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.
Jeffrey S. Epstein, MD
Member, International Alliance of Hair Restoration Surgeons
View my IAHRS Profile