Regular Member NW3VKY Posted January 30, 2013 Regular Member Share Posted January 30, 2013 I have been researching FUE for some time, the different techniques, punch sizes, inner diameter, outer diameter, what is feasible to harvest larger follicle units, etc. The one main question I have......what is the generally accepted size punch for a caucasion male, with medium caliper hair in donor area. I am a NW 3V and most of my need is in the vertex. I have about 50 cm sq which needs to be restored - of area - about 7 cm x 7 cm. So, obviously, I want the most density possible and don't necessarily want a bunch of 1 units. I know it depends on how closely they are packed, as well. My question is, if the clinician is taking 2,3 and 4 units for my crown, doing FUE, what would be the minimum punch size that they would need to use ? My research tells me that since a 1 unit avg about .46mm (at bulb); a 2 unit is .78; a 3 unit is about .86 and a 4 unit is .94mm, the clinician would need to use a 1mm punch to effectively get the larger 3 and 4 units. I know these are averages and that mine may be smaller. So, when I see some of the experts like Lorenzo (who appears to us a .75mm on most cases), Feller and others who use .8mm most of the time, it makes me think that either they are transecting the larger 3 and 4 units or maybe they are not going down to the bulb root, but simply going down over the shaft, breaking the dermal layer and pulling it out, without damaging the root of the larger units. I would just like your opinion on the feasibility of the .8mm punch in extracting larger units. Link to comment Share on other sites More sharing options...
Senior Member Mickey85 Posted January 30, 2013 Senior Member Share Posted January 30, 2013 Doctors like Lorenzo and Feriduni(both told me this) use an array of gauges depending on the hairs they are targeting. Smaller gauges for the single hair grafts and bigger gauges for the 3's and 4's. One size does not fit all and the FUE doctors who are serious about the procedure know this and won't use one gauge for the whole procedure regardless of race. Not sure about other Doctors. The only 2 threads you will ever need: Revamped Advantages/Disadvantages of FUE. Myths dispelled. Educate yourself Everything FUE. Manual, motorized, ARTAS, NeoGraft, physician details and more Link to comment Share on other sites More sharing options...
Regular Member NW3VKY Posted January 31, 2013 Author Regular Member Share Posted January 31, 2013 What is the inner diameter of the Hans Implanter device that Lorenzo uses ? I would think it would have to be at least 1.2mm to accommodate up to 1mm punched grafts/donor sites. Is the Hans Implanter a good device to use for placement ? It seems that it would be very sensitive and easy to transect the bulb on placement as the clinician tries to extrude the root into the placement site all at one time. Plus, it seems like it would be difficult for handling by the assistants to keep from "over-handling" the grafts putting them into the implanter one by one. Link to comment Share on other sites More sharing options...
Senior Member Mickey85 Posted January 31, 2013 Senior Member Share Posted January 31, 2013 What is the inner diameter of the Hans Implanter device that Lorenzo uses ? I would think it would have to be at least 1.2mm to accommodate up to 1mm punched grafts/donor sites. Is the Hans Implanter a good device to use for placement ? It seems that it would be very sensitive and easy to transect the bulb on placement as the clinician tries to extrude the root into the placement site all at one time. Plus, it seems like it would be difficult for handling by the assistants to keep from "over-handling" the grafts putting them into the implanter one by one. Unsure about the diameter of the implanter pen. You bring up some good points about the potential for transection and it's potentially large gauge. I think it could be thinner than 1.2mm. Just because the punches are 1mm doesn't mean the actual grafts are. FUE is blind extraction so it's better to use a slightly bigger punch and extract the hair successfully(even if the scar will be slightly bigger) than to have a smaller scar and a dead graft. I'm slightly weary of the implanter. Alot of amazing FUE doctors like Lorenzo, Dr Hakan and Erdogan(I think) use it with great results but I think about the recipient damage it may cause compared to the thinner blades Feriduni and Bisanga use. The implanter pen resembles a needle rather than a blade so possibly more invasive but you probably won't be able to tell. Lorenzo has almost 200 clear videos showing close ups of the recipient site with no marks or scars showing. I think Lorenzo is possibly the best FUE surgeon in the world. If you want to worry any less, don't go through with a procedure The only 2 threads you will ever need: Revamped Advantages/Disadvantages of FUE. Myths dispelled. Educate yourself Everything FUE. Manual, motorized, ARTAS, NeoGraft, physician details and more Link to comment Share on other sites More sharing options...
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