Hello, I am Dr. Jaehyun Park at Dana Plastic Surgery. Today I will talk about one of the most important factors for hair transplant surgery that may be a little difficult to understand. It is about the distance between each graft. The secret behind the distance between each graft I published a thesis about the distance between grafts in an SCI journal. Today will be based on this thesis.

We divided the change in width of the graft by depth. So we measured it in 4 different depth, 1mm, 3mm, and 5mm. Why follicular unit? Since we extract one graft at a time, the we see how the grafts change as we move down. As you can see a graft can consist of 1 hair, 2 hair or even 3 hair follicles. The general concept is that a 3 hair follicle graft is like this, not like this.

It gets wider as it goes down. In other words, how much does it spread out? It depends on the depth. We have to know this in order to decide which punch size to use. The difference in shape of grafts according to the depth Please like and subscribe to our channel! So if the size of the graft is 0.8 at 3mm and end up using 0.6 sized punch.

And punched 3mm The hair on both sides will be cut off leaving only the middle. This is why it is an important concept. As you can see in the graph The orange represents 3 hair follicular unit. Blue represents 2 hair follicular unit. And there isn’t much difference with 1 hair follicle. We measured 2 and 3 hair follicles.

There are 3 levels, 1mm, 3mm, and 5mm. As it gets deeper the horizontal width increases. If the level of the skin is 0.28 or 0.398 it gets much wider at 3mm and 5mm. In other words, the hair follicles are more spread out as it goes deeper. The key factor for FUE is the size and depth of the punch. So say if the depth of the punch is 0.88. then it cannot go deeper than 3mm.

The difference in distance of each graft according to the depth Then what if there is a graft with 3 hair follicles? The measurement for that is in the second graph. So this is the interfollicular unit distance. It is comparing the distance between each follicular unit by its depth. At the skin level, it is approximately 0.7 and at 3mm it is around 0.548 and at 5mm it is 0.436.

We are looking at a picture of a scalp during surgery. Just by looking at this, the doctor might think Oh since there is a fair distance between these two grafts it won’t damage the graft adjacent to it. But in the end the graft will be damaged. This is called hidden graft damage. By damaging the grafts adjacent to the one that is being punched

it will limit the number of grafts that can be used for the next surgery. By looking at this concept, it is obvious that the distance between grafts is important. Then we can think about this in two ways. Which punch size are we going to use and how deep are we going to punch. If we go deeper, there is one more factor. Third factor is at what angle is it punched?

So we talked about the width and the distance between each grafts. This shows a great effect on the results of the FUE process. The thing we have to keep in mind is As we move down the head, the grafts get wider at the bottom. This is why the distance between two grafts become closer. If it is 0.7mm at the skin level, at 3mm it becomes 0.5mm which is about 30% difference.

But generally, we punch deeper than 3mm. Punch size and depth is the fundamental factor for good results. Next episode: Female hair loss and scalp micropigmentation

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