Coalition Hair Transplant Surgeon Dr. Alan Feller Discusses Manual vs. Powered Follicular Unit Extraction (FUE) Tools

This question, from a member of our hair loss social community and discussion forums, was answered by Coalition hair transplant surgeon Dr. Alan Feller:

Dr. Feller, During follicular unit extraction hair transplant surgery do you use a motorized FUE extraction tool or a manual tool or both?

I have invented, patented and commercially produced both manual and powered FUE instruments. When I first started I preferred manual tools. But then I put a punch on a rotary tool, basically a hobby motor, and thought it might speed up the process. Others had done this on their own as well. But it was large and more powerful than necessary so I looked into reducing the size and weight. While doing that I realized that the torsion force created by the drill spinning in one direction might be doing harm. I also felt that too much heat was being created at the tip. So I sought to build an oscillating motorized tool that cut slower and with a small degree of arc, which I did. It has its place in certain kinds of patients, but its main strength is that it allowed novices the ability to score grafts better than they could manually. I showed the tool off at a booth in Amsterdam in 2010 and was made an offer for my company that I couldn’t refuse. So I sold it lock, stock, and barrel. They continued improving the design and the last I saw it looked more lighter and sleeker.

But I found that with practice and having worked on a number of different kinds of scalps over the years that I was more proficient with a manual punch and even faster. So I haven’t used a motorized punch in years because I haven’t needed to. If, however, I find too many grafts are being damaged during scoring I may pull out the motorized tool and give it a try.

So to me, a very sharp, thin-walled punch with gradations inscribed on the tip for depth measurement is the best tool for FUE. This along with either the two forceps method of Lorenzo for delivery or the one forceps and needle perforation technique that I developed years ago for delivery.

Dr. Alan Feller
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David
Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q & A Blog.

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