Follicular Unit Extraction (FUE) is undoubtedly the world's most sought after alternative to traditional hair transplant procedures. FUE's superiority to traditional strip techniques are many folds. First and foremost, FUE does not leave a visible linear scar in the patient's head. It does not involve stitches, scalpels and is many times less traumatic to the patient than strip procedures. In addition, healing time is a lot faster using FUE. Doctors can also choose the types of follicular units to extract while allowing for a minimal of grafts wastage or transection.

Despite the obvious reasons for choosing FUE in surgical hair restoration, one contentious debate about the merits of this technique remains: possibility of donor scarring in the form of tiny white dots.

hypothetical illustration of FUE donor scarring

What If the White Dots Can Be
Eliminated or Minimized ?

For the first time in history, Dr. Arvind Poswal led a full fledge discussion about possible techniques designed to reduce or eliminate the "white dots" effect in FUE donor site.

According to Dr. Arvind, the pathway to a hardly detectable donor site can be summarized by achieving this goal: in the wound healing battle for dominance between the forces of collagen synthesis, fibrosis, scarification, and epidermization, stack the cards in favor of epidermization. The aim should be to jump start epidermization and delay the forces of collagen synthesis. The injectable sealant mentioned via the grafts epidermis is rich in basalis and suprabasalis cells (with their vital growth factors TGF alfa, KGF, EGF receptors, Integrins, and cytokines etc), sebaceous, root sheath, sweat gland cells (progenitor cells some with growth factor potentials) and extracellular matrix ingredients. These factors may all aid towards giving epidermization a head start over the forces of scar formation by stimulating early migration and proliferation of epidermal cells to fill the void. This process could potentially be explosively hastened by actually adding perifollicular dermal debris into the void. Basic research supports that this may provide a surface that attracts and encourages the surrounding epidermal cells to migrate towards and carpet. Basic science supports that collagen IV (from basement membranes) and collagen I (from adult reticular dermis) amongst other factors are responsible for this effect.

Step by Step Illustration

Following are pictures of the donor sealing protocol as performed at Dr. Arvind Poswal's clinic. The detailed step by step pictures will help readers understand the concept fully.

FUSE graft extraction

FUSE graft immediately after extraction

FUSE grafts before extracting the donor sealant

The donor sealant(epidermis) separated from the graft

Donor sealant being applied to the donor sites

For a more in-depth discussion about donor sealing protocol among doctors and forum members, please click

Picture of donor sealing protocol, step by step
Donor Selaing, an in-depth discussion

To contact Dr. Arvind Poswal, please visit www.fusehair.com
Questions, please email hairsite@aol.com

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