Can someone tell me what the difference is exactly between Trico closure, HITS, LEDGE, etc? Which is best?

Hi Emu

I believe they are all relatively the same but let's see what Master Falc has to say.

Steve,

Great question.

HITS (performed by Dr. Epstein) and LEDGE (performed by Dr. Rose) are variations of the trichophytic closure.

I've posted more detail on FUT, FUE, and the Trichophytic closure here.

Best wishes,

Falc

Dr. Rose’s Ledge closure is a technique where he uses a scalpel to score the lower edge of the strip incision. He uses a scalpel to cut the epidermis at a 1 mm depth. This method is very accurate as a scalpel can be used to pick the follicles to be included or exclude. Also, a true right angle is created. Some physicians use scissors to create a slope rather than a ledge. In Dr. Rose’s opinion, this slope results in a less secure closure verses the more secure ledge.

What technique leaves more of a "bump" ?

mm,

“Bumps” and elevated scars are not attributed to the closures discussed in this thread. These problems are more associated with bad techniques and individual healing tendencies.

I found this in an old thread... not sure why I didn't find it before. It really does a good job of explaining the different techniques (thanks Dr. Shapiro).

http://hair-restoration-info.com/eve/forums/a/albumcomm...60861/m/6991072522?r

Good find, Emu. This is a very definitive thread by Dr Shapiro. It nicely covers the trichophtyic variations of Rose, Frechet, and Marzola. Thanks.

Which closure technique does Dr Shapiro use?

I believe that Dr. Shapiro likes to trim the bottom edge of the incision, regardless of which method he uses.

I will have to ask this in an in-depth manner in order to properly answer the question.

Perhaps Janna will catch the thread and give a better response.

Hi Jason,

There are few different techniques to the trichophytic closure, and Dr. Shapiro has tried them all. Lately, he has been using a very sharp blade he used use for making incisions called Sharpoint blades. These come in number of different sizes. He uses this instrument to score the 1mm x 1mm dermis, and then uses the scissors to extract the tissue. So, he basically uses both the ledge and the scissors (Frechet) method. He feels he has greater control and efficiency with this technique. Dr. Shapiro has alternated trimming the bottom edge on some patients and the top edge (Marzola) on others depending on his criteria for switching. He's been trimming more top than bottom recently. I’m not sure what the criteria(s) are for the bottom or top, but I believe he has not definitively seen one being better than the other.

I hope this helps.

Thanks Janna!!!

Good Catch!!!!!

Another great post on this topic:

http://hair-restoration-info.com/eve/forums/a/tpc/f/346...871082522#8871082522