Transplanted grafts with or without white bulb?

[giegnosiganoe]

Why do some surgeons leave a white bulb and others (I guess) trim it off? What's the difference?

Attaching some cropped pictures from recent threads.

[DrTBarghouthi]

Yes it depends on several factors I guess. Some fine ones may be refined and that means the top white epithelial skin cap might be trimmed too. It can also depend on the punch size and the angle of extraction. A more perpendicular angle would give a bigger white top than a more acute angle of extraction. In all cases it is not part of the functional graft. In fact too many bog white caps and make it a bit harder to dense pack as they are often the biggest part of the graft.