Hair transplantation Follicular Unit Excision (FUE): Introducing the multipurpose octagonal ring punch

Abstract

SUMMARY The technique of follicular unit excision for harvesting grafts for hair transplantation procedures has become very popular. This technique relies on the use of small punches to remove viable grafts. Many different punch shapes have been developed to accommodate the varying nature of skin and hair characteristics, resulting in hair transplant surgeons requiring a variety of punches to suit a wide range of patients, which can be overwhelming to the beginner when trying to decide on the optimal choice of a punch to suit a particular skin characteristic. We describe a novel multipurpose ring punch that can be used on patients with a variety of skin and hair characteristics, as well as for shaved and long hair FUE. Features of this punch include an octagonal ring that protrudes from the outer wall of the punch and functions to control the punch’s trajectory into the deeper dermis during incision. Additionally, this punch has a dull, notched edge which allows for use in long hair and shaved FUE without sacrificing ease of incision through the epidermis. This punch is the first of its kind to have this breadth of versatility with a one‐size‐fits‐all design.

Concepts, Terminology, and Innovations in Follicular Unit Excision Hair Restoration Surgery

“…6,17 The ring punch has a protrusion on the outer wall that aims to slow down the punch as it enters the fatty tissue. 6,13,14,19,25,26 Regular/Cannula punch: This is a regular cylindrical punch made of stainless steel; comes in various sizes. 6,13,14,19,25 Blunt/Dull punch: This punch has unsharpened edges (►Fig.…”

“…Simultaneous Extraction and Placement Technique -grafts are implanted shortly or immediately after harvesting from the donor site. 6,13,14,19,25 Several types of punch designs, each with different advantages, can be used including flared punches, edge-out punches, long-hair punches, and ring punches 17,26 . The flared punch with a trumpet shaped tip aims to keep the follicles away from the sharp outer cutting edge (Fig 6).…”

“…The long-hair punch has an asymmetrical design with microopenings which enables the excision of intact long hair shafts (Fig 7) 6,17 . The ring punch has a protrusion on the outer wall that aims to slow down the punch as it enters the fatty tissue 26 .…”

“…Several types of punch designs, each with different advantages, can be used including flared punches, edge-out punches, longhair punches, and ring punches. 17,26 The flared punch with a trumpet-shaped tip aims to keep the follicles away from the sharp outer cutting edge (►Fig. 6).…”