Dr. Antonio Alvi Armani

Repair Cases: Why smaller sessions are not a good idea.

In the past, there has been a general philosophy to do smaller number of grafts per session. I have found, as in one of my repair cases today from London, UK, that after 800 or so grafts, the patient has almost no outcome that he is happy with. The donor scar is usually not just superficial, but goes down much deeper. The fibrosis extends both vertically and horizontally. The need to repair him is obvious in the front. However, the tissue now is tougher to work with both in the recipient area and the donor area.

Therefore, its better to do larger sessions for many reasons.

The three obvious reasons are:

1. Better cosmetic results; more pleasing to the patient.
2. Lesser scarring, and therefore, less damage to his donor area. In this way, he or she has greater donor reserve.
3. Lesser number of procedures needed.

In today's case, the patient from London, UK who had 800 grafts before, we are doing over 4000 grafts.

My other case today from Croatia is a large first time sessions similar in number of grafts.

This new philosopnhy will eventually overtake the smaller session surgeries. It is in the interest of the patient to obtain the best results with the least damage.

--Dr. Antonio Alvi Armani