title: The Mercedes incision in hair restoration.
abstract: Standard technique for hair transplantation includes plug composite grafts placed in circular recipient defects of smaller diameter. The plugs can also be placed in slit incisions that are temporarily dilated to accommodate grafts. Two drawbacks of these techniques are the appearance of row cropping resulting from the regular pattern and compression of individual grafts caused by scar contracture. These drawbacks result in tufting and a "doll's head" appearance. The expansile Mercedes incision as described here camouflages these failings. Donor minigrafts are taken with a biopsy punch knife or as strips in a standard fashion. A Mercedes logo-shaped defect is then made at the recipient site using a no. 11 scalpel to create a three-armed stellate incision. The incisions are rapidly made with the axis oriented parallel to the direction of the native hair shafts. The graft is then pushed in flush with the skin. The triangulation eliminates compression of grafts because they are spread in three directions rather than squeezing in a tight circular or slit configuration. The use of the stellate incision along with altering its rotational orientation in a haphazard pattern also prevents row cropping. Thus, the Mercedes incision is quicker and yields an overall improved result.
authors.affiliation: Division of Plastic, Maxillofacial, and Reconstructive Surgery, University of Pittsburgh School of Medicine, PA 15224, USA.
authors.forename: S L
authors.initials: SL
authors.lastname: Bernard
authors.forename: J K
authors.initials: JK
authors.lastname: Smith
mesh_terms: D000505:Alopecia / Q000601:surgery*; D006197:Hair / Q000637:transplantation*; D006801:Humans; D012535:Scalp / Q000601:surgery*; D014180:Transplantation / Q000379:methods