Author Bio: Dr. Sanusi Umar MD is the author of this article.
Chances are, if you’re considering a hair transplant procedure, you’ve done a fair amount of research and have come across a method called Follicular Unit Excision – FUE Hair Transplant. You’ve no doubt noticed that plenty of clinics tout their own take on something called an FUE hair punch, the most basic tool in your doctor’s arsenal. These hair punches come in different shapes and sizes, all claiming to be the best or most effective for FUE hair replacement.
Viewed collectively, the sheer number of choices available may be overwhelming to not only a prospective patient, but even to most FUE providers themselves, who often just restate what their FUE equipment supplier tells them. As a consumer, you deserve the facts on the different benefits each variety of FUE punch stands to offer in order to determine what type of FUE punch is right for you.
The following video goes into more detail on differences between various types of FUE hair transplant punches.
VIDEO: What is an FUE Punch Tool? How Do Different Types Aid in FUE Hair Extraction?
The FUE punch is the business end of all FUE equipment, the point of the spear, so to speak. This makes it the most important part of any FUE hair extraction system. It generally takes the form of a hollow metal tube with an opening at one end.
The FUE punch engulfs the follicle, encompassing it entirely. It scores the flesh, separating the specimen from surrounding structures. When this has been accomplished from the top to the bottom of the hair follicle, the graft is ready to be extracted and used elsewhere on the body. The process is called follicular unit excision.
Rotary FUE Punches
These FUE punches are defined as punches that exert their cutting action by rotating along a radial axis relative to the long axis of the cylinder. The radial rotation can be unidirectional and continuously in either a clockwise or anti clockwise direction, or it could be bidirectional whereby it oscillates by alternating between partial clockwise and anti-clockwise motions.
Oscillating FUE punches are useful in FUE hair extraction in patients of challenging skin thickness.
Different Types of Rotary FUE Punch Cutting Tips
Rotary FUE punches can be further classified by the types of tips used to score the skin. Namely:
- Sharp FUE Punch
- Blunt FUE Punch
- Hybrid FUE Punch
Sharp FUE cutting tips feature cutting edges that face the skin and inner edges parallel to the follicle to be reckoned with. There are three main types of sharp punches, depending on the location of the bevels:
- Outer beveled: beveled edges run on the outer rim of the punch leading to the cutting tip from the outside
- Inner beveled: beveled edges run on the inner wall leading to the tip
- Inner and Outer ( Bi-beveled): beveling is done on both the outer and inner rims of the punch leading to a centrally located cutting tip facing the skin.
Blunt FUE punches, invented by Dr. James Harris, use a blunt cutting tip that face the skin.The blunt surface can be either
1. Rounded: where the cutting tip surface touching the skin is convex (Harris US patent 2004: US9044262B2)
2. Flat: Where the cutting tip surface touching the skin is flat (Harris US Patent application 2013: US20150018844A1)
Hybrid FUE Punches invented by Dr Sanusi Umar (US8876847B2) combine the best of both worlds. In hybrid punches, the cutting tip is flared away from the central axis of the punch cylinder and the follicles. Thus the tip of the cutting edge points away from the follicle. The follicles abuts the blunter non threatening of the punch while the sharp cutting tip faces and cuts away the surrounding tissue.
Hybrid punches as first conceived by Dr Sanusi Umar (Dr U), can be:
1. Predominantly sharp: Wherein the outer and inner walls come together at a sharp outward facing (Flared) tip
2. Predominantly blunt: Wherein the part abutting the punch has an accentuated bluntness. Dr U demonstrated in a land mark publication in the plastic and reconstructive surgery journal that the blunter hybrid punch performed marginally better then a sharper hybrid punch in extracting Afro-textured hair by FUE.
This hybrid punch mediated scenario protects the graft and greatly reduces the likelihood of transecting it. Hybrid FUE punches can be differentiated by the relationship between the sharpness of the outer edge and the dullness of the inner edge. This ratio can be optimized to suit a wide variety of skin and hair textures.
Non-Rotary FUE Punches
Non-rotary FUE punches are punches whose cutting action is brought about solely by moving the punch solely in an axial direction relative to the axis of the cylinder of the punch. Mounted on a hand piece, the axial cutting movement can be wholly manual wherein the punch is completely stationary on the hand-piece whereby the cutting motion is 100% caused by the operator moving the punch and hand piece in a axial direction. Ot could alternatively by mounted on an electro-mechanical or pneumatic hand piece device the bring about a rapid back and forth axial movement of the punch on the hand-piece. The frequency of the vibration could be sub sonic, sonic or ultrasonic (Ultrasonic FUE). Non rotary punches generally have a sharp cutting tip (Point of the spear) with side cutting edges that could range from sharp to blunt. Dr Umar has pioneered the field of non rotary punch FUE and has opened up the vast potential of this unique FUE path to resolving issues like stubborn Afro textured hair FUE, Unshaven FUE and long hair FUE. Dr U has several patents and pending patents on the non rotary punches which he calls Dr.Upunch Curl (hooked shaped non rotary punches adapted for tackling Afro hair FUE) and the Dr.UPunch Stealth which are less hooked and adapted for unshaven adn long hair FUE).
Additionally, non-rotary FUE punches can be broadly classified into:
- Bi-pronged or
Manual Vs. Mechanically-Driven Punches
Punches can be wholly manually driven or the movement can be aided by an electromechanical or pneumatic system.
Rotary FUE punches, also known as mechanically-driven FUE punches, spin radially with the help of a small motor. These punches are mechanical and electrically-driven.
In a manual context, the FUE punch is mounted on a handpiece. There is no spinning action involved, rather the punch is plunged straight into the skin along the axis of the long punch cylinder. The operator provides the force driving the punch into the dermis. The punch tips have to be sharp for this reason. Non-rotary FUE punches can be either bi-pronged or multi-pronged.
Manual FUE Hair Extraction
Your doctor may wish to employ either a rotary or non-rotary punch using a manual method. Here, the tool is attached to a handle and rotated with twisting action of the hands and fingers alone. This form of FUE hair extraction is especially useful in the case of a non-shaven FUE hair transplant or one done on an individual with thick skin and tightly-curled hair. It is, however, exhausting, and not ideal for many other FUE scenarios like body hair extraction. Providers are also prone to carpal tunnel syndrome, among other types of repetitive motion-induced injury.
Mechanical FUE Hair Extraction
In mechanical FUE hair extraction, the punching action comes from a mechanically-driven hand piece. Using mechanical FUE hair transplant tools allows the operator to focus on the task at hand while the FUE hair transplant tool handles a portion of the physical work.
ACCESSORIZED FUE PUNCHES: Specialty FUE punches
Any of the FUE punches described above can be characterized to further suit them to more specific cases. Serrated tips, windowed tips, slitted tips, expanded inner chambers (“roomed” tips), hexagonal outer perimeter (Hexed punches) and other several function enhancing accessorization.
FUE Punches Featuring Rooming:
The expanded inner chamber of roomed FUE punches collects more of the native tissue supporting the graft without expanding wound size.
Slitted FUE Punches:
The slit along the side of slitted FUE punches gives the technician an opening with which to guide the follicle into the punch without transecting it. This has been adopted by may FUE practitioners in performing long hair FUE
Windowed FUE Punches:
This variety is useful for unshaven FUE hair transplant where there is a long strand of hair that must be managed during the procedure.
Hex-Shaped FUE Punches:
Hexagonal punches aid in separating the graft from neighboring structures.
Textured FUE Punches:
Textured FUE punches are useful for many reasons. Texturing aids in the process of pulling the graft from the excision wound. This principle works on a physical basis and eliminates the need to resort to much more harmful forms of extraction, such as suction or physically handling the grafts with tools like forceps. The less the follicle grafts are subjected to, the more likely they are to survive when transplanted elsewhere.
Common Questions Our Patients Ask About FUE Hair Transplant Tools
What is an FUE punch?
An FUE punch is the main component of any type of FUE hair extraction system. It is the tool used to physically separate the grafts from the surrounding tissue during your FUE Hair Transplant procedure.
How does the Dr.UPunch i™’s hybrid punch tip differ from those of ordinary FUE extraction tools?
A blunt inner edge protects your grafts from a sharp outer cutting tip. This innovation in FUE hair extraction dramatically increases yield by minimizing the possibility of transection while the operator scores the skin and extracts each follicle.
What is the most effective type of FUE punch for my skin and hair type?
The answer to this question will depend on several circumstances. If you’re considering an FUE hair transplant yourself, your chosen specialist will most likely sit down with you before going to work to assess your needs, both physical and otherwise. Click the button below to schedule a free consultation with Dr. U in our Los Angeles-based office. We work with patients of all kinds – We use the Dr.UGraft FUE system which is the only FUE system currently able to take on all skin and hair types and all donor locations without the need for tests surgeries.
Interested in learning more?
If you still have questions, feel free to give us a call or use the button below to ask Dr. U about the possibility of having a hair transplant done yourself. We’re always happy to welcome any additions to our growing family of satisfied clients.
Harris, James A. Dissecting Punch for Follicular Extraction and Tools and Methods Using Same.
Harris, James A. Follicular Extraction Method and Device.
Umar, Sanusi. “Comparative Study of a Novel Tool for Follicular Unit Extraction for Individuals with Afro-Textured Hair.” NCBI, 27 Sept. 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC5055031/.
Umar, Sanusi. Hair Punch.