Category: FUE

Is there a 0.75 mm dull punch? Or is it possible to use Dr. James Harris’ two step technique with a 0.75 mm tool, so there would be a lot less transected follicles?

Follicular extraction is a very delicate and technically challenging process with its transection risks. As you can imagine, smaller diameter instruments will have more transection rates. It is a balance between technology and technique that will ultimately determine the acceptable transection rate. I have personally developed and used a 0.75mm and even a 0.70mm dull and sharp punch utilizing many techniques (including the two step technique). It is my opinion that the technology has not been perfected to my satisfaction for the entire Follicular Extraction process and damage with the an instrument of this size is generally unacceptable. With the current state of technology, acceptable FUE procedures can be done with a 0.9mm diameter punch.

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Hello or “Hej” – as we say in Sweden.

I did read a post from you talking about FUE instruments, you use 0.9mm and smaller tools will cause greater follicular holocaust, you said.

Recently I did read a blog entry from you where you talked about FUE and the development of smaller tools.

I’m confused. Here in Sweden we have an intresting option, 0.6mm. Is this pure nonsense or could this surgeon be that good? Method is called “FUE plus” and is said to transplant 120-180 hairs / cm2.

I did notice that you said that 200 hairs / cm2 is the original density provided by the “man above”.

Why increased follicular holocaust when using smaller instruments?

I am hopeful that some breakthrough will come about that will allow smaller instruments to be used, but alas I have not seen them yet. Without knowing the doctor who proclaims such miraculous instruments, as a betting man, I would wager that some lack of proper representation is the case here. Add to such a wonderful instrument, the ability to achieve within 90% of God density and you have FUE God Plus. That means that some doctors can improve on what God might do if he (or she, depending on your beliefs) was a transplant surgeon here on earth.

Dear Dr. Rassman,

I am considering having a transplant procedure at your clinic. My preference would be to have the fox procedure since I would like the option of a very short haircut and am very physically active…. swimming, etc. and want the least amount of scar detection.
My question is this: Will having a fox procedure possibly limit my donor site options years down the line when I may need to come back to fill in other areas?

Thanks!

Everyone has a limited donor bank of hair and FUE will deplete that donor bank just like strip harvesting will do. The question I’ve been asked a few times is: Will there be more donor area with FUE than with traditional strip harvesting? The simple answer is only a guess as no one to my knowledge has pushed the donor supply far enough to find out the answer to that question.

Hi Doc,

Quick question regarding your “FUE Scars” response on May 30th. Are any tools under research or developement (at NHI or anywhere else) that will leave wounds in the 0.75 mm or less range? Or does “impractical” mean “impossible?”

Thanks!

There are some doctors using a 0.75mm sharp punch for FUE which is smaller by a factor of 30% from the 0.9mm punch. The follicular holocaust is very large. If it were reliable, I would be using it. Some doctors are telling their audience of patients that they CAN do this successfully with a 0.75 mm sharp punch. I am just a mortal and will not delude the public into believing what they may want to hear, or selling them a ‘bill of goods’ that I believe promotes the business at the patient’s expense.

If the technique can be perfected (we are trying to do just that), then it would be superior to what we do now with a 0.9mm instrument, because the wound would be much smaller, faster healing (now it heals in 5 days), create a smaller scar (now the scars are 0.9 mm round) and possibly would allow more harvested follicles. But alas, the technology is where it is now, that is, except in those doctors who promote their godly likeness.

Hi Doctor,

I have been adviced by a hair transplant surgeon against FUE, instead he suggested FUT.

The reason he gave was – the scars of FUE, which are generally left open to heal are very dangerous in weather condition like south asia. The scars are prone to get infected. Also he mentioned about various types of sealing but he also added that it doesnt help much.

He advocated FUT over FUE for- its less prone to infection, it takes less time, its costing much less and the it suitable for large number of grafts (I need around 2000 grafts on frontal area).

I am confused as I dont want the scar involved in FUT, but want a safer procedure.

So is FUT more safer/better suited alternative than FUE for my condition?

First, if you are clean and wash your hair regularly, FUE is not a problem even in wet or warm climates.

I agree with your doctor otherwise. The FUT is less expensive, easier to get larger sessions, and probably in his hands, safer than FUE. I personally try to tell my patients that scarring above 3mm occurs in less than 5% of patients. The use of a trichophytic incision and fascial closures as discussed in this blog, should address the scarring risks in most patients.

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