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Extraction tool size- Fue doctors


#1

Would any of the top Doctors here who perform the FUE technique be willing to disclose the size of the punch they use for their FUE technique? I believe the patient has the right to know, and if this has already been discussed please accept my appology and redirect me as to where i can find this information.


#2

» Would any of the top Doctors here who perform the FUE technique be willing
» to disclose the size of the punch they use for their FUE technique? I
» believe the patient has the right to know, and if this has already been
» discussed please accept my appology and redirect me as to where i can find
» this information.

Easy. Nobody knows what Dr. Woods uses and Dr. Cole’s tool size is all over the map according to CIT’s ever-so-vague posts. The rest all say they use .75mm, good luck if this is how you make your decision.


#3

» » Would any of the top Doctors here who perform the FUE technique be
» willing
» » to disclose the size of the punch they use for their FUE technique? I
» » believe the patient has the right to know, and if this has already been
» » discussed please accept my appology and redirect me as to where i can
» find
» » this information.
»
» Easy. Nobody knows what Dr. Woods uses and Dr. Cole’s tool size is all
» over the map according to CIT’s ever-so-vague posts. The rest all say they
» use .75mm, good luck if this is how you make your decision.

I really wonder why there are such secrets about the tool size used.
Everyone with FUE experience know that it is unnecesary to use tools over 0.8 mm. We use tools, unpattended and available 'of the shelve" with a size of 0.7-0.8 mm.


#4

Agree with you bverotti.
I could understand if they cost megabucks but they are only a few hundred dollars each.
What would be good if the docs with special trade secret tools went to a conference/workshop and done a ht on a patient with say Dr Reys/Ilter.
Both do one side of the patients head and have regular updates,then after twelve months shave his head down and compare the donor extraction area for scarring.
This could be done with a few docs watching to observe and comment what there thoughts are.


#5

I believe that people have the right to know what is being done to them, and what instruments are being used to achieve that purpose.

It’s called full disclosure.

Using larger punches may not affect a majority of patients, but may only affect 5-7% of all total patients (arbitrary number for purposes of discussion)

While this may seem like a low percentage, the fact is that if YOU are one of the 5-7% your going to be unhappy and wonder, “How did this happen?”

The inference we can draw from this is that using larger punches will not leave noticeable scarring on most patients, and for patients who experience this phenomenon the result is a. An acceptable tolerance percentage for the clinic and b. The risk of patient dissatisfaction is financially low enough not to warrant a change to smaller punches.

To be fair, there are those who say that either small white dots, or the potential for white dots is more acceptable than any strip scar. This is a reasonable argument, with the exception that IF a patient has no idea of the % of risk, they cannot accurately weigh these issues.

There are arguments on both sides as far as use of tools, sizes,who does the extractions, etc…but without proper knowledge the argument is incomplete.

For example, I have had 2 strip surgeries, going for a 3rd + FUE —does it really matter if I end up with some white dots in my donor region? I can never go below a #2-3 guard regardless, so in my case, it really doesn’t matter. It does matter from the standpoint of destroying adjacent follicles with larger tools, there is that argument.

Additionally, if you use small tools and attempt to punch 3-4 hair grafts and leave 1-1.5 transected grafts in the extraction site, some may grow to disguise the extraction sites, others may not, plus there is a question of “yield”

In my opinion, a happy medium should be sought–tailored to the interests of the patient–for those like myself, we can afford to use slightly larger punches b/c maximizing yield is the most important.

Others wanting to shave down where donor appearance is most important have a different need.

It goes back to having the proper information at hand to make these decisions.

Take Care,
Jason


#6

To reaffirm Dr Bisanga prefers the use of 0.75 & 0.8mm extraction tools and finds these able to remove larger follicular units even those with high calibre hairs. This can be performed with low transection contrary to some and transection in itself is not the sole domain of smaller punches, it can happen regardless of punch size. What is an important aspect that may not be recognised is skin tension and splay of the FU to name two aspects. Both unless understood become harder the smaller the extraction tool, but that does not mean transection has to spiral or yield has to suffer; it basically means that the Dr performing FUE to the highest levels has an adept skill.

An important aspect of FUE is not so much the punch size, that is just the conclusion of what is necessary, but more to do with being able to remove an intact follicular unit, not damage peripheral FU, keep scarring to a minimum whilst maintaining an educated extraction pattern.

The size of the punch has nothing to do with the extraction pattern or the amount that can be removed; if a larger punch collects more hairs in a single extraction that just means a larger hole has been made and potential larger scarring. That said as much damage can be inflicted with a smaller punch if an educated extraction pattern is not adhered to.

Extracting the maximum hair with a punch is no better than going back years; yield will not be determined necessarily by punch size, but using the correct punch and understanding skin/hair nuances. The idea of a HT be it FUE or FUT should not just be getting whatever we can in the recipient but maintaining as much as possible the integrity of the donor; otherwise we would all accept full heads of hair and large scars as long as the hair was just enough hair left to cover.

FUE is an excellent technique when used with the right candidate and performed to a high standard with an educated protocol. It can allow small procedures to be performed without the need to have a linear scar, it allows Strip patients an alternative to max the FU safely without stretching the limits of their scalp laxity and for repairs when the donor has been impaired allowing for hair to be removed out of the normal zone, and in some cases can be a life saver for repair patients, giving another option, sometimes the only option.
To get back to punch size, it is important; it will vary from person to person. The correct punch size can enable a single FU to be removed, this has the added benefit of being able to adjust and determine the surrounding FU that can be removed so as to harvest the maximum amount without compromising the donor for future possible procedures.


#7

.

» An important aspect of FUE is not so much the punch size, that is just the
» conclusion of what is necessary, but more to do with being able to remove
» an intact follicular unit, not damage peripheral FU, keep scarring to a
» minimum whilst maintaining an educated extraction pattern.
»Absolutely. Great points!