Defining the most effective way to reduce rates of hair transplant graft transection has long perplexed leading FUE (Follicular Unit Excision) practitioners from around the world. Previously, it was widely believed that the hair shaft’s morphology and curliness determine the susceptibility to damage during the procedure. However, this did not explain why individuals with extremely curly hair may have lower transection rates compared to patients with more relaxed hair. Based on direct patient experience, across numerous cases, Dr.U has found a much clearer and stronger correlation with a different variable, the firmness and softness of the skin compared to hair curvature. This insight led to the development of a new and unprecedented paradigm called Intuitive FUE, which serves as the basis for engineering his Dr.UGraft ™ technology.
The Limitations of Hair Shaft Curliness as the Explanation for Graft Transection
Since general FUE punches are built with a basic cylindrical configuration, it is assumed that they can encompass and align more easily straight hair shafts compared to curly or wavy hair types. Practitioners must rely on the angle and position of the visible hair shaft as an essential cue for adjusting the basic FUE punch device to find the actual follicular unit. With straight hair and a straight-shaped punch, this can be expected to be a more straightforward feat. When applying this type of instrument to curly hair, the graft may become damaged due to the unpredictable change of hair direction beneath the skin. Hence, the difference in these scenarios has long been attributed as the primary explanation for how transected grafts occur.
However, as a specialist performing hair transplant surgeries in black patients, Dr.U noticed that transection rates for individuals with highly curly hair were not necessarily higher than those with straighter or more relaxed hair textures. In fact, the degree of hair curl, when measured against graft damage, appeared to be unrelated. Some patients with less curly hair would display significant transection rates.
Dr.U observed a wide variation in graft damage rate in patients with African hair types. Individuals whose hair is characterized by significant curl could often produce grafts that came out fine. Meanwhile, some people with more relaxed hair would sometimes be difficult to extract. These anomalies also reveal themselves in other populations where the hair is generally more straight, such as in Middle Easterners and some Asian and Caucasian types.
If It’s NOT About Hair Curliness, Then What Is It?
Dr. Umar noticed that the skin texture in those with lower success rates tended to be thicker and firmer. Similarly, this trend was present to some degree, even in other races.
Additionally, it was found that another population of patients with extremely soft and extremely thin skin would often register a rather high graft transection rate for the opposite reason.
Dr. U also noticed that graft attrition rate could also change, even in the same individual, between one area of the scalp or body and another.
Due to these accounts and the consistency of these patterns, Dr.U concluded that skin thickness correlates much more closely with graft transection compared to hair type.
How Does Skin Thickness Affect Transections in FUE Hair Transplant Procedures?
The overall success of a hair transplant surgery will largely be due to the number of viable grafts. This is heavily contingent on how well an FUE punch device can separate the follicle from the structures anchoring it in its place of origin. Failures in this area can cause grafts to fall victim to various mechanical injuries.
Skin thickness affects the strength of the anchoring attachments and how easily an FUE device can free the graft from these connections.
The two major types of skin Dr. U aims to address with the Dr.UGraft ™ FUE system are as follows:
- Skin that is thick and hard – Thick skin is unyielding and composed of many more layers of interconnected tissue. This gives the FUE punch much more to work through, as the hairs are attached more intimately to the sheath that envelops them. With thicker skin generally comes a longer follicle, as well. When the length of the follicle is underestimated, the base of its bulb may not be entirely excised. This then results in torsional damage, impaction, and graft death. FUE systems of the past have failed to accommodate patients of African and Arab descent for these reasons, and not because of the angulation of the hair they grow, as was previously believed.
- Skin that is thin and soft – Conversely, exceptionally thin skin brings its own challenges to the table. The delicate dermis of individuals with thin skin is easily torn by FUE equipment. Naturally, that makes deriving a viable graft much more challenging. Remember: for a graft to grow successfully in the recipient area, it must have a sufficiently bulky skin graft still attached and intact.
The Dr.UGraft ™ Technology Overcomes Skin Thickness Differences For FUE Transplant In Scalp and Body Areas
Across all individuals, the scalp will be more challenging to penetrate compared to body donor regions.
Since the Intuitive FUE capabilities of Dr.UGraft ™ devices can adapt to extremely thick or soft skin thicknesses, it offers the versatility to be used effectively on the scalp or body areas within the same patient.
Dr.UGraft ™ technology performs extractions on the head and body areas (i.e., the beard, neck, chest, and abdomen). The larger donor pool adds to and enhances the patient’s overall graft count.
Intuitive FUE – The Dr.UGraft ™ difference
Dr.UGraft ™ offers the world’s first Intuitive FUE technology, which addresses individual differences in skin thickness. Patients can now benefit from a more reliable means for achieving a reduced FUE transection rate. A lower rate meant better forms of growth and coverage in their final results.
At the heart of the Dr.UGraft™ concept is an immensely intelligent approach to FUE. This new technology strikes a delicate balance between gently informing the user of the correct setting for the patient’s skin type and putting control directly into their hands.
Rather than the basic cylindrical structure, the Dr.UGraft ™ punch is designed with a conical or funnel shape. This shape allows the punch to respond to depth. Whereas a cylinder slides vertically straight down, a conical shape will encounter resistance as it goes deeper into the skin. This type of device will then stop at the ideal speed and strength (i.e., torque) settings. This allows for the punch to prevent transection or continue until it successfully separates the graft from its surroundings.
The Dr.UGraft ™ hand is sensitive to the resistance of the punch to the skin
It reacts to this resistance by slowing or stopping the punch rotation.
If the skin is extremely thick, the Dr.UGraft ™ punch will have difficulty penetrating the skin at the baseline speed and torque settings. It may even stop prematurely before it has separated the graft from its connections. These phenomena alert the operator to adjust the speed and torque parameters accordingly.
Likewise, if the skin is too soft, the Dr.UGraft ™ punch may continue rotating downward, failing to reach a reasonable stopping point. This signals the practitioner to lower the settings to reduce the device’s power and determine the parameters to excise the grafts safely.
Dr.UGraft™ Versus Other FUE Punch Systems
The analogy of a car provides a clear and easy-to-understand illustration of the difference between Dr.UGraft ™ Intuitive FUE technology and other FUE punch systems. The accelerator can be likened to the features and settings that increase the punch’s speed. The gears are analogous to the settings that increase the punch strength across different skin types.
All other FUE technology systems are built with the equivalent of a single gear and a single speed within the single context of flat roads. Their general cylindrical structure makes them incapable of stopping on their own at a precise point of depth. Instead, they depend on the operator’s ability to time the duration of the punch rotation to stop the device manually.
Dr. UGraft’s Intuitive FUE paradigm accounts for various skin thicknesses. The punch technology built around these principles includes adjustable settings for multiple speeds and torque strengths. Unlike other FUE systems, these parameters can are customizablele for different patients.
Because Dr.UGraft ™ has identified the common denominator responsible for graft transection among all populations of patients, it can offer the very first all-in-one system which achieves the goal of reducing mechanically incurred damage to the graft. So far, operators have been relying on switching between multiple systems to achieve lower transection rates for specific patients. Dr.UGraft ™ completely replaces this cumbersome practice of using more than one device.
The Additional Supporting Features Behind the Dr.UGraft ™ Advantage
Besides its customization settings based on skin type, Dr.UGraft ™’s Intuitive FUE technology includes other features that work together to lower patient transection rates.
The hybrid shape of the punch includes a dull, curved surface that constantly interfaces with the graft. At the same time, the sharp cutting edge points away from the graft. Therefore, they will not come into contact with the follicular unit.
Furthermore, the attachable Dr.UGraft ™ Revolution console irrigates the grafts. This, in its turn, provides hydration while they are being extracted through a controlled drip-fluid mechanism. The hydration lubricates the punch tip at its point of contact with the skin allowing the device to advance more smoothly into the deeper tissue layers. This serves to then facilitate the process of severing the interconnecting attachments.
The fluid hydration also lubricates the interior lining of the punch. This reduces friction between the inner metal surface and the graft tissue. Coupled with a roomed interior, the hydration prevents the follicular unit from adhering to the inside of the punch. The unit turning as it rotates is a common dynamic responsible for transection through torsion-based injuries. This type of graft injury occurs when the base of the follicular unit remains attached to its source as the top part turns and twists off.
These features and functionalities culminate in Dr. U’s notion of intuitive FUE. Intuitive FUE reduces the guesswork that used to be an unavoidable part of the FUE process. It allows the doctor to assess the set of circumstances before them with the help of their tools (namely, the Dr.UGraft ™ system as a whole), freeing them to focus on the task at hand entirely, allowing them to work at length and without fatigue.
Dr.UGraft ™ Makes FUE Hair Transplant Possible for All Types of Patients, Regardless of Ethnicity or Donor Area
The aspects described above make Dr.UGraft ™ radically different from every other FUE system available on the market today. No other suite of tools can perform adequately and consistently on all types of patients and in any donor area. The versatility offered by Dr.UGraft ™ is valuable for any hair surgeon seeking to treat a wide variety of patients.
Frequently-Asked Questions – Intuitive FUE
What does intuitive FUE mean?
Intuitive FUE is a descriptor that applies to any FUE system optimized to sense and respond to individual differences in patient skin type, letting the human operator to select the customized settings for excising grafts without transecting them. This quality is what makes Dr.UGraft ™ so powerful when dealing with all types of hair and skin types.
Does hair type or skin type matter more in FUE hair surgery?
Traditionally, hair texture was thought to be the main factor in achieving the best FUE results possible. Thanks to Dr. U, however, we now know that skin type is much more strongly correlated with transection rates. Dr.UGraft ™ is the first of its kind to cater specifically to the needs of all skin types, both thick and hard and soft and thin.
How can the Dr.UGraft ™ system tell what settings are best applied to different types of patients to lower the FUE transection rate?
The hyper-sensitive Dr.UPunch i ™ is tested on the dermis. Due to the funnel-shaped aspect of the punch, the device encounters resistance. As noted earlier, the handpiece attached to the punch will sense this resistance and slow or stop the device rotation. If the instrument fails to reach a halting point (i.e., due to the skin’s softness) or if it does not turn or rotate sufficiently (i.e. due to the thickness), the operator can then modify the speed and torque settings accordingly.
This ability to adapt allows Dr.UGraft ™ to successfully lower transection and excise hair from all skin types.
The Dr. U Hair Clinic is in Manhattan Beach, Los Angeles, California. We serve patients of all backgrounds and conditions; if you’re interested in receiving treatment, you can fill out our free online consultation form. Those interested in learning more about FUE with questions that weren’t addressed in the previous section are invited to send them our way through our Ask Dr. U button:
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Further Reading
Learn more about Dr. U’s revolutionary FUE system on our sister site for the Dr.UGraft ™ brand
