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Research Article: No-Shave Long Hair Follicular Unit Excision Using an All-Purpose Skin-Responsive Device

Date Published: 2023-12-21

Abstract:
No-shave long-hair follicular unit excision (LH-FUE) is an FUE hair transplant technique in which hair grafts are harvested from the donor area without the need to shave or trim the hair. This method aims to retrieve intact grafts while preserving the natural hair shaft length.– The procedure’s growing popularity stems from its advantages, notably the immediate visualization of expected transplant results and the ability to precisely determine the optimal angle for graft placement. An end-result preview is especially beneficial when transplanting areas such as the hairline, eyebrows, eyelashes, and beard. Implanting long-hair shafted grafts also allows the camouflaging of recipient and donor areas, limiting signs of surgical intervention for patients desiring fast reintegration into social and professional activities.– The procedure aims to directly harvest intact hair follicles by FUE at their natural length while keeping hair shafts from wrapping around the device’s punch tip or being cut. Despite these benefits and increasing popularity, no-shave LH-FUE is unpopular with hair surgeons because it is time-consuming and technically challenging, with one study reporting a harvesting rate of grafts/h by an expert practitioner. A major cause of inefficiency with published no-shave LH-FUE techniques is the use of recesses (open slots, notches, or grooves; see Figure A–C) on the cutting end of their punches.– With these devices, the long hair shaft of the follicle slides into a recess to avoid being cut.– This requires a reorientation to the punch recesses to capture the target graft’s follicular shaft, in an effort to minimize the risk of breaking the shaft. Thus, the process is technically challenging, requiring meticulous eye-hand synchronization, and is time-consuming,– resulting in a higher patient cost and decreased appeal to FUE surgeons. Here, we report an all-purpose skin-responsive FUE technique designed to improve the efficiency of no-shave LH-FUE using a recess-free punch (Figure D). Further, we report the influence of skin and hair type on no-shave LH-FUE. Figure A recess-tipped asymmetric long-hair FUE punch featuring notches (A). A recess-tipped punch showing an open slot (B). A flared serrated hybrid punch with grooves cutting across its flat cutting tip, symmetrically located in each quarter of its circumference (C). The advanced hybrid Intelligent Punch® of the UGraft®, showing flaring, with no recess on its cutting edges or tips. There is texturing of the wall immediately proximal to the cutting edge (D).Abbreviation: FUE, follicular unit excision.

Introduction:
No-shave long-hair follicular unit excision (LH-FUE) is an FUE hair transplant technique in which hair grafts are harvested from the donor area without the need to shave or trim the hair. This method aims to retrieve intact grafts while preserving the natural hair shaft length. – The procedure’s growing popularity stems from its advantages, notably the immediate visualization of expected transplant results and the ability to precisely determine the optimal angle for graft placement. An end-result preview is…

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