Fue Hair Transplant Canal Opening

The canal opening process starts with the drawing of the front fold line (frontal line). The right front line is the front line closest to the golden ratio on the face.

While drawing the front line, the distance of the front line to the eyebrows must be measured. However, full symmetry should be avoided. It should not be forgotten that a fully symmetrical straight front line will strengthen the feeling of transplanted hair.

It is recommended to use special laser pointers to create the front line. A mixture of Bupivacaine (marcaine) and Lidocaine + Prilocaine (citanest) is used for anesthesia of the front line. It is adjusted by considering the desired anesthesia time.

Bupivacaine (marcaine) has an effect time of up to 10 hours. However, its effect increases in 30-45 minutes after the application. The effect of Lidocaine + Prilocaine (citanest) starts within 5 minutes and lasts for 2-3 hours.

Anesthesia starts with Supraorbital / Supratrochlear bundle branch block. An injection of 2-3 cc to be made 1 cm above the supraorbital gentian to be palpated on the eyebrow is usually sufficient for the block. After a five-minute wait by pressing under the eyebrows, the frame to be made half an inch below the front line is completed with local anesthesia.

Bringing the anesthesia to body temperature before the procedure and cooling the tissue reduces the pain and burning sensation during anesthesia. Using needle-free injection pens does not reduce the pain and burning sensation, contrary to popular belief.

The transplantation area should be inflated with thymocel. Thymocel is used to remove the vascular nerve packs and control bleeding. It is 1/10000 serum containing low dose adrenaline. The amount of adrenaline used for bleeding control should be kept in minimum in order to reduce the risk, considering systemic side effects and intraoperative necrosis. Generally, 1 ampoule 0.5 adrenaline in 100cc mai provides bleeding control.

Canal opening should be started with the front line, and conscious mistakes should be made to avoid a straight line while creating the front line. Then the front line should be combined with the guide canal lines drawn from the hairy area.

The punch used to take the canals during the canal process should be opened with blades with a diameter of 0.1 mm larger than the diameter, and care should be taken that there are solid tissue pieces between the opened canal and that the canal do not join.

Channel opening determines the frequency and direction of hair transplantation. Therefore, it should be done by an experienced doctor and should not be rushed. Care should be taken to ensure that the channels enter the hairy area and that there is no linear result.

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