The ability to extract individual hair follicles requires great dexterity and hand-eye coordination. However, it also requires the right equipment. To make the tiny, circular incisions, punches can be manual or motorized, sharp or dull, and can have options to control the exact depth of the incision.
To appreciate the full implications of these instrument choices, a basic understanding of the anatomy of the hair follicle is required. Each hair follicle has a sebaceous gland and an arrector pili muscle attached below the skin surface. The sebaceous gland supplies oil to the skin and the arrector pili muscle provides insulation to the body by causing the hair to stand on end when the ambient temperature around the body drops. This is an attempt to preserve body heat by trapping the air between the hairs, and this involuntary muscle contraction is more commonly known as goose bumps.
Here are a Few Commonly Asked Questions about Follicular Unit Extraction
How is the hair follicle anatomy important to follicular unit extraction techniques?
Both the sebaceous gland and the arrector pili attachments must be cut in order to release the hair follicle. So, whatever the system that is chosen must at least cut deeply enough to release the follicle from these two attachments. Located at the end of the hair follicle is the bulb, but this will release without having to cut all the way to it.
I have curly hair. Am I a candidate for follicular unit extraction?
One might think that the hair follicle beneath the skin is straight, but this is not necessarily the case. If the patient has curly hair, the curl above the skin surface will continue below the surface. The more curl above will correlate with more curl below. To have a successful transplant, the hair follicle must be released intact, but if the hair follicle has a curl not far below the skin surface, it could easily be cut in half crosswise with a straight cutting instrument. Patients with curly hair are candidates for follicular unit extraction, but the transplants can be more difficult and take more time.
What type of instrument do you use?
To deal with every follicular situation, I have chosen to use the Powered Cole Isolation Device (PCID) motorized sharp punch. It is very advanced in the infinite choices of settings it offers to best harvest each follicle. However, specifically with regard to the depth of the punch, I am able to set the punch depth to go just as deep as the sebaceous gland and arrector pili muscle in order to minimize the transection of the follicle. This depth can be easily adjusted throughout the case if the depth changes in different regions of the scalp.
If you have additional questions about follicular unit extraction, you may contact the Hair Transplant and Restoration Center for a consultation.