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TThe History and Concepts of Blunt Dissection... Hairtech


#1

I was sitting around thinking one day (recently) and something about the “SAFE FUE” procedure that had suddenly dawned on me. Sometimes simple answers to my own questions are right in front of my face and I will overlook the answer for a time before I finally say to myself, “oh, so that’s what you mean.” Airhead hairtech.

One of the questions I had to myself, and this stemmed from years before I worked for Dr, Harris. I was working in FUE but a different procedure altogether. A sharp punching FUE. Then this fellow I never heard of comes to the seen with his own FUE procedure and it is called the SAFE FUE that uses blunt punches. What the heck is that I thought. I even asked my colleague at that time…

What is the blunt dissection punch? Why would he call it, blunt dissection? Why even use a blunt tipped punch? It doesn’t make sense. Then I asked a doctor I was working for at that time and he said it did not work, and did not make sense. Fast forward now…

Time goes by… By serendipity, I end up at Dr. Harris’s clinic. Then I am finally exposed to the SAFE FUE technique. I am utterly surprised as I have stated this and now exposed many threads using this technique.

But what is the SAFE FUE technique? What is the priniciple of it? It did not dawn on me until a poster (Marco) asked a simple question about cutting the arrector Pili muscle while performing SAFE FUE. Then at that moment and time, everything became very very clear to me. To the point that I felt dumb but happy at the same time.

And this is why I started this thread. To convey to everyone what the simple principles are behind this technique that in my eyes as a biologist makes sense.

First a quick basic lesson for the lay ghost readers. Many may know this already but many have jobs in areas that have nothing to do with biology so this is why I begin here.

Anyone can cut out an appendix out of a human being. Anyone can take a knife and just start cutting and eventually, you make it to the appendix. Goal is accomplished… appendix removed. But what has happened? You have sliced and diced your way to the appendix and cut every artery, vein, nearby organ, and other structures on your path down to the appendix. This is not good. You killed that human being. That was the initial concepts of the primitive surgeon from the middle ages. They learned through trial and error that slicing and dicing, did not work. But determination and several thousand deaths, a new concept was born… “blunt dissection.”

Blunt dissection by definition in surgery is the exposure of structures or separation of tissues without cutting with a sharp edge. That’s it! Why was that important? Because the slice and dice turned into a better technique by which the surgeon now would first cut the skin normally to open up the skin… then use scissors to separate structures in the path down to the appendix. However a technique had to be used in order to blunt dissect. Blunt dissection meant the surgeon starts out with the scissors closed, puts the scissors into the cavity, then open the scissors. OPENING the scissors was blunt dissection. Immediately, this resulted in nothing being cut or destroyed. I myself, working at the organ center in the past, used this technique daily to remove various tissue on donor patients. Blunt dissection is used in virtually every surgical technique today.

So now we arrive to where this related to the surgically advanced follicular extraction or SAFE FUE, which uses the basic principles and concepts that has been used for centuries and centuries.

Dr. Harris basically thought… Hey, this is what I did in Ear, Ear, Nose and Throat (Dr. Harris’s residency training), why not do this in FUE. So was born a blunt punch. Which is simple just as in the appendix case, one first cuts the skin with a sharp edge with the 0.75mm sharp punch which is only 0.5mm in depth, and then using a “blunt edge” punch, push the instrument straight into the adipose. Without having a blunt edge, the structures around the follicles are protected from being cut as would be using a sharp punch only. So several concepts seen in blunt dissection in removing the appendix, are observed in the blunt punch.

  1. Minimal bleeding. This is critical to point out that blood vessels are for the most part kept in tact.
  2. Virtually bloodless surgical field. Surgeon can have better field of view.
  3. Transections percentiles are significantly low. No sharp edge to cut follicles.
  4. Rapid healing times of the donor area are observed from less traumatized tissues.

So this was my internal revelation to myself that happened to me recently. While I knew the procedure worked well, I did not relate the technology to the cornerstone of all surgeries performed today. And to prove my genuineness, here is the email exchange Dr. Harris and myself when it all came together.

Dr. Harris,

So you agree with my stupidity in that I just realized that the blunt punch
uses the concept of blunt dissection like in gross anatomy or in general
surgey, i.e. using Mayo scissors to blunt dissect fascia or something. I
never considered the “blunt dissection concept” like we used in lab. The
blunt punch was developed as not to destroy surrounding structures like a
sharp punch would right?

Yes sometimes I am an airhead. Sometimes I do not connect the dots.

Thomas

From: THOMAS ORTIZ [mailto:stortiz1@hotmail.com]
Sent: Monday, July 23, 2007 6:15 PM
To: jharris@hsccolorado.com
Subject: doc I need your expertise

Tom,

Your description of what happens is exactly the way I conceived of the blunt punch working. When I used to take a tumor off the carotid artery or dissect one from the facial nerve I only used blunt dissection. If you wanted to preserve something and separate it from something else you always used BLUNT `dissection. So you are entirely correct in your conceptualization.

Dr. Harris

ANd that is basically the the history of blunt dissection.

:smiley:


#2

A quoted post from a different site…

slick wrote:
A cut is a cut is a cut is a cut. If you use a blunt punch or a sharp one, the tissue has to be separated either way. So what is the reason to use a blunt punch? I didn’t understand it from your post.

Bverotti wrote:
Dr. ILter and Dr. Harris both came up with basically the same idea at the same time.

The idea is comming from critical area surgery.
For example when drs are very close to critical arteries or organs they prefer to use ‘unsharp’ instruments. If they accidently touch the critical tissue with a duller instrument is usually does not cause disaster. The dull instruments is not completely dull however, it is still able to cut.

Same idea for FUE. Using ‘unsharp’ instruments is key to avoid transections. We have been doing it for some years now and it is one of the most important elements in order to drop transections to at most 1%.

I hope this clears things up a bit.


Consultant for Prohairclinic Belgium.
‘FUE only’ institute, procedures by Dr. Ilter and Dr. De Reys


#3

Dr. Harris’s words,

"Tom,

Slick wrote that a “cut is a cut” which is true but blunt dissection is not a “cut”. Blunt dissection is using instrumentation to find natural tissue planes between the structure you want to isolate and the surrounding tissue without “cutting”. In the case of follicular units it’s the separation of the follicles from the surrounding dermis. The lack of vascular damage is readily visible as there is less bleeding with blunt dissection as compared to sharp, whether it’s in head and neck tumor resection or with FUE.

Dr. harris"


#4

Well Hairtech and Dr. Harris,

Unfortunately you have some missunderstandings regarding basis of the SAFE technique but I will try to get you up to speed on this concept.:-):slight_smile:

The single major advantage of the blunt dissection is complete abrogation of transecting the splayed dermal papilla

as I have discussed at several international conferences (Marco, ISSSS (International society of Sheep sheering 2002; Marco, blunt disection in the SAFE technique Journal of advanced FUE concepts vol 3: 1963)

I do not see that the circumfollicular vasculature (as we say at the ISSS) can be protected by blunt disection since it must be seperated durring the procedure and must surely be broken as it can not just slide out of the way.

One down side of any blunt disection can be that structures that get in the way and cannot be pushed out of the way (such as the pili muscle)COULD be torn rather than cleanly cut if they are firmly attached.

As I have said before:
“All in all the protection by the SAFE technique on the splayed papilla outways the disadvantages and theoretically allows a much smaller punch.”

(Marco, Procedings of the international society of surrealist dislexic schitzofreniks, 2008)


#5

We agree with you 100%. No one is saying that all vasculature is protected Marco. And how can you get Dr. Harris up to speed when he was the developer of the SAFE technique.

The vasculature that is directly connected to the follicle has to be sheered or cut or the unit cannot slide out. However some of the vasculature surrounding the follicle, presumably is protected and pushed out of the way during blunt dissection.

Dr. harris said that there were no claims of nothing cut at all as in the vasculature.

I noticed immediately the massive decrease in bleeding when I first saw the blunt technique is every case thus far. So the blunt dissection technique must play a role in that part as well as the protection of splayed follicles.


#6

» We agree with you 100%. No one is saying that all vasculature is protected
» Marco. And how can you get Dr. Harris up to speed when he was the
» developer of the SAFE technique.
»

Because I invented the SAFE technique in 1966. It was called the Marco technique but it never caught on. Dr. Harris took my idea after I discussed it with him at pre-school and he developed it.:expressionless:


#7

Geez man you made me laugh.:smiley:


#8

Now the SAFE FUE Technique does have a variant. Surgical techniques should not be limited to one technique only. And in most disciplines in medicine this is true. Take for instance cardiac bypass. Is taking the saphenous vein from the leg and grafting it to the the coronary artery the only approach to restore bloodflow into a part of the heart that is blocked? No! There are alternatives. Stents, balloon angioplasty (expanding the coronary artery with a ballon), and thrombolytics (clot busters that dissolve a clot) all are alternatives.

Well the same goes for the SAFE FUE. There is a variant approach that still lies within the blunt dissection realm… Using a serrated blunt tip punch.

Here is a video to illustrate.

http://www.youtube.com/stortiz1


#9

» Because I invented the SAFE technique in 1966. It was called the Marco
» technique but it never caught on. Dr. Harris took my idea after I
» discussed it with him at pre-school and he developed it.:expressionless:

Now you both are making me laugh…

Dr. Harris’s response…

"Tom/Marco,

Actually I invented it when my parents gave me a toy doctor’s kit for
Christmas when I was 5 years old. On that day I decided to become a doctor
and invented the SAFE System because my dad was going bald. This was in
1962; therefore it preceded his idea in 1966 by 4 years. But of course the
photos of that occasion are a little fuzzy and in black and white and it’s a
little hard to make out the PlayDoh model of the dull punch.

Dr. harris"


#10

“Dear Marco, Thank you for instructing us on the current law suit, we have more time since successfully completing defence of OJ Simpson and think that you have an excellent case.
In our view your position is analogous to the Facebook Uconnect pursual. In the face book case there was a verbal communication between Zuberg (facebook) and Uconnect. The case is unlikely to be won by Uconnect founders since a written secrecy agreement should have been in place. In contrast, we believe that you have a good case for suing the developer of the SAFE method since you transmitted your idea before either of you were able to write and therefore oral contracts are legally binding in pre-literate years (see bush Vs Yeltsin supreme court 2001).

By the way Marco your electro sensing punch which detects and bleeps at the point of interaction with the pili muscle similar to the devices used in electrolysis for perfect depth control during transplantation has produced amazing results for me so thanks for the transplant. I hope you did not tell anyone about that idea! Your faithfully, Johnnie Cochran”


#11

Oh my God… I fel on the floor.


#12

» Oh my God… I fell on the floor. One small little thing you left out Marco.

Johnnie Cochran died last year(no he really did). Massive myocardial infarction. So you must have the ability to beam thoughts through the six feet of dirt from his fixed tissues from his dead brain.:smiley: :smiley:


#13

http://www.youtube.com/stortiz1


#14

http://www.youtube.com/stortiz1