FUE and Punch sizes...

I wanted to discuss actual research done on punch graft sizes. There is obviously a variable to punch sizes in relationship to the individual’s hair texture, FU size, or any other physical factor that would contribute to the need of a larger punch size. Outside of lower transection rates and quicker procedures, is there a benefit to larger sizes? Is there a noticeable difference to scaring long term when comparing a 1mm punch to a .8 mm punch? Have there been any studies done recently to evaluate whether it is actually worth risking a higher transection rate using smaller punches? Common sense says the smaller the punch size the smaller the scarring. However, is there a point where dropping below a certain size, it essentially becomes irrelevant cosmetically speaking?

... Hoping a few FUE Docs chime in on this one.

You raise some good questions, and a few concepts need to be addressed with regards to the FUE procedure.

First of all, the size of the hole after a graft extraction is not a direct relationship to punch size- for it is the outer diameter, not the inner diameter which affects the scarring. So in other words, not all 1 mm punches have the same outer diameter.

Second, there is a tradeoff it seems, between larger punch size and lower transaction, but this does not seem to be the main determinant of hair transaction. At some point, and speaking from observation, not any formal studies, I have found that sometimes a perfectly sized 0.8 mm punch produces better grafts than a 1 mm punch.

The bottom line- is to find a surgeon who is confident in his consistent ability to achieve the very best results with the FUE technique.

Thanks Dr Epstein for chiming in. I have to say, I thougt this would have gotten a few more replies.