Not All FUE Punches Are the Same

[Michael Vories, MD]

We have been seeing patients who have had a FUE procedure performed with the ARTAS robotic system in which the punches used seem quite different in size from the ones we use, even though they are being told they are the same size.  This patient had a 2000 graft ARTAS procedure about two years ago, in which he was told the occipital harvesting was performed using a 0.90 mm punch. We performed a second 2000 graft surgery one year ago using a sharp punch system, also with a 0.90 mm punch. He came in this past week for a smaller procedure and that is when the photo was taken after his hair was clipped. The extractions in the upper half of the occiput was performed two years ago using the ARTAS machine, and the lower half was using our sharp punches one year ago. We did not perform any extractions in the upper half for fear of over-harvesting. As we all know, FUE is not a non-scarring procedure, but the scarring is definitely related to the punch size, and keep in mind that all punches are not calibrated equally.

[Mycroft]

Definitely a stark difference in the scarring here. Hopefully the patient is able to achieve a satisfying result because it looks like enough of the donor area was compromised by the larger punch that his options may be limited in the future.

[Sean]

Valuable piece of information here.  You can clearly see Artas is not the same.  
 

It has given a moth eaten look in donor.  The whole point of FUE is to look scarless as possible.  Well here, a shaved head, and you go the beach, you can see a person has some odd dots.  ARTAS messed the donor.  This is why FDA and regulatory bodies need to be more involved with tools used in surgery.  
 

Very valuable and rare comparison shared here. Imagine the density loss and donor area graft loss.  

[LonelyGraft]

@Michael Vories, MD

great example. Could it be that the providers using artas are referencing the inner diameter of the punch only? When in reality when the entire (inner+outer diameter) are measured the true punch diameter is probably closer to 1.1mm or even higher?

[Michael Vories, MD]

I believe this is likely to be true. Depending on the thickness of the punch wall, there can be a considerable difference between the internal and external diameter of the punch. The measurement of the punches we use is based on the external diameter, which is what will determine the actual wound size.

[nordicwarrior]

7 hours ago, Dr Abhinav Kumar said:

The patient may not have buzz cut in  future without the donor getting visible when he ages and there is reduction in donor hair volume.

@Dr Abhinav Kumar what do you suggest is the best option for people wanting to do a buzz cut later?

[Melvin- Admin]

For full disclosure and transparency, I have had to hide some responses made from a physician. Apparently, this physician was affiliated with another clinic, and some of the information he has been providing has been brought into question. I need to research this a bit further and speak with the physician and the clinic, until further notice some of his responses that give personal experience information will be hidden. 

Best wishes, 

 

Melvin