Premade Incisions vs. Stick and Place: A Multicenter Retrospective Comparison of Hair Transplantation Outcomes in China.

Background: Based on the differences in the procedures of recipient site creation and graft placement, hair transplantation implantation techniques can be classified into premade incisions (PI) and stick and place (S&P). However, limited studies have systematically compared their clinical outcomes.

Methods: A retrospective analysis was conducted on 191 Chinese patients (95 in the PI group and 96 in the S&P group) from four hospitals, undergoing follicular unit excision between August 2022 and August 2024. Intraoperative metrics such as graft density and implantation speed were compared, while postoperative evaluations included the maximum shedding rate, the survival rate, the complication rate, and patient satisfaction. Additionally, junior surgeons practicing one technique on simulation models were assessed for a learning curve.

Results: The PI group demonstrated faster implantation speed (719.3 ± 50.7 vs. 553.9 ± 51.9 FUs/(hour*N), p < 0.001) and a shorter learning curve (7.3 ± 0.2 vs. 8.5 ± 0.2 FUs/(hour*day), p < 0.001). However, the S&P group achieved higher graft density (p = 0.003), lower maximum shedding rate (95.9 ± 2.9% vs. 70.3 ± 2.5%, p < 0.001), and higher patient satisfaction (p = 0.023). No significant differences were observed in the survival rate and the complication rate.

Conclusions: This study provides a comprehensive evaluation of the clinical outcomes of PI and S&P techniques in Chinese populations. While PI demonstrates procedural efficiency and a simplified learning curve, S&P is associated with enhanced precision and superior patient satisfaction.

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