Punch size

[41M]

Is there any relation between punch size or punch depth and yield? I have heard from some consultations that the fat surrounding the follicle impacts survival rates but I different doctors gave mentioned punch size and some have said it's depth of punch not circumference. Does anyone know or heard of the actual facts? This would help me in deciding on a repair procedure after one failed hair transplant with low yield at the Hairdr in Leeds

 

[mania]

I think so that the pouch size and punch depth really matter ...

 

[Bobbins]

It's easier to transect grafts when using smaller punches. The depth (and diameter) of the punch will influence scarring and the amount of time it'll take to recover.

The goal is to extract the entire follicle cleanly and with minimal damage to it. Skilled surgeons use the smallest and shallowest punch needed to achieve that.

 

[41M]

Thank you for this answer. If I understand correctly, larger punches cause more scarring and longer recovery but less chance damaging follicle. Whereas smaller punches are difficult to use for clean extraction without the right skill level?

 

[Bobbins]

Thank you for this answer. If I understand correctly, larger punches cause more scarring and longer recovery but less chance damaging follicle. Whereas smaller punches are difficult to use for clean extraction without the right skill level?

That's how I understand it. Usually people with thicker hair or with more hairs per graft need larger punches. Similarly patients have different distances between the surface of their scalp and the follecular unit which determines how deep the punch needs to be. I'd imagine surgeons experiment with the first few extractions to work that out for each patient.

From what I understand there are various components that make up the follecular unit that need to be extracted cleanly and ideally with some surrounding tissue. There's then some debate about whether that tissue need trimming or not, but I haven't looked into that much.