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What are Micrografts and Minigrafts?

micrografts
Micrografts were larger than today's follicular units.

Minigrafts and micrografts both refer to a piece of hair-bearing tissue that has been specially prepared for a hair transplant. These grafts must be inserted directly into premade incisions, called recipient sites. Micrografts and minigrafts both reflect the same type of procedure as both are created during strip surgery. If a stereoscopic microscope is not being used to prepare the grafts from the excised donor strip then they are by definition referred to as minigrafts or micrografts.. However,  minigrafts and micrografts fell out of style in the early to middle 2000's with the onset of better hair restoration equipment and techniques such as follicular unit strip surgery (FUSS) and, subsequently, follicular unit extraction (FUE). Minigrafts typically contain multiple follicular units and in total three to ten hairs (according to a 1997 synopsis) while micrografts only contain one to two hairs. As a result, minigrafts provide a stronger degree of coverage and volume. Micrografts, however, were best used to recreate the hairline. If a hair clinic chooses to use minigrafts today, it is usually in combination with a more modern technique but this is not always the case and in fact is quite rare for a number of reasons.

 

Micrografts, Minigrafts, and Hair Plugs

Micrografts and minigrafts were the next logical progression from hair plugs, which used a large 4 millimeter or 5 millimeter punch device to scoop out the donor hairs for transplantation. Micrografts, and even the larger minigrafts, were much smaller than hair plugs, which often left unsightly scars and other noticeable complications. Minigrafts and micrografts evolved into follicular units when the stereoscopic microscope was introduced into the field of hair restoration by Dr. Bobby Limmer from Austin, Texas. A 1997 study compares both mini-and-micro-grafts after observing ninety grafting sessions. Even though 10% of the patients experienced cysts, the study shows that the patients enjoyed a 97% satisfaction rate. This was nearly twenty years ago, however, and techniques have evolved considerably since then.

 

What are Some Disadvantages of Minigrafts and Micrografts?

minigrafts
Minigrafts can never look natural without smaller micrografts or follicular units.

Many consider these procedures to be outdated due to the following reasons:

  • Time constraints – these grafts require multiple sessions, and sometimes the procedures can even take one or two years before the patient reaches a final result that is satisfying. This is compared to the more modern follicular unit strip surgery (FUSS) and follicular unit extraction (FUE) techniques, which can also require multiple sessions, but can also only take hours or days to complete. Quite a difference!
  • Inferior to follicular units – follicular units are much smaller than minigrafts and micrografts because they have less supporting tissue around the follicle. When it comes to density and coverage, nothing can beat follicular units.
  • Excess skin – unlike follicular units, minigrafts contain extra skin tissue that is not necessary for hair growth. This excess tissue does not help the hair follicles at all, and may increase the likelihood of scarring. These scars are known as “ridging”, which is where the excess skin causes the grafts to raise upwards noticeably.
  • Recovery time – since the incisions are larger than with follicular units, the wounds take a longer amount of time to heal. Longer recovery times also increase the chances for infections and other complications.

 

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