bullitnut
4 awesome repairs with SMG
These may be silly questions but i'm curious nethertheless to what is the optimal sized graft.....do differant clinics vary on this and does the size of the graft have any impact at all on yield?
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Bigmac
Administrator
Staff member
Good question as some clinics will trim grafts down whilst others prefer cubby grafts. If extracting via Fue the punch size will have an effect on this.
DHI
Valued member
Dear bullitnut,
The first issue is that the size of the graft should be adequate in order for the graft to be viable and grow hair. The usual 1.0 size punch in the FUE method is adequate for extracting the normal follicular unit which is of 1mm in diameter.
There are various researches done. Others show low survival of chubby grafts and others show low survival of very thin ones.
The professionals in the hair restoration field have various opinions.
Some believe that getting the stem cells is adequate for the follicular unit to give hair, so that means that even a thin graft can grow hair. Others believe that the surrounding tissue is necessary in order for the graft to be well fitted in the placement hole.
To be honest DHI believes that the main issue is how the graft is treated during the whole procedure from the moment of its extraction, its preservation and finally its placement. All the above should be done by avoiding harming the graft as well as the recipient skin. Both the graft and the recipient skin should be viable in order for the graft to grow hair. So if the procedure is done properly there should be no fear for the final growth.
The other issue is that extracting grafts with multiple follicular units is of the benefit of the patient's final hair density since these ones will grow more hairs in total. So it is preferable being able to control the transection of the grafts and get multiple follicular units as well as single ones.
The first issue is that the size of the graft should be adequate in order for the graft to be viable and grow hair. The usual 1.0 size punch in the FUE method is adequate for extracting the normal follicular unit which is of 1mm in diameter.
There are various researches done. Others show low survival of chubby grafts and others show low survival of very thin ones.
The professionals in the hair restoration field have various opinions.
Some believe that getting the stem cells is adequate for the follicular unit to give hair, so that means that even a thin graft can grow hair. Others believe that the surrounding tissue is necessary in order for the graft to be well fitted in the placement hole.
To be honest DHI believes that the main issue is how the graft is treated during the whole procedure from the moment of its extraction, its preservation and finally its placement. All the above should be done by avoiding harming the graft as well as the recipient skin. Both the graft and the recipient skin should be viable in order for the graft to grow hair. So if the procedure is done properly there should be no fear for the final growth.
The other issue is that extracting grafts with multiple follicular units is of the benefit of the patient's final hair density since these ones will grow more hairs in total. So it is preferable being able to control the transection of the grafts and get multiple follicular units as well as single ones.
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topccat29
29 year HT veteran
I definitely agree with some of this DHI post. One can easily say the skinny graft is less viable and hence a lower survivability rate just as one can say there is a higher transaction rate with a smaller fue punch. What is always left out is in who s hands are we speaking of, when the difficulty factor rises the skill level must be there at the same time, if it is not then yes you have failure resulting in low survivability.
I also agree that multi unit grafts have their place and I would consider them larger grafts and not necessarily chubbier.
As the difficulty factor rises in anything sometimes the rate of work needs to slow down and one needs to have the skills but if the end result is superior then maybe one should opt for the superior result and not the easy one. I'm sure chubbier grafts are easy to place but one's goal should be to always strive to become better at the hard stuff.
I m not a doctor but this same logic would apply to many things in life.
Jim Rohn has a quote I have often connected with "Don't wish it was easier, wish you were better". When it comes to work I have always seemed to follow that path for some reason. It always seemed to be a never ending goal to just become better and on the same token I have seen many that just want to get through the day.
I can appreciate anyone who strives at just wanting to become better.
Dense packing is a good example not all clinics can do it............why?
I also agree that multi unit grafts have their place and I would consider them larger grafts and not necessarily chubbier.
As the difficulty factor rises in anything sometimes the rate of work needs to slow down and one needs to have the skills but if the end result is superior then maybe one should opt for the superior result and not the easy one. I'm sure chubbier grafts are easy to place but one's goal should be to always strive to become better at the hard stuff.
I m not a doctor but this same logic would apply to many things in life.
Jim Rohn has a quote I have often connected with "Don't wish it was easier, wish you were better". When it comes to work I have always seemed to follow that path for some reason. It always seemed to be a never ending goal to just become better and on the same token I have seen many that just want to get through the day.
I can appreciate anyone who strives at just wanting to become better.
Dense packing is a good example not all clinics can do it............why?
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H
hairtech
member
Good post Topcat.
I wanted to add that most clinics do use the 1.0mm punch and the more experienced clinics try to use smaller punches. In my opinion the range of punches should be between 0.8mm to 1.0mm and never larger.
For the past 5 years we have safely used a 0.9mm on 99% of our cases and went higher for difficult cases and with good yield.
In my opinion the increase in diameter after a 1.0mm also increases the chance for scarring probably exponentially in each 0.1mm increments. I argued about this for years.
Below is an example of a rare case we had 1 week ago where a 0.9mm was used and easily extracted 4's, 5's, and even 6 haired grafts.
I wanted to add that most clinics do use the 1.0mm punch and the more experienced clinics try to use smaller punches. In my opinion the range of punches should be between 0.8mm to 1.0mm and never larger.
For the past 5 years we have safely used a 0.9mm on 99% of our cases and went higher for difficult cases and with good yield.
In my opinion the increase in diameter after a 1.0mm also increases the chance for scarring probably exponentially in each 0.1mm increments. I argued about this for years.
Below is an example of a rare case we had 1 week ago where a 0.9mm was used and easily extracted 4's, 5's, and even 6 haired grafts.
Attachments
scepticsausage
member
In the picture they all appear about the same length, what would be the best length?
Last edited:
H
hairtech
member
They come in all lengths. Some are really short and some are really long. They come in all lengths. Good question.
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