Does the size of the FUE punches influence the size and visibility of the tiny scars ?
For a few years, the choice of the optimal diameter of a FUE punch has been the object of heated discussions. Two schools of thought exist. The first one advocates for using a diameter of 0.7 mm, or 0.8 mm maximum, in order to minimize the scar on the one hand and to avoid damage to the grafts surrounding the one extracted on the other hand. As far as the second school of thought is concerned, it advocates for using an “optimal” diameter which takes into account the particular characteristics of each donor are. In practice, the objective is to choose the diameter which is as small as possible but which allows to obtain “beautiful grafts”. Indeed, small punches of 0.7 or 0.8 mm deliver most of the time grafts of one or two hairs; those which contain more hairs are rare. However, a diameter of 0.9 to 1 mm delivers – with a limited transection rate – beautiful grafts that contain a number of hairs higher than those obtained with small punches.
My personal approach is as follows: after observing the donor area, I choose the most adequate punch size. Then, I adjust, through successive trials, the punch size and the incision depth. I prefer obtaining grafts rich in hair in order to reach an optimal density within the recipient area. I even often combine two punches of different diameters, the first one for the grafts with 3 or 4 hairs, and the second one for the grafts with 2 hairs.
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