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FUE: The Surgical Assistant’s Role Tina Lardner Denver, Colorado ISHRS 19 th  Annual Scientific Meeting Anchorage, Alaska September 14-18, 2011
Disclosure ,[object Object],[object Object]
Objective ,[object Object],[object Object]
Assistant’s Role ,[object Object],[object Object],[object Object],[object Object],[object Object]
Overview of FUE
1. Patient Prep ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
2. Assisting in Surgery Superior to the patient Opposite to the physician’s hand Prone, exposing occiput area Side, exposing temporal Area Surgeon Position Patient’s Position Assistant’s Position Patient’s Position
3. Graft Extraction ,[object Object],[object Object],[object Object],[object Object]
3. Graft Extraction ,[object Object],[object Object],[object Object]
3. Graft Extraction - Capping ,[object Object],[object Object],Upper third of epidermis is removed Cap
3. Graft Extraction Challenge
3. Graft Extraction ,[object Object],[object Object],Second pass Third pass 1st pass 2nd pass  3rd pass 1-2cm wide ,[object Object],[object Object]
3. Graft Extraction ,[object Object],[object Object],[object Object],[object Object]
4. Graft Inspection ,[object Object],[object Object],[object Object],[object Object],[object Object]
4. Graft Inspection
4. Graft Inspection Sebaceous glands Terminal follicles: pigmented with bulbs extending to fatty layer Epidermis Dermis Fatty layer Bulbs Epidermal cap Miniaturized follicle
4. Graft Inspection Transection Examples of telogen follicles
4. Graft Inspection ,[object Object],[object Object],[object Object],Stripped dermal sheath Damaged bulb Damaged hair shaft Transection Epidermal Cap
4. Graft Inspection FUE COUNT SHEET  ( SAMPLE  ) PATIENT:_____________________ DATE:______________ EMPLOYEE: SC  AA  AM  HS  AN  BT  CB Intact / transected ,[object Object],[object Object],[object Object],[object Object],[object Object],14  2/0 7  4/1 13  1/0 6  CAP/ 12  3/0 5  3/2 11  4/2 4  4/0 10  3/0 3  2/1 9  4/1 2  3/0   8  2/0 1  2/0
5. Graft Placement
5. Graft Placement ,[object Object],[object Object],[object Object],Hanging bulbs: no surrounding fat
5. Graft Placement ,[object Object],Gently  collect and grasp all the bulbs
5. Graft Placement ,[object Object],Insert the longer bulb  first ,  then guide the other bulb(s) in Note curvature of implanted hair follicle
5. Graft Placement Incorrect placement Epidermis is not flush with the skin and hair is pointing in the wrong direction Epidermis flush with the skin Correct placement Epidermis flush  with the surface of the skin
5. Graft Placement ,[object Object],[object Object]
6. Post Op Care ,[object Object],[object Object],[object Object]
6. Post Op Care 1 Day Post-op: Scabs have formed 8 Days Post-op: Hairs in between extraction sites have grown out FUE Scars: Although scars are difficult to see, if hair is cut too short, they become visible
Conclusion ,[object Object],[object Object],[object Object]
Thank you

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Fue surgical assistant's role

  • 1. FUE: The Surgical Assistant’s Role Tina Lardner Denver, Colorado ISHRS 19 th Annual Scientific Meeting Anchorage, Alaska September 14-18, 2011
  • 2.
  • 3.
  • 4.
  • 6.
  • 7. 2. Assisting in Surgery Superior to the patient Opposite to the physician’s hand Prone, exposing occiput area Side, exposing temporal Area Surgeon Position Patient’s Position Assistant’s Position Patient’s Position
  • 8.
  • 9.
  • 10.
  • 11. 3. Graft Extraction Challenge
  • 12.
  • 13.
  • 14.
  • 16. 4. Graft Inspection Sebaceous glands Terminal follicles: pigmented with bulbs extending to fatty layer Epidermis Dermis Fatty layer Bulbs Epidermal cap Miniaturized follicle
  • 17. 4. Graft Inspection Transection Examples of telogen follicles
  • 18.
  • 19.
  • 21.
  • 22.
  • 23.
  • 24. 5. Graft Placement Incorrect placement Epidermis is not flush with the skin and hair is pointing in the wrong direction Epidermis flush with the skin Correct placement Epidermis flush with the surface of the skin
  • 25.
  • 26.
  • 27. 6. Post Op Care 1 Day Post-op: Scabs have formed 8 Days Post-op: Hairs in between extraction sites have grown out FUE Scars: Although scars are difficult to see, if hair is cut too short, they become visible
  • 28.

Notas del editor

  1. Epidermis slides off during extraction and the follicles are left behind Most common Scar tissue: increased tethering mushy dermis No harm to the follicles left behind; epidermis will grow over the capped area.