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.
- Minimal bleeding. This is critical to point out that blood vessels are for the most part kept in tact.
- Virtually bloodless surgical field. Surgeon can have better field of view.
- Transections percentiles are significantly low. No sharp edge to cut follicles.
- 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.
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.
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.
ANd that is basically the the history of blunt dissection.