Depth of incision?

[sweetfreedom]

Something that had never crossed my mind before is what depth the doctor's instruments have to go to in order to extract the donor follicles?

I have been trawling through loads of videos (clinic's own and Youtube) and watching the extraction tool did make me wince abit. I have no knowledge of anatomy but when you feel your scalp there doesn't seem to be any fleshy covering at all! Maybe the covering is very firm?

I'd be interested in more knowledge on this

Thankyou in advance

 

[Bigmac]

Sure there is something on this forum about this, will link it if i find it.

 

[RichTea]

I am interested in this because at the start of my HT the Nurse mentioned my donor follicles were very deep and was having trouble getting them out until she changed to a tool that did the trick .

I was wondering what the difference was between patients with shallow and ones with deep follicles . and does this make any difference in the chance of the HT taking and growing ?

 

[sweetfreedom]

Thanks, I look forward to some info on this.

As I said, when I feel around the donor area there seems to be no 'fleshy' covering and it's hard to imagine there being enough depth to extract anything, though of course there must be!

When the tool(s) is used does the doctor ascertain the depth himself or does the tool have a 'stop depth?' And if so does this stop have adjustment?

My concern I suppose is alittle gruesome in that I wonder about the tools striking bone and wondered how this is avoided. Apologies, I had to ask!

 

[Bigmac]

The FUE punches have a stop depth as the docs set the punch to to the depth required in the punch holder, as for strip, again the doc will set the cutting blades to the depth he requires.

 

[sweetfreedom]

Bigmac wrote:

The FUE punches have a stop depth as the docs set the punch to to the depth required in the punch holder, as for strip, again the doc will set the cutting blades to the depth he requires.

Thanks bigmac, I have also posed the depth question (along with another member) in the other section about new FUE punches

 

[sl]

Depth can vary from person to person and in extreme cases even vary on the same scalp, also with hair characteristics. It's an important factor with FUE and understanding this aspect otherwise transection can increase, so depth and orientation must all be equated for the method of extraction in order to perform FUE well.

 

[Bigmac]

Thanks Sl.

 

[martinvain]

Stephen what are the indicators of depth? i.e. do you know what criteria the Dr applies when FUE punching?

I assume there must be an average depth of a follicle but what, if any, tell tale signs are there that a follice may be shallower or deeper than average?

I think this is a pretty interesting topic.

 

[sl]

Hi martinvain,

It's an important topic actually as this is an area often not discussed but very important in performing FUE well, keeping transection down and yield high.

FUE is a blind technique, we can't see the graft in the skin so orientation and depth is something that has to be estimated initially, a good FUE doc will tell you that they can "feel" the FU as the punch surrounds it, this comes with time and performing many FUE procedures.

Of course there is an average approximate depth to the FU's and can differ dependent on hair characteristics, with the first few punches made by the doctor they can establish the orientation and depth. I remember a case we performed a while ago when Dr. B was saying the depth was changing almost with every punch and it was making punch/extraction that much harder to keep transection down. After discussing with the patient the approach to the op was slightly changed to accommodate slightly less grafts than initially quoted to keep the transection down to acceptable levels.

 

[sweetfreedom]

Thanks Steve, some good info.

I think it possibly is something that is largely overlooked.

As you know, I have been interested in FUE for a few years now and have never really given this particular aspect a second thought. But as you suggest, it is reliant on the skill of the doctor and his interpretation of the donor area. This more than anything else must ensure the protection of the precious follicules, and also aid the healing process.

I guess this amongst other less important criteria ultimately determines whether FUE surgery is successful, and emphasises the incredible need to source the very best doctor. In doctor B you have that for sure. As with many 'trades' his skill must now be instinctive and that would instill the greatest confidence for me.

Kind Regards

 

[sl]

In many professions you can have those that have an innate skill and those that find it very hard to build their skill set, a little like football, some are just naturally talented and others have to train hard to get near the same levels.

It's important to get things into perspective otherwise it can sound like FUE is impossible to perform well, it is not, hopefully my case, and many others are testament, but it does require much more understanding of anatomy compared to Strip, requires more patience to perform, more dedication.

Caution should be taken and when researching and don't be shy of asking probing questions, compare answers from the different docs/clinics and research the logic and correctness. The information is out there to be found just you have to look for it sometimes.

FUE has more areas if you like "to go wrong" as each extraction is blind it's almost like performing multiple ops within one large one, but it can be performed well and as good as Strip if protocols are placed to keep the harvesting within % levels of the donor density and an educated pattern of extraction to give options for the patient in the future, be it more FUE or Strip.