Jump to content
Sign in to follow this  
GasMan

Scarring From Fue? Punch Size Issue?

Recommended Posts

I am hoping to get a better understanding of the size of tool used and the possibility of scarring with FUE. I know that Dr Cole, who I have a very high regard for, says that extractions of 1.5mm or less do not normally show scarring that is visible under any normal viewing circumstances. However, I also have read of people who have complained that a 1mm tool has left visible scarring on their head (when shaved).

 

This is very confusing, is it all down to individual healing characteristics? There is a strong suggestion that if you use too small a tool (0.75mm? 0.5mm?) you risk compromising the yield – which makes sense – but it is unclear how high the risk of that is either.

 

As much as I would like a small punch to reduce scarring, I wouldn'y like to think I maybe damaging vital grafts which may fail to grow.

 

Obviously the more hairs in the FU the bigger the tool required I guess? So maybe a combination of different size tools are used? I've heard its very common now for the 0.75mm tool and the 0.9mm tool. Does anyone know where the limit is now? Are doctors anywhere nearer using smaller FUE tools without compromising yeild?

 

I guess finally its always a compromise, and maybe FUE scarring, although not perfect, is still superior to a linear scar?

 

I would be keen to hear other peoples views on this especially if you are a HT doctor who practicing FUE?

Share this post


Link to post
Share on other sites

Hi mate - Hope all is well!

 

I am hoping to get a better understanding of the size of tool used and the possibility of scarring with FUE. I know that Dr Cole, who I have a very high regard for, says that extractions of 1.5mm or less do not normally show scarring that is visible under any normal viewing circumstances. However, I also have read of people who have complained that a 1mm tool has left visible scarring on their head (when shaved).

 

I have had a 1mm punch used on me and there is hardly any evidence of scaring, this was performed by Dr Jones - when I experienced all that shock loss :D Nothing to do with punch size i might add.

 

I then have had Feller perform various FUE sessions on me for my hairline and old strip scar with 0.8mm and 0.9mm size extraction tools which left absolutely no scaring.

 

This is very confusing, is it all down to individual healing characteristics? There is a strong suggestion that if you use too small a tool (0.75mm? 0.5mm?) you risk compromising the yield – which makes sense – but it is unclear how high the risk of that is either.

 

I think individual healing characteristics play a role but non more important than the right surgeon performing the procedure who knows what they are doing and who uses appropriate size tools. Particular clinics that use smaller punches experience poor yield and through experience now it has been proven that there is no need to use a smaller punch than a 0.8mm. Anything below this is potentially going to play a heavy role in poor yield - this is FACT as i have met several guys who have experienced very poor FUE yield from various clinics. When asked what size tool was used it was below 0.8mm - you do the maths :)

 

As much as I would like a small punch to reduce scarring, I wouldn'y like to think I maybe damaging vital grafts which may fail to grow.

 

There is no evidence of scaring with 0.8mm and 0.9mm these sizes also do not jeopodise the grafts integrity either.

 

 

 

Obviously the more hairs in the FU the bigger the tool required I guess? So maybe a combination of different size tools are used? I've heard its very common now for the 0.75mm tool and the 0.9mm tool. Does anyone know where the limit is now? Are doctors anywhere nearer using smaller FUE tools without compromising yeild?

 

I don't believe there is any need to go below 0.8mm as stated above - why run the risk of poor yield!!

 

I guess finally its always a compromise, and maybe FUE scarring, although not perfect, is still superior to a linear scar?

 

It all depends on the size session / personal requirements as to whether FUE or Strip via Tricho closure is more suitable to the individual. In the right Doctors hands there is minimal scaring now with both methods.

 

FUE lends itself to small sessions ideally ie hairline where as Strip will obviously enable you to achieve more grafts in one session and benefit larger requirements for obvious reasons.

 

 

I would be keen to hear other peoples views on this especially if you are a HT doctor who practicing FUE?

 

He are some pictures of Dr Fellers FUE donor sites:

view2.jpg

Patients%20Gallery%20006.jpg

-----------------------------------------------------------------------------------------------------------------------------

1aaa.jpg

hairrot%2013%20days.JPG

-----------------------------------------------------------------------------------------------------------------------------

49.jpg

290.jpg

post-17-1152276788_thumb.jpg

post-17-1152276805_thumb.jpg

post-17-1152276837_thumb.jpg

post-17-1152276857_thumb.jpg

post-17-1152276872_thumb.jpg

post-17-1152276887_thumb.jpg

Share this post


Link to post
Share on other sites

Hi Gasman,

 

The arguement about punch size is alive a kicking on other sites; smaller the better? not necessarily; there is an increased chance of transection and damage to the surrounding follicular units. Two reasons why punches should be custom to the scalp are the size of the follicular unit and the density of FU in the donor area.

 

1mm_punch_scarring.bmp FUE is not scar free; this is with a .75mm tool, used to avoid transection in this case. Scarring can vary from non visible to 1-2sqmm.

 

25__harvesting.bmp Over harvesting of the donor can be a problem with FUE, to avoid this stick to approx. 25%-30% harvesting rule. This will avoid a cosmetic density change in the donor and prevent shock loss to the donor due to over harvesting.

 

Variables to be concidered by the doctor performing FUE include:

 

Punch Size, inner & outer diameter

Hair shaft diameter and spacing between hairs and follicular units

Ethnic skin variations

Punch sharpness- renewed reguarly during the procedure

Hair direction

 

1_mm_punch.bmp This person's density is 75FU sqcm; a 1mm punch has enough room to remove the FU without damaging the surrounding units.

 

FUE_variables.bmp Here you can see the variations in punch size and the effects to the surrounding FU.

 

Phil

Share this post


Link to post
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Loading...
Sign in to follow this  

×
×
  • Create New...