1. Punch diameter which affects size of wounds/ FUE punch diameters range from 0.6 – 1.3mm
2. Punch configuration which influences the shape of the wound. The shape of the wound has a tremendous impact on how well the wound heals and size of scars

The direct relationship between the diameter of punch and wound size is rather obvious and needs no further explanation. The shape of the punch and the way it affects the wound shape and degree of scarring however needs explanation. If a punch is configured to produce wounds with inverted edges, it would heal better than wounds created by a punch of the same size that creates wounds with everted edges as the photo and video below illustrate :

Best punch size for fue hair restoration : FUE PUNCH SHAPE IS AS IMPORTANT AS PUNCH SIZES IN INFLUENCING SCARRING – PHOTO ILLUSTRATION

One of the primary goal of the invention of the UGraft UPunch system is to create a tool that incorporates beard and body hair grafts to expand the donor pool. Unlike scalp skin which has abundant hair that could cover unwanted scarring, the body does not and any untoward scarring would be readily visible. UGraft – UPunch technology recognizes this and was specifically designed high quality wound healing results.  For this reason, the UPunch Rotor was designed with divergent cutting edges (pointing away from the follicle). The result is that the wound expands with depth resulting a inverted to straight wound edges compared with regular FUE punches which create wound edges that are more everted (like an inverted pyramid). Inverted edged wound heal better than everted edged wounds as illustrated in the series of photographs below:

UGraft Patient In Video Shows Off Beard Area Healing After >4500 graft extraction

Best punch size for fue hair restoration : FUE PUNCH SHAPE IS AS IMPORTANT AS PUNCH SIZES IN INFLUENCING SCARRING – VIDEO ILLUSTRATION

The following video explains the concepts discussed above:

BEST PUNCH SIZE FOR FUE HAIR RESTORATION: SIZE DOES MATTER

If two FUE punches of the same shape are compared, the quality of healing of the wound they create as well as the quality of the graft extracted are affected by the size of the punch terms of diameter. With larger diameters, it becomes much easier to surround and encapsulate the entire follicular unit without incurring any type of damage. On the downside, large punch sizes also create bigger wounds. And scarring can be more visible as a result.

Generally, Follicular Unit Extraction punch sizes  range from 0.6-1.3 mm. The choice of diameters to use depends on different factors. Examples of considerations include:

1. The number of follicles present within the follicular unit
2. The size of the individual follicles
3. How much importance the patient places on  cosmetically insignificant scarring vs graft growth rate

(1) the number of follicles present within the follicular unit

Follicular units define modern hair restoration grafts. They are natural groupings of hair. Usually, these clusters may consist of anywhere from 1-4 follicles. However, there are even occurrences of follicular units with higher numbers such as five or even seven.

The diameter of a follicular unit will be much larger if it consists of a larger number of hairs. Therefore, this is important for the surgeon to consider in choosing a punch size for an FUE transplantation.

Using very small sized punches would result in longitudinal division of muti-haired follicles resulting in extracting mostly singles (Figure 1a). Although the wound size would be tiny resulting in nearly invisible scarring, the coverage from such a transplant would be very sparse. Also, the transection in the donor area would result in donor depletion as some of the transected hairs would be damaged permanently (Figure 1b). In this video, Dr Umar illustrates the danger of using tiny punches for FUE:

(2) the size of the individual follicles

Most hair follicles (including the dermal sheath) are about 0.42mm in diameter. However deviations from this average will need to be assessed in choosing a more aptly fitting punch.

(3) how much importance the patient places on  cosmetically insignificant scarring

Some patients plan to wear extremely short hair styles. This might include a global buzz cut or primarily the lower back region of the scalp. Either way, the visibility of scars would be a major concern.

The formation of scar tissue has to do with the skin’s own healing and repair processes. Therefore, it cannot be prevented or stopped. However, the choice of very small FUE punch sizes for a hair transplant procedure can render the tiny round scars as being virtually negligible and unnoticeable to the naked eye. However as explained already, most of the grafts derived from using tiny FUE punches would be singles and finer caliber hairs which would result in poor coverage

Best punch size for fue hair restoration : The Use of Two Or More Follicular Unit Extraction Punch Sizes

Due to the varied diameters of grafts that are likely to be encountered during a hair restoration procedure, it is actually common for many doctors to use different punch sizes within a single procedure. This is important for potential patients to realize if they are wondering about the best size FUE punch to use.

Best punch size for fue hair restoration : Advanced FUE Hair Restoration With uGraft

The best type of punch to use would one which takes optimal advantage of both factors of size and shape. The UPunch Rotor of the UGraft does this very well. As illustrated above, the shape of the punch is engineered to result in the best wound shape which heal better. Dr U would also switch punch sizes based on the size of the patients follicles and diameter of their follicular unit groups. This methodology results in optimal wound healing outcome as well optimum graft yield. Dr U has also explained how the shape of the UGraft – UPunch Rotor can result in better yielding bulkier grafts.

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