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FUE Punch Size & Donor Management (Hair Transplant)

posted by BHRClinic Homepage E-mail, Brussels, Belgium, 05.03.2008, 20:50

» » The larger the incision made into skin has the potential for greater
» » scarring; obviously the skill of the incision will have an impact but
» » simply a larger hole is made in the skin tissue and more fibrosis is
» » caused and greater pigmentation alteration; thus making the scarring
» » potentially more visible and larger. If the larger punch is used and
» the
» » extraction pattern not monitored to approximately 27% the donor can
» » visibly lose density, because a “moth eaten” look on the scalp and make
» it
» » almost impossible to harvest any amount of grafts.
»
»
» What is 27% ? Are you saying once you extract more than 27% of the donor
» it will become visibly thin?
I think the study prove that the use of a 0.5 mm punch is probably ill advised; of course FU are mainly in an elliptical fashion because on average they contain an uneven number of hairs; hence the average being 2.2/3 etc; but that does not mean the punch diameter has to be distorted dependent on the shape of the FU; under that principle almost every FU would require a variant in punch differential which is not true. Using a suitable size tool is adequate to be able to remove the FU and surrounding tissue whilst maintaining the integrity of the surrounding FU and the skin tissue and also keeping the removed FU intact; whilst preserving the donor area and allowing little to no obvious scarring.

IF you wanted to use an elliptical punch there is a great chance the ellipse has a grand axis and small axis so what size punch would you use to decrease scarring and preserve donor; also taking into consideration the angulations of the punch any slide to obtuse will increase scarring.

The % of movement with strip and FUE is very different and a large variant between the two procedures and a reason why they cannot be compared; you cannot compare the removal of a strip of skin tissue then sutured to marginally affecting the scalp laxity and the surface area of FU being removed even if standardised in respect of density; both techniques can live but not easily compared.

With respect to blunt and sharp as far as I am aware Dr Harris uses a sharp tool punch through the epidermis and then the use a dull punch to penetrate the dermis so he doesn't transect the upper follicle; in that respect it has little bearing on transection; in respect of the dermal interface is irrelevant and as far as Dr A who knows, let him join the discussion.




27% of FU per cm is approx what can be safely removed without OVER HARVESTING your donor; of course you can remove more and many do under the principle that the light reflection only penetrates to the skin when approx. half is removed. While this maybe true the principle of donor management work very differently; if you are prepared to remove say 50% then any real or viable options in the future are lost;on an average density of 75 you leave the person with a density close to 35 and few to no options in the future; even with strip. If the idea is to shave it will leave very large areas of no hair and if a larger punch used scarring; and if the idea is to have more FUE in the future the area is already been over harvested.


BHRClinic is located in BRUSSELS, BELGIUM and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

---
Philb
BHR Clinic
info@bhrclinic.com
www.bhrclinic.com

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