A follicular unit is a group of one to four terminal hairs existing on the scalp naturally. Follicular Unit Excision is the surgical procedure in which a terminal hair is extracted from the scalp with some adjacent skin to get a full dense skin implant having follicles with intradermal fat, dermis, and epidermis of the scalp. This follicle extracting technique involves many surgical tools like a scalpel, laser, or another cutting tool. The current article focused on the availability of a novel follicular unit excision device in Lahore Pakistan. This mode of hair transplant is the most popular among alopecia patients. If the procedure is followed in the right way it will give the best results.
This extraction has two phases. In the first phase the scalp with hairs unit is an incision (cut) and in the second phase, this scalp is extracted with all skin layers. This extensive practice usually takes 5-6 hours. It is a scar less surgery immediately after the treatment. This graft extraction is practicable over the head, beard, chest, and other body parts. A multipurpose device named punch is used to extract the graft effectively. This a novel follicular unit excision device overcomes the undesired problems for curly hairs, different skin tones, skin texture, skin location, non-shaved areas, and long grafts.
Punch pattern on the scalp
Intelligent Punch is used to extract the terminal hairs over a wide range of scalps of different ages, skin types, and ethnicity. The punch scheme was adjusted on a wide range to solve all the problems related to incision and excision of a hair with roots. With the use of the punch; a novel follicular unit excision device technique there will be no scar and pain during treatment.
Cutting Axis of punch
The punch must be cut with the tissue deeply that surrounds and supports the hair follicle to its lateral axis. The obtained patch of follicle should ascend into the lumen of the punch. This pattern will damage the surrounding scalp. Therefore, the cutting axis of the punch should be flared outward of the terminal hairs to minimize the further damage to the scalp.
The punch should be flat and shrill
Sharp punches give exact results with less damage to the scalp. When we cut the follicle unit with a sharp punch there will be less damage to the underneath scalp and to the follicle edges. But if we cut a light punch more force is applied, which leaves more distorted follicles and buried grafts. So, a sharp hit with a novel follicular unit excision device gives safe results.
When we cut the graft for hair transplant the punch should be shrill at the edges and must be deep to retain all the skin layers of the scalp. A flat punch can enter deep enough without hurting the follicle. The concept of wide and flat punch with a novel follicular unit excision device is likewise important.
Width and length of a punch
The Diameter of a punch should be 1.00 mmm or more. Practically the width of a punch at the head grafts ranges between 0.9mm to 1.0mm and for body skin it should be 0.7mm to 0.8mm. The high diameter punch will give you a discrete graft having more follicle units but leaving a scar on a large area. In case of a small punch, there will be no scar but grafted a small number of hair bulb units. If the punch is deep the injury will occur to the blood vessels during follicle harvesting. So, it’s better to use a guard over the puncher according to the desired length.
Non-Shave punch with optimal diameter size
Non-shaven punches are chosen by those who demand short-time treatment. The grafts are obtained from a non-shaved scalp and then cut the hairs up to 1.5mm length grafts. Grafting approach with a novel follicular unit excision device reduces the duration of the procedure. When a graft is obtained from the scalp it gets twisted at the edges. To overcome this problem the diameter of the punch is increased from 1mm average value to a maximum of 1.1 mm.
Reduce Crushing and Burying of Grafts
As a straight punch inclines any buildup of tissue in the lumen can interfere with the punch lumen. The all-purpose punch reduces the risk by sustaining the ascent of the graft and reducing tissue buildup. To reduce the pulling effect of the graft the punch should be rooted in the hypodermis layer of the scalp. Common use of dulled/blunt punches.
The flexibility of the punch device to handle different types of graft, beard, and body make it successful in all scenarios. Some practical advantages are;
Ø There is little pain or numbness, making it more practical or convenient to use.
Ø The graft survival rate is 99%. Hair restoration of the patient will boost their self-esteem.
Ø There is no scar or linear scar observed.
Ø The procedure used local anesthesia which is the least harmful.
Ø Faster recovery about 24-48 hours after the procedure.
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