Case Study – Punch Size Matters

The FUE method is considered the new breakthrough in hair transplant surgeries today and is growing in popularity.

In this article we’ll show you what could go wrong if your surgeon doesn’t use the correct punch size in a Follicular Unit Extraction (FUE) hair transplant.

If you’ve started your homework on hair transplant procedures, you’re probably well aware of the term “punch size”. Punch size refers to the size of the tool used in order to extract the hair follicles and replant them in the desired recipient area.

There are several reasons why patients choose to have an FUE transplant as opposed to the older Strip (FUT) method however, the main reason most patients opt for the FUE technique is because they’d rather avoid the long linear scar on the back of the scalp that Strip tends to leave. It is a great alternative if you like to keep a short hairstyle. Now does this mean FUE is entirely scarless? Let’s discuss the factors that can influence whether an FUE procedure will leave scars and how aesthetically unpleasing those scars can look.

The main determinant of scar size in an FUE hair transplant is the size of the punch used to extract the hair follicles. These punches typically range between 0.6mm-1.4mm in diameter. In general, a small punch size will result in a smaller FUE scar and with a good surgeon it will likely be invisible to the naked eye. Likewise, a larger punch can lead to larger scars. If a large punch tool is used, the follicles can be extracted more easily and there is less risk that the follicle will be damaged by the punch as it penetrates the skin since the punch covers a larger area around the follicle. For this reason, less skilled doctors tend to use larger sized punches to perform FUE without letting patients know the difference.

The punch size used differs from surgeon to surgeon. However, it is a common understanding amongst most board-certified physicians that the larger the punch size the higher the risk of scarring. Here at Modena Hair Transplant, Doctor Yazdan prefers to titter between a 0.7mm and a 0.8mm punch to extract grafts which greatly reduces the risk of scarring and can easily remove 3 hair-follicular units in tact and unscathed.

Some doctors will tell you they prefer to use a larger punch in order to have room to extract 3-4 hairs although more than likely, these doctors don’t have the experience and skill it requires to extract the follicles containing multiple hairs using a smaller tool. “This isn’t something learned overnight and it takes years to optimize the technique” Dr. Yazdan adds.

A larger punch makes it much easier for the doctor to extract and they’re able to perform several surgeries a day. At Modena, Doctor Yazdan never performs more than 1 surgery per day, giving every last bit of his attention to the patient so he can take his time to give you the best results possible.

Many consider FUE minimally invasive because a small punch is used to harvest single hair grafts one at a time. The result is hundreds if not thousands of tiny round “holes” where the donor hair follicles are taken. You’re also seeing more doctors overharvesting the donor zone because they’re promising patients these ludicrous graft numbers that are just unrealistic leaving you with more scars and less hair. While it’s true the FUE technique won’t leave you with one large linear scar, it can leave you with thousands of ‘tiny’ round scars if not done properly. Dr. Yazdan prides himself in his technique- never using large punches and never overharvesting so there’s no damage to the donor area.

You’re also seeing more and more doctors dabbling in the use of robotic devices to assist in extraction, yet these machines are only capable of using larger punches (1.2mm) and to date haven’t yet advanced to the point of using smaller punches. Unfortunately, these robots still don’t have the capability for precision like the human hand does. At our clinic, Dr. Yazdan himself always does the procedures- no robots over here!

The photos above pretty much speak for themselves. The photo on the left was done by a previous doctor at another clinic using a much larger punch size probably around a 1.0mm punch. The photo on the right shows Dr. Yazdan’s work using a 0.7mm punch, notice any difference? Well you should! Just a few millimeters larger of a punch in an FUE procedure can make a huge impact on the skin and on your ego!

For questions or to schedule a consultation, call one of our offices conveniently located in Irvine, Newport Beach, Beverly Hills and Las Vegas at 888-717-5273 or contact via our website at contact Modena Hair Link