Choosing Punch Size For Hair Transplantation
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So super common question is what is the best size to hair punch for performing fue or follicular unit extraction? Well, there's a couple of issues here. The first thought here is will a smaller hair punch lead to less scarring based on several studies that cut off is thought to be around 1.5 millimeters. Punches larger than 1.5 millimeters are believed to create scarring punches below 1.5 millimeters are believed to have the same amount of scarring up to a point. So we definitely want to have punches that are smaller than that size. The second issue is going to be how small can you go before you're going to have an issue, not properly harvesting the hair for this. We want to look at the diameter of the hair. The smallest single hair unit is going to be about 0.45 millimeters. Now, I don't know many surgeons who can look and remove a 0.45 millimeter hair safely without damaging the surrounding structures.
So most surgeons they're going to want to have a punch slightly larger. So you're looking at at least a 0.5 to 0.55 millimeter punch for single units. However, some of the best units with follicular unit extractions are going to be doubles. Triples quadruples, a double unit hair graft is going to be about 0.85 millimeter wide. So the smallest punch size I recommend for most patients to deal with is a 0.9 millimeter. And that's what I, what I use. If you're below 0.9 millimeters, you're going to have too many damaged tears called transections. Now the upside of a smaller punch might be less scarring, but in several studies, they've kind of examined the look of the back of the head and found that patients with 0.9 millimeters 0.8 millimeters one millimeters and 0.7 millimeters. There wasn't a significant difference. The amount of hypopigmentation. In fact, there was none. So I'd rather get the least amount of scarring with the overall goal of the procedure, which is to successfully remove the hair. So I think 0.9 millimeters is the sweet spot for most patients.