Comparative study of follicular unit extraction between different ethnic groups with 0.9 mm & 1.0 mm punches<br />Dr Anast...
Since the introduction of Follicular Unit Extraction in 2003, we have witnessed significant progress in the speed of extra...
One of the key points in Follicular Unit Extraction is the caliber of the cylindrical punch used to extract the hair folli...
 Avoid, if possible, the numerous little empty spots in the donor area that create the “moth-like” effect</li></li></ul><l...
High partial or  total transection may affect final hair growth<br />
Struggle for balance<br />Smaller punch Vs bigger punch<br />Higher yield of extraction Vs faster healing & less marks<br />
There is proof that there are differences in the caliber, length & density of the hair follicles between different ethnic ...
Questions<br /><ul><li>Which is the optimal choice of punch to combine high quality extraction & less visible marks in the...
 Is there a punch suitable for all patients?
 Do people from different ethnic backgrounds have the same response to the same instruments using the same technique?</li>...
 To compare patients’ groups of different, distinct ethnic origin in terms of quality & actual yield of extraction using t...
 The 0.9 mm punch was selected on the hypothesis that it may combine the effectiveness of the 1.0 mm punch in extraction w...
Selection criteria-ethnic groups<br /><ul><li>Selection of distinct ethnic groups, representative of their area, from diff...
 Selection of distinct ethnic groups that the doctors participating in the study have sufficient experience with
 Selection of one Caucasian ethnic group, the Greeks
 Selection of one Asian ethnic group, the Indians</li></li></ul><li>Greeks<br />A distinct southern european ethnic group ...
Indians<br />A large, distinct Asian population resident to the Indian subcontinent with a variety of origins & characteri...
Materials & Methods<br /><ul><li>Random selection of patients, separated in two groups, Greeks & Indians
 Random selection of age, grade of alopecia & condition of the donor area
 Doctor selection between those that:</li></ul> Had experience of both patients’ groups<br /> Experience in FUE procedures...
The same doctor would cut the same number of hair follicles in each marked area
 The caliber of the punch used would be 1.0mm or 0.9mm & it would be given randomly to the doctor by the supervisor
 The doctor would perform a test extraction before the comparative study, to establish the depth & direction of the hair f...
 After the cutting of the hair follicles, the doctor would extract the hair follicles & the assistant  would count the exa...
 The supervisor would estimate the average ratio of hair per hair follicle
 The hair follicles would  then be transplanted to the recipient area with implanter devises
 Photos were taken after the extraction & placement in both donor & recipient area
Upcoming SlideShare
Loading in...5
×

Comparative study of follicular unit extraction between different

894

Published on

Since the introduction of Follicular Unit Extraction in 2003, we have witnessed significant progress in the speed of extraction& the quality of the extracted hair follicles
In the recent years, FUE techniques have gained wide acceptance around the world & they have become very popular between hair restoration specialists as well as patients suffering from hair loss
In general, there is a rapidly spreading worldwide trend towards minimally invasive hair restoration procedures that will provide the best possible results with the least possible discomfort & the minimum possible damage of the donor area

Published in: Health & Medicine, Lifestyle
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total Views
894
On Slideshare
0
From Embeds
0
Number of Embeds
2
Actions
Shares
0
Downloads
8
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Comparative study of follicular unit extraction between different

  1. 1. Comparative study of follicular unit extraction between different ethnic groups with 0.9 mm & 1.0 mm punches<br />Dr Anastasios Vekris MD, Konstantinos Giotis,<br /> Dr Viral Desai MD <br />DHI Medical Group<br />19th ISHRS ANNUAL MEETING<br />Anchorage, September 14-18 2011<br />
  2. 2. Since the introduction of Follicular Unit Extraction in 2003, we have witnessed significant progress in the speed of extraction& the quality of the extracted hair follicles<br />In the recent years, FUE techniques have gained wide acceptance around the world & they have become very popular between hair restoration specialists as well as patients suffering from hair loss<br />In general, there is a rapidly spreading worldwide trend towards minimally invasive hair restoration procedures that will provide the best possible results with the least possible discomfort & the minimum possible damage of the donor area<br />
  3. 3. One of the key points in Follicular Unit Extraction is the caliber of the cylindrical punch used to extract the hair follicle<br />The punch must have the proper caliber in order to:<br /><ul><li> Provide the best possible extraction, avoiding total or partial transection of the hair follicle
  4. 4. Avoid, if possible, the numerous little empty spots in the donor area that create the “moth-like” effect</li></li></ul><li>The “Moth-like” effect after FUE<br />
  5. 5. High partial or total transection may affect final hair growth<br />
  6. 6. Struggle for balance<br />Smaller punch Vs bigger punch<br />Higher yield of extraction Vs faster healing & less marks<br />
  7. 7. There is proof that there are differences in the caliber, length & density of the hair follicles between different ethnic groups (e.g. Caucasians Vs Asians)In daily practice, there is evidence that patients from different ethnic backgrounds respond differently during extraction in the hands of the same surgeon, using the same technique & the same tools <br />
  8. 8. Questions<br /><ul><li>Which is the optimal choice of punch to combine high quality extraction & less visible marks in the donor area?
  9. 9. Is there a punch suitable for all patients?
  10. 10. Do people from different ethnic backgrounds have the same response to the same instruments using the same technique?</li></li></ul><li>Objectives of the study<br /><ul><li>To compare the use of different caliber punches in the same population
  11. 11. To compare patients’ groups of different, distinct ethnic origin in terms of quality & actual yield of extraction using the same technique & the same caliber of punches</li></li></ul><li>Selection criteria-punch caliber<br /><ul><li>The 1.0 mm punch was selected as the most commonly used punch nowadays
  12. 12. The 0.9 mm punch was selected on the hypothesis that it may combine the effectiveness of the 1.0 mm punch in extraction with significantly less trauma & scarring of the donor area </li></li></ul><li>1.0 mm Vs 0.9 mm<br />S= πr²<br />r1=0.45 mm<br />r2=0.5 mm<br />r1<br />r2<br />Although the diameter of the 0.9mm punch is only 10% smaller than the 1.0mm, the surface that is extracted is 20% smaller than the 1.0mm<br />
  13. 13. Selection criteria-ethnic groups<br /><ul><li>Selection of distinct ethnic groups, representative of their area, from different continents & different backgrounds
  14. 14. Selection of distinct ethnic groups that the doctors participating in the study have sufficient experience with
  15. 15. Selection of one Caucasian ethnic group, the Greeks
  16. 16. Selection of one Asian ethnic group, the Indians</li></li></ul><li>Greeks<br />A distinct southern european ethnic group with significant influences from the Mediterranean area, Asia Minor, the Balkans & Central Europe.<br />A vast variety of hair types & colors, from straight blond to curly black. <br />Hair follicles of medium length.<br />
  17. 17. Indians<br />A large, distinct Asian population resident to the Indian subcontinent with a variety of origins & characteristics, ranging from the Dravidian people of the south to the Indo-Aryan of the north.<br />Long, thick dark colored hair with thicker & longer hair follicles.<br />Usually straight hair but wavy or curly hair can be found mostly in south India<br />
  18. 18. Materials & Methods<br /><ul><li>Random selection of patients, separated in two groups, Greeks & Indians
  19. 19. Random selection of age, grade of alopecia & condition of the donor area
  20. 20. Doctor selection between those that:</li></ul> Had experience of both patients’ groups<br /> Experience in FUE procedures between 2-7 years with more than 300 hair restoration procedures each<br /><ul><li>Assignment of cases per doctor was random</li></li></ul><li>Materials & Methods<br /><ul><li>On each patient, two equal parts, side by side, in the middle of the donor area were selected, marked & photographed
  21. 21. The same doctor would cut the same number of hair follicles in each marked area
  22. 22. The caliber of the punch used would be 1.0mm or 0.9mm & it would be given randomly to the doctor by the supervisor
  23. 23. The doctor would perform a test extraction before the comparative study, to establish the depth & direction of the hair follicles
  24. 24. After the cutting of the hair follicles, the doctor would extract the hair follicles & the assistant would count the exact number of extracted hair follicles & those that were totally transected & separate them according to the number of hairs per hair follicle (singles, doubles, etc)
  25. 25. The supervisor would estimate the average ratio of hair per hair follicle
  26. 26. The hair follicles would then be transplanted to the recipient area with implanter devises
  27. 27. Photos were taken after the extraction & placement in both donor & recipient area
  28. 28. Follow up appointments to be scheduled to estimate the healing process & hair growth (1,7,30 days after & every 2 months up to 12 months after the session)</li></li></ul><li>
  29. 29. Results<br />
  30. 30. Results-Greeks<br />
  31. 31. Results-Indians<br />
  32. 32. Results-Comparison<br />
  33. 33. Total transection rate<br />
  34. 34. Ratio hairs/hair follicle<br />
  35. 35. Conclusions<br /><ul><li> The use of smaller caliber punch (0.9mm) does not seem to significantly affect the total transection rate (12% Vs 10%) or the ratio of hairs/hair follicle (2.28 Vs 2.27) in Greek patients
  36. 36. The use of smaller caliber punch (0.9mm) seems to significantly affect both the total transection rate (30% Vs 19%) & the ratio of hair/hair follicle (1.85 Vs 2.04) in Indian patients
  37. 37. Despite the caliber of the punch used (0.9 or 1.0 mm), it seems that there is significantly higher total transection rate in Indians in comparison to the Greeks (19% & 30% Vs 10% & 12%) & lower ratio of hairs/hair follicle (2.04 & 1.85 Vs 2.27 & 2.28)
  38. 38. While the use of smaller caliber punch in Greeks seems to have no negative effect to the quality & quantity of the extraction, it seems to largely affect in a negative way the quality & quantity of extraction in Indian patients
  39. 39. Further studies are required to establish the benefit in hair growth by using bigger or smaller caliber punches & the quality of the healing of the donor area</li></li></ul><li>The significant difference in the transection rate & the hairs/hair follicle ratio between the Indians & the Greeks may be attributed to the different properties of the hair follicles in the two groups:<br /><ul><li>Indians tend to have thicker hair follicles that may be easily transected if a smaller punch is used
  40. 40. The hair follicles in Indians are longer and deeper in comparison to the Caucasians. This may lead to difficulties during the extraction that may lead to increased transection, partial or total</li></ul>There must be a balance between the need to extract good quality hair follicles and the need to respect the donor area <br />
  41. 41. Some practical tips<br /><ul><li>Always start with a test extraction. It will guide you to choose the proper instrument
  42. 42. It is quite safe to use smaller caliber punches (0.9mm) in Caucasians without compromising the quality or the quantity of extraction
  43. 43. In Indians, keep all your guns on the table but you’ll most probably need the big ones
  44. 44. Always respect each individual. There is no “magic” tool that can meet the needs of all patients
  45. 45. Marketing small caliber extraction may be trendy & a good advertisement for your practice but always remember: 0.5mm punches will provide excellent results in the donor area without any visible marks but, most probably, there will be no visible hair growing in the recipient area as well </li></li></ul><li>THANK YOU<br />
  1. A particular slide catching your eye?

    Clipping is a handy way to collect important slides you want to go back to later.

×