I’m interested in having an FUE hair transplant procedure, but I’m getting conflicting information. Some say that manual FUE is the best, while others say motorized FUE is the best, can you please help understand which is better?

Don’t get caught up in surgical intricacies that hold no value on how you should research a surgeon or clinic. Surgical hair restoration is a sophisticated cosmetic procedure, and the tools a surgeon chooses doesn’t hold any bearing on their actual skill or results.

Manual vs Motorized

Follicular Unit Excision (FUE) removes follicular units one by one from the back and sides of the scalp with a small surgical punch. The surgical punch can range from 0.7mm to 1mm in circumference. The surgical punches can be manual, meaning the surgeon/technician must score the skin without any mechanical assistance, or they can be motorized.

Motorized devices rotate and oscillate with the push of a button. These devices can extract grafts rapidly. Mechanically-motorized devices have gotten a bad reputation because some clinics have been careless in their extractions- this has led to donor depletion and overharvesting

So Which Is Better?

We asked the Coalition of Independent Hair Restoration Physicians approved surgeon Dr. Raymond Konior, and he had this to say:

The most useless topic of manual versus motorized should be relegated to the trash heap. It may have held relevance at some point in time, but it means little today. Patients should also be leery of dogmatic statements made about how an individual conducts his or her practice as the only person who can provide definitive detail as to what is done and how it’s done is the surgeon himself.

The fact is that I use multiple devices for extracting grafts, with the device of choice depending on the situation at hand.  There are days when a motorized technique is best and days when a manual technique is best.  There are days when a straight-wall trephine is best and days when a flared-wall trephine is best.  There are days when a straight-edge trephine is best and days when a serrated-edge trephine is best.  This argument reminds me of guys arguing which is better, a straight-edge screwdriver or a Phillips screwdriver.  Of course, the answer is that it depends on the situation at hand.  

Also remember, there are some talented surgeons who can use every technology effectively and some who, despite having the best of the best instruments, can’t extract quality grafts on a consistent basis.  When it’s all said and done, it’s not the instrument that matters as much as the surgeon choosing the instrument to use for the situation at hand. 

If you place the world’s finest and most expensive Steinway piano in front of most people, very few would be able to generate a beautiful song.  On the other hand, place one of the world’s top five pianists in front of a Walmart special keyboard and you will probably hear some darn good tunes.

Conclusion

The overall result and skill of a hair transplant surgeon do not depend on a certain tool, as tools vary depending on the situation. The most important factor to consider when selecting a hair restoration physician is their results.

Melvin

Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network and The Coalition of Independent Hair Restoration Physician

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