Using Proper Degrees of Magnification in Hair Transplant Surgery

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This podcast is on the proper use of magnification, visual magnification. The surgeon really needs to do good work and doing hair transplant procedures. I’m 51 years old going on 52. I’ve been in practice about 20 years now. And even when I was in my residency in my twenties, I was still using 2.5 X magnification to surgery. So it has, I think, little to do with age and a lot to do with the accuracy that you want to achieve when performing surgery, but not every part of a hair transplant procedure requires the same degree of magnification. Oftentimes you think everything should be highly magnified, but that’s a problem too, because if you’re overly magnified, you lose a forest for the trees. You can’t see the big picture and becomes problematic. So let’s talk about what magnifications I use and when do I use them and why?
So I use in hair transplant surgeries, 2.5 X, 4.5 X and 6.5 X. These refer to the number of Mac, the number of times of magnification over a normal view. For example, one X would just be, I’m looking at normal perspective. 2.5 X would be two and a half times magnification compared to normal vision. So when do I use two and a half X magnification? I use it when I do a strip harvest or linear harvest off the backside. 2.5 X is perfect for me to see the follicles really well with one exception. When I’m working with white hair, very difficult to see, I switched to 4.5 X. It makes it very easy to see. So I use 2.5 X for normal 4.5 X, four high. And for fue harvesting, I use 6.5 X so much higher magnification. Casually, I’ll use 4.5 X depending on the situation, but in most cases I’m using 6.5 X when I’m making recipient sites, which is making the little sites where the grafts will be placed into.

I use between 2.5 X and 4.5 X, depending on the situation. In most cases, I’m using 2.5 X. The reason for this is if I go to 4.5 X, I can overly dense pack an area and use all the grafts in an area that would otherwise be more, be better allocated over a wider area. So I don’t want to do that. However, if you think, well, then you really should be using four and a half X because I would rather have everything dense, packed hair transplant surgeries is the art of illusion, which means if I put in 3000 grafts, I have to make that 3000 grafts look like 20,000 grafts. And so the art of illusion is being able to distribute the grafts in a way for maximal outcome. And the 2.5 X in the vast majority of cases does really, really well so that I can achieve the gradient flow and the density pattern that I need over an entire head.

There are a few exceptions when I use 4.5 X loops. One is if I really, really want to dense pack an area. For example, just the other day I was doing a female hairline lowering. Actually this lady had a female hairline lowering surgically. There was a lot of scar tissue. It was a very narrow row that I needed to create with a lot of grafts. So to make a female hairline look natural, I have to use quite a few more one hair grafts in the front hairline. And also she had a lot of miniaturization behind it, where I had to make sure that I was not going to transect those hairs and how low the angles I was placing the temples. I needed to use a four and a half X loop magnification so that I made sure that everything was distributed well, and that I really achieved what I wanted to.

Now, whenever I use anything, 2.5 4.5 6.5, I’m constantly looking back under normal vision with ambient lighting to make sure that I’m, the pattern is proceeding as I would like. You never want to stay within that loop confined and not lose the forest for the trees. So that’s important as well. And under the direct magnification, I’m using a Xenon headlight that has incredibly bright perspective. It gives me the best illumination as possible. And then I have two ambient lights surrounding or surrounding going to look as well. The point of this is really to understand that surgeons, no matter what their age bracket is, they really, really need to be using proper magnification for the best results. If you’re using too low magnification, you’re not getting the most accurate results that you can. And that also refers to my assistants. My assistants are using at least 2.5 X to place occasionally use higher magnification depending on the situation, but they need the magnification as well. And under, when they’re doing FUT or strip magnification doing dissection, they’re using a stereo microscope. So it’s even a higher level of magnification, far higher than I’m using with anything else that I’m doing. So all of these elements are important. And so of seeing well, allows you to get great results.