The condition of hair follicles produced by different punching methods during FUE surgery.

[BACKGROUND] Achieving successful outcomes in hair transplant surgery involves various critical factors, including donor area harvesting, graft survival, and minimizing post-operative complications. This study investigates the differences in grafts obtained using the rotary and oscillatory punch methods during follicular unit extraction (FUE) surgery.

[METHODS] The study involved 15 patients undergoing FUE. Four 4 × 6 cm areas in two rows were selected for each patient, with each row utilizing a different punch method (rotary or oscillatory). The grafts were extracted and examined under a microscope, classified into single, double single, double, and triple categories. The total yield rate and average number of hairs per graft were measured and compared.

[RESULTS] The average number of hair follicles per graft was 2.029 for the rotary method and 2.084 for the oscillatory method, indicating no statistically significant difference. However, the total yield rate was 88.3% for the rotary group and 90.5% for the oscillatory group, with the difference being statistically significant. In selected cases with soft scalps or deeper punch requirements, the oscillatory method showed significantly better results, with an average of 2.078 hairs per graft compared to 1.836 for the rotary method. The total yield rate in these cases was 91% for oscillatory and 86% for rotary.

[CONCLUSION] While the overall differences between rotary and oscillatory punches are minimal, the oscillatory punch is significantly more effective in cases with soft scalps or deeper punch requirements. Adhering to a structured guideline before extraction can help reduce the transection rate and increase the number of hairs per graft.