About Video

Popping occurs when a graft is placed into a site and then the lateral pressure on the tissue around the graft causes it to pop out. This pressure may be due to multiple factors, including grafts that are too large for the given sites, sites that are too shallow, skin with limited elasticity (e.g., scar tissue), rough placement, excessive bleeding, and scalp that is manipulated and pulled by two assistants working in close proximity. The best way to avoid popping is to test the fit at the beginning of the site-creation process. Sometimes, with an originally good fit, grafts seem to “swell” due to soaking in the storage solution and hence require redoing the sites. Another method to resolve this problem is to skip sites in a consistent manner, placing every other site, and then coming back to fill in the sites left vacant in the first pass. Using damp gauze and applying gentle pressure with the entire palm of the hand over the full expanse of the recipient area for a sustained 2 minutes can help settle the area and minimize further popping. Be aware that during cleaning and dabbing, one or more grafts can slide out of the site and end up caught underneath the gauze. Always inspect every piece of gauze before discarding. In some situations, using a blow dryer to dry placed grafts may help, i.e., “seal” them before progressing to the next area. If such a patient returns for a second procedure, use of implanters may help overcome popping. In that situation, the physician would make sites and implant grafts simultaneously.