Hair, like you've
never lost it.
™
HAIR TRANSPLANT SPECIALIST
Manual Vs Motorised FUE
Manual FUE
Manual FUE has always been considered the gold standard in hair restoration surgery. It involves the operator using a sharp punch of approximately different sized punches ranging from 0.8 to 1mm based on the texture of the donor hair.
Advantages of manual FUE:
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The operator gets to feel the grafts carressing the skin and conceptualise the different layers of the scalp. This in turn produces superior quality grafts.
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The operator has better control over the speed of rotation of the punch therefore minimising the sheering forces resulting in less trauma to the grafts.
The operator has better depth control resulting in less transactions and also less scarring.
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In an experienced pair of hands, manual FUE can yield exceptionally good numbers.
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Disadvantages of manual FUE
As the punches are sharp, the transaction rates can be very high in an experienced pair of hands.
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The learning curve with mastering manual FUE can be painfully long and a lot of practitioners tend to lose confidence in the early stages of their career as the transaction rates can be exceptionally high.
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In patients with slightly thicker skin, manual fue can become very laborious as the punches keep getting blunt and also the operator struggles to get perfect angles.
In patients with different hair textures i.e afro carribean or curly hair, manual fue can become very laborious as the operator has to use a sharp and a blunt punch thereby increasing the duration of the procedure.
Motorised FUE
Motorised FUE involves the use of a motor device to aid in the rotation of the Fue punch. There are hundreds of motorised systems on the market and a review of the systems are beyond the scope of this article. We believe motorised FUE has revolutionised this industry by allowing more practitioners to achieve reasonably good results with FUE.
Advantages of manual FUE:
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The learning curve for the practitioner can be exceptionally short.
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With use of blunt punches, the transaction rates can be minimal.
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The speed of extraction has improved exponentially with the use of motorised FUE.
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Patients with different skin and hair textures who would have been previously unsuitable for FUE are now able to undergo FUE because of automation.
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Disadvantages of motorised FUE
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As the practitioner fails to develop a feel for the grafts, the transaction rates can be unacceptably high.
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Some practitioners opt to leave the motor in a continuous mode to increase the speed whereby causing higher transaction rates and increasing scarring.
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With the introduction of motorised FUE, more non medical personel are performing FUE extractions which is against the law as the lack of medical expertise can cause irrepairable damage to the patient.
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The scarring with motorised punches can be unsightly.
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With the increased prevalence of motorised FUE, I believe that the practitioner will lose a deeper understanding of grafts and tissue quality which they would have developed had they done manual FUE prior to motorised.
Main Issues That Are Generally Overlooked
When Counselling
Patients For A
Strip Surgery Are:
Quality Control
After the strip is dissected, it is generally passed on to a team of technicians who trim the strip into individual grafts. During the process of trimming there is an unknown entity that becomes into play. That is the skill and motivation of the technician. Hence it is a known fact that surgeons that have consistent teams achieve far better results than someone that relies on freelance technicians. Whilst exploring options of a strip surgery, it is advisable for a patient to meet the team and get to know the team that will be operating.
Scarring
It is a well known fact that strip surgery can produce significant scarring in the donor area, when performed by untrained hands. A simple test a patient can perform is to pinch the back of the scalp to check for signs of laxity. If the client is known to have a tight scalp the chances of poor scarring with a strip surgery increase exponentially.
Placement of
Grafts
Historically strip surgery has been promoted as a surgery that has better outcomes because of the presence of galar fat at the bottom of the grafts. Whilst it might offer better leverage for the technicians whilst replacing the grafts, studies have shown that the growth of the grafts is not dependent on the presence of the galar fat. With improvements in extraction and placement of grafts by FUE, the outcomes are much better with a strip surgery.
Quality of
Grafts
During the process of extraction of follicles using strip surgery, the number of follicles per graft is significantly less compared to that extracted by FUE. This is because most of the grafts that are extracted with a strip surgery have follicles containing single and double hairs. Whereas with a FUE, the surgeon has complete control over the grafts and he can pick and choose the ones that give maximum benefit to the client. Besides, the technicians are encouraged to keep the grafts skinny by dissecting most of the tissue surrounding the grafts as this helps in quicker placement of grafts. I believe the preservation of the pilosebaceous unit is key maintain the natural appearance of follicles and this is where FUE trumps FUT.
FUE Scarring
There is a common misconception that FUE leads to pitting scarring. Though it is a fact that badly performed FUE can lead to visible ‘dot’ like marks on the back of the scalp; with improvements in FUE, the chances of visible scarring is negligible and by following certain protocols and extraction there is evidence to suggest that the scarring is almost invisible.
Duration of
Surgery
Whilst everyone acknowledges the fact that FUE takes a lot longer to perform and hence the grafts might stay outside the body for a longer duration than in FUT, my argument is that one can achieve good outcomes with FUE with fewer grafts than with FUT. This helps with improving the yield as it decreases the duration of the surgery and also the fatigue factor associated with technicians replacing a large number of grafts associated with FUT surgery.
Our clients have voted our FUE as one of the least painful surgical procedures they have undergone. Most of our clients are back at work in under 48 hours.
Recommended
by many.
We believe in a business model that is solely based on recommendations and hence 90% of our clients come through a personal recommendation. With the personal trauma suffered from sub-optimal surgery, Dr Reddy has a personal motto of making sure that none of his patients go through the same
