Can you tell me about the surgery?

DR. TRUE: On the day of the procedure, we'll ask you to come into the office by eight, having eaten some breakfast and taking a first dose of an antibiotic. When you come to the office we'll have a little paperwork to do, we'll get some baseline photographs, which are just for the medical record. We'll take some vital signs, make sure that blood pressure and everything are normal.

Then we give a little bit of mild tranquilizer, typically Valium, by mouth. All that does is produce some mild relaxation, just makes it easy for the patient to relax throughout the course of the day. It is worn off by the end of the day. Then we prepare the donor area by shaving a narrow band in the donor area. We use the CompuMed computerized local anesthesia system them to anesthetize the donor area. Once that's done, then we remove the donor area, suture, and then as that's happening the team of nurses and technicians assigned to each person that day begins to use the microscopes to prepare the individual grafts. That process can take anywhere from an hour to three hours, depending upon the size of the case.

While that's going on, if hairline design work is involved, that's when we do our design session. I'll sit down, map things out, look at pictures, get mirrors, and map out the area so that both we as the physicians and the patient are satisfied with our plan and our approach, and then the doctor starts making all of the tiny little micro-incisions.

We do that by using custom little micro blades that can be anywhere from .7 millimeters up to 1.2 millimeters. One of the critical things about the procedure that we do is, we sit down with the microscope with each patient and look at their grafts and their follicles and determine what size we want to use for that person, and also determine the depth so that we can get these follicles as close as possible within the scope of the treatment and also have them sitting at exactly the right level so that when the skin is all healed it's completely flat. There are no bumps, there are no pits, or anything like that.

Once the doctor has laid out all of the receptor sites, then the team of nurses and technicians assigned to the patient begins to place the grafts. Everything is done by hand. It's very meticulous and highly-skilled work. The nurses' and technicians' role in the case is very important, that they also are very highly skilled professionals for their part of the procedure.

Two or three people will be working together in placing the grafts. The anesthesia is maintained throughout the procedure. You do get periodic stretch, rest room, lunch breaks as time goes along. At the end of the procedure we'll show a DVD that shows a patient going through post-operative care, and then we'll go over all of those steps so that everything is completely clear.

At the end of the procedure, the surgeon comes in, inspects, makes sure everything is sitting exactly the way that it should, goes over instructions again with the patient, and then we make appointments for the post-operative visits at that point.