Although coronal vs. sagittal incisions have been discussed over the years, there still are no definitive conclusions. Let us consider two aspects.

First, let's talk about the appearance of the results of the coronal vs. sagittal slits. The use of coronal incisions makes most sense only in areas where one can clearly see the hair's root. When viewing someone face-to-face one is able to clearly see the hairline, along with the hair's roots.

This is the part of the scalp where it makes most sense to use coronal incisions. When viewing the top of the head you can't see the coronal arrangements, because one cannot see the roots Therefore, using the coronal slits or the sagittal slits does not make much of a difference.

Secondly, we have not yet seen a study on the comparison of the regrowth rate of hair implanted using coronal vs. sagittal incisions. Therefore, we can only assume that because the coronal incisions are perpendicular to the blood vessels in the scalp, theoretically, they have a higher chance of damaging the blood supply. Therefore, the follicle survival rate should be higher when using the sagittal incision, due to less blood vessel damage.

According to the above reasons, we here at NHTMC only use coronal incisions for the hairline and sagittal incisions for the rest of the scalp. Here is a photograph for better viewing of our technique:

Question: Do I need to come back for suture removal?

Question: Do I need to come back for suture removal?

Answer:

At NHT Medical Center we use a polyglactin 910 suture to close the donor area. I prefer using sutures to staples because they are more comfortable for the patient and result in a less noticeable scar. In addition, these absorbable sutures begin to fall off on their own 7 to 10 days after surgery as the wound heals. The patient does not have to return for suture removal saving him a trip back to the office.

This photo is of a donor incision five days after surgery. At this point you can no longer see the suture.

An article in the 1999 Journal of the Canadian Dental Association reported on the advantages of the polyglactin 910 suture compared to staples. In the survey, researchers evaluated 42 patients with scalp wounds from cosmetic surgeries. They closed half the wound with the irradiated polyglactin 910 vicryl rapide fast-absorbing suture and the other half with traditional staples. In the study of these 42 patients they found:

· No inflammatory reaction in the areas closed with the absorbable sutures compared to 1 case in the wounds closed with staples
· An average pain score of 1.82 reported by patients for the sutures compared to average pain score of 6.7 for the staples
· No patient reported suppuration, hypertrophic scarring, or alopecia with either method
· All 42 patients in the sample preferred sutures to staples