How important is the punch size in FUE hair transplants?

How important is the punch size in FUE hair transplants?

In this article I show you what can go wrong if your surgeon doesn’t use the correct punch.

There are several main reasons why patients choose to have a FUE (follicular unit extraction) hair transplant as opposed to the older strip method.

Firstly the strip method is a much more invasive process which involves literally cutting a strip of skin from the back of the head. Many patients prefer to avoid this painful procedure by opting for the gentler FUE procedure.

However the main reason most patients opt for the FUE technique is because they want to avoid the long linear scar which the strip technique leaves on the back of the head.

But does this mean that the FUE technique is entirely scarless? Let’s discuss the factors that can influence whether an FUE procedure will leave scars and how big those scars will be.

One the main determinants of scar size in an FUE hair transplant is the size of the punch (circular scalpel) used to extract the follicles. If a large punch is used follicles can be extracted more easily. There is less risk that the follicle will be cut or 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 often use a larger sized punch to perform the FUE technique.

However the larger the punch, the more probable it will be that there is a visible scar on the skin.

Take a look at the photo below.

This shows one of the patients who had a previous FUE procedure performed by another doctor. As they can clearly see the patient’s head has many highly visible circular scars from the previous doctor. I am not certain what size punch was used on this patient, but evidently it was too big. Also visible in the photo are the small red dots of my new extraction sites made with a much smaller punch. The difference is clear to see.

Of course, other factors can play a role in the formation of scars such as a patient's skin type and individual physiology of healing, but with a well performed FUE procedure any scars should be of the smallest possible size.