Hair transplant surgeons use a wide range of instruments and utensils during a hair transplant operation. The primary instrument hair transplant surgeons use is the punch tool. Punches can be manual, robotic, suction-assisted, motorized, or take other forms. Depending on the sharpness, shape and size, the punch will exhibit different capabilities and executions.

It is our expert opinion that the manual punch is the most accurate and effective of the surgical punches due to its very small diameter aperture (Dr. Yazdan uses the smallest size for maximum detail, 0.7 millimeter) and tremendous free-from aesthetic capability. By free-form capability we mean that it is capable of handling extremely difficult angles (associated with curly hair for example) and skin types (whether loose or tight). A manual punch – when under the direction and usage of a master transplant surgeon – can create high quality grafts and a most natural-looking hairline.

The punch incises the skin surrounding the hair follicle (follicular unit), freeing it from the surrounding tissue in order to be implanted safely in the scalp.

Dr. Yazdan’s State-of-the-Art Instrumentation
Dedicated to research and improvement in the field, Dr. Amir Yazdan is one of the foremost innovators of specialty FUE utensils and devices. Over the span of a decade, Dr. Yazdan has engineered punches that are the sharpest in the world and made from the highest quality materials. Dr. Yazdan’s micro punches boast a unique design to minimize scars and have a transection risk rate of below 2.5%, the lowest in the industry.

Moreover, Dr. Yazdan only conducts manual extractions using the smallest possible punch, for purposes of maximum accuracy, aesthetic precision and natural-looking design.

Manual vs. Robotic FUE Hair Transplants
Based on clinical experience and a study of the various hair transplantation methods and instruments, Modena Hair Institute maintains that manual FUE operations done by hand from start to finish result in the most natural and symmetrical hair line. No machine or robotic device (yet developed) can mimic the artistic finesse and pure design of the work done by the hand of an expert hair restoration specialist.

Even as many come to understand that high tech machines and surgical devices are simply neutral tools which provide no guarantee of even half-way decent results, many hair clinics continue to market FUE machines like the NeoGraft and Artas as immediate routes to excellence and success. Yet usually the opposite is true, based on our clinical experience. Any hair restoration practice that markets a machine more than a surgeon is cause for suspicion and concern, as only a highly competent and skilled surgeon can use a robotic instrument successfully – and even then there are no guarantees or special advantages to using a machine.
On average, based on the repair clients we have received and deep

knowledge of the technical advancements in hair restoration over the last decade, hair follicle/transection damage can be higher when using robotic devices as opposed to manual extraction by an experienced surgeon. Compare the advantages and disadvantages of manual and robotic punches below:

• Smaller incisions when done manually, due to small diameter punches
• Smaller scars when done manually
• Larger incisions and deeper punches when done robotically, which can mean larger scars
• The vacuum suction of certain robotic machines can damage the follicle and dry out the graft
• Larger grafts require larger recipient site incisions which can mean lower density and unnatural appearance

Robotic Devices and Unskilled Technicians
We’ve discussed the disadvantages associated with the method and application of robotic devices, but there exists another great area of concern: such devices are operated – many of the time – by poorly trained and outsourced technicians who are often performing the surgery without a doctor present.

Why would manufacturers of state-of-the-art robotic devices market their product to doctors and clinics with little to no hair restoration experience? The answer: to gain a bigger return on their investment. It has been reported that since the NeoGraft company markets primarily to physicians with no prior hair restoration experience that the physicians can hire teams of hair transplant technicians who often perform the entire procedure for the physician.

The International Society of Hair Restoration Surgery (ISHRS) has issued a consumer alert regarding this practice. Many hair transplant surgeons simply found no need or advantage in purchasing such surgical devices, and so these companies began to advertise and sell to doctors with little to no hair restoration experience.

Dr. Amir Yazdan, MD, is an internationally renowned hair transplant surgeon, expert guest on Dr. Phil and The Doctors, creator of the GroMD hair restoration product line, ISHRS member, accredited member of the IAHRS and a visceral advocate for patient care. Learn more about Dr. Yazdan or read rave reviews from his patients.