Upper and Lower Trichophytic Closure with Wavy Two-Layered Closure for Optimal Hair Transplantation Scar

  • Kazuhito Yamamoto


The trichophytic technique was first reported in facelift and flap procedures in the mid-1970s. For donor harvesting in hair restoration surgery, it was described by Drs. Patrick Frechet and Paul Rose (lower trichophytic closure) and Dr. Mario Marzola (upper trichophytic closure) in 2005. The trichophytic closure has improved the appearance of donor scars since its introduction. In 2009, I reported that the appearance of a donor wound can be further improved by adding an additional wavy two-layer closure to upper and lower trichophytic closure. We achieve an invisible scar in greater than 95% of patients using this method. However, making proper judgments depending on the characteristics of the patient is indispensable in order to obtain good results.


Wavy Trichophytic Donor closure 


  1. 1.
    Frechet P. Donor harvesting with invisible scars. HT Forum Int. 2005;15:119–20.Google Scholar
  2. 2.
    Rose P. Paul Rose, MD, presented a similar technique at the ESHRS meeting and writes. HT Forum Int. 2005;15:120.Google Scholar
  3. 3.
    Marzola M. Trichophytic closure of the donor area. HT Forum Int. 2005;15:113–6.Google Scholar
  4. 4.
    Yamamoto K. Trichophytic closure of both wound edges after strip excision for hair transplantation. HT Forum Int. 2009;19:185,190–1.Google Scholar
  5. 5.
    Yamamoto K. Double trichophytic closure with wavy two-layered closure for optimal hair transplantation scar. Dermatol Surg. 2012;38:664–9.CrossRefPubMedGoogle Scholar
  6. 6.
    Pathomvanich D. Donor harvesting, a new approach to minimize transection of hair follicles. HT Forum Int. 1998;8(5):1,4–5.Google Scholar
  7. 7.
    Pathomvanich D. A refined open donor harvesting to minimize follicular transection. In: Pathomvanich D, Imagawa K, editors. Hair restoration surgery in Asians. Tokyo: Springer; 2010. p. 109–15.CrossRefGoogle Scholar
  8. 8.
    Haber RS. The “spreader” technique and indications. In: Unger W, Shapiro R, editors. Hair transplantation. 5th ed. New York: Informa Haralthcare; 2011. p. 279–81.Google Scholar
  9. 9.
    Kim D. Saving the sebaceous gland in the trichophytic closure. HT Forum Int. 2009;19:89.Google Scholar
  10. 10.
    Puig C. Controlled dissection for trichophytic closures with a ledge knife. HT Forum Int. 2008;18:207.Google Scholar

Copyright information

© Springer Japan KK, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of SurgeryKyoto Prefectural University of Medicine/Wellness Beauty Clinic OsakaOsakaJapan

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