Dr. Rose… is a one of the greatest physicians in hair transplant to walk the earth. He has not only helped to develop FIT in its infancy which put it where it is today, The standards of hairline design by Dr. Paul Rose pushed “hair mills” like “Bosley” and “MHR” to conform to making more natural hairlines. Dr. Rose was the ISHRS president for 2006. Dr. Paul Rose is a physican that is highly overlooked.
However, Paul Rose has made a new discovery in FUE/FIT science. He has developed a new punch. He coined it the slot punch. This punch is a varient between the sharp and blunt punch. To make a long story short, the slot punch cuts the cutting surface area drastically to allow blunt dissection as well as lining up the graft for a direct hit. Below is a diagram.
I’m going to see Dr. Rose later in July to assist him on a case and use the punch. About two months ago we used it on a case and it really worked out fine.
» » How much does Rose charge for fue? I’m not 100% sure but it around $8-9 per graft.
»
» Could you post some results from this doc? I’m scheduled to go down to Florida in July and will get these results for you.
Here is some more information concerning the punch.
Excellent question. The punch is driven straight down into the adipose. A score of the surface is made initially with a sharp punch. This is a relatively shallow score… 0.1mm at best. After the initial score, there is no need for a sharp punch. A blunt punch is typically used after the score. Why? Because adipose tissue is like butter for example. Butter is easily cut with a blunt instrument. A butter knife can cut butter.
The same goes for adipose tissue. A blunt instrument easily pushes into the adipose layer. Why is this important? Because, the follicle bulbs are contained within this layer. Why use a sharp instrument into this layer if it will chance transecting a graft? That is a major issue with sharp punch techniques. They continue to cut into the adipose without the need. The blunt punch can literally hit a bulb and it won’t cut or smash it. It simply goes into the shaft of the punch.
Now the slot punch will do all of these things except while pushing into the adipose, it will also allow for the graft to slip into the slot and the physician can see the direction of the hair follicle. It is an added control step that Dr. Rose wants for his new tool.
»
» Now the slot punch will do all of these things except while pushing into
» the adipose, it will also allow for the graft to slip into the slot and
» the physician can see the direction of the hair follicle. It is an added
» control step that Dr. Rose wants for his new tool.
Dr. A was using this and developed this years ago.
» The slot? That is cool. Well now Dr. Rose has developed a variant.
Yep, this is what he first used that allowed him to say that he extracted under “direct vision”. He had a slot in the side of a kind of punch and used forceps to pull from the slot.
I think that the description by Dr. Rose may miss the important point that once the muscle is dissected then and only then does the follicle get easy to pull out. This is all second hand info and of cause I have no direct knowledge.
Ok so does Dr. A use this exact punch now or then? Just wondering because this will be a good debate on comparing the two punches. Thanks for the enlightement Marco.
» Ok so does Dr. A use this exact punch now or then? Just wondering because
» this will be a good debate on comparing the two punches. Thanks for the
» enlightement Marco.
I can’t speak for him and unfortunately, it seems he is in a bit of a mood with you:lookaround: but I think that he has changed things since he talks about needles now although despite that fact that he is very open I really don’t understand completely what he is up to.
You could try begging for forgiveness but I know that you didn’t really mean any harm. I can see that you were a bit too enthusiastic and just got caught up in a photoshop moment.
Yea man crap happens and I said sorry. And I do want to visit his clinic one day. Anyway, I hope we can continue this topic one day with the comparisons. Thanks Marco.
» » Can you explain how it works? Seems a bit confusing. Wont the blunt
» punch
» » crush the grafts? How do you manage to ensure that does not happen?
»
» The blunt actually protects the grafts from being cut. The graft bulbs
» are left fine without crushing.
The blunt punch, when you use it, you rotate it and press down, right?
Pressing down will lead to an increased splay of the hair follicles. Driving them further apart from each other. Much like pulling the top of the graft will drive the hair follicles closer to each other.
That will be likely to crush some of the hair follicles in the grafts, in my opinion. I suspect the crushed/rudely touched follicles may look normal and still be pressed upon by the blunt edge of the blunt punch.
So, I am curious, much like the rest, what measures you take to prevent that.
Ok now you are stepping over the line a bit V. You and I might not see eye to eye on how we perform our procedures, however I have never stated that you crush bulbs or smash bulbs.
In fact you are freakon completely wrong about a few things about the blunt punch.
The SAFE blunt punch technique is usually performed in a two step process. However some patients do not need to have the scoring and then the blunt punching. One can simply punch with the blunt only and produce the same results. What makes you think that pushing the blunt punch will cause more splay? Have you done this before?
I have asked you now V, about 8 times now how you do the expansion needle process. What part of the needle expands? Draw a diagram or 2 and you ignore the question. Here is a diagram of our procedure.
» Ok now you are stepping over the line a bit V. You and I might not see eye
» to eye on how we perform our procedures, however I have never stated that
» you crush bulbs or smash bulbs.
»
» In fact you are freakon completely wrong about a few things about the
» blunt punch.
»
» 1. The SAFE blunt punch technique is usually performed in a two step
» process. However some patients do not need to have the scoring and then
» the blunt punching. One can simply punch with the blunt only and produce
» the same results. What makes you think that pushing the blunt punch will
» cause more splay? Have you done this before?
»
» I have asked you now V, about 8 times now how you do the expansion needle
» process. What part of the needle expands? Draw a diagram or 2 and you
» ignore the question. Here is a diagram of our procedure.
»
»
No, hairtech. I have never stated that crushing will be the rule with blunt punch.
I have merely stated an opinion and asked you how you ensure that the bulbs will not be crushed.
After all, if you see your own diagram, the hair bulbs are splayed apart in the grafts on the sides, but you show all of them inside the punch’s orifice in the central one.
I am curious, like others, how you explain that diagram.
It does not seem logical to me that when you press down with the blunt punch, the hair shafts, instead of splaying out, come close together.
» “I am curious, like others” Yes but I am still waiting for over 2 years on
» the direct vision video and and expanding needle concept. Ohh Well.
Dr. A has explained his technique many times. Many of our patients get to see close up, how all the steps of the extraction are performed. The live procedure recorded on a handycam and shown to them.
However, its Dr. A’s prerogative when, and where, he decides to put the video of his various techniques.
Here, OTOH, my curiosity was based on the diagram that is already posted. Sure you can see the difference, Duck.
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