FUE hair transplant being a blind technique while harvesting, requires accurate angles of harvesting, skillful use of the micromotor and atraumatic extraction of grafts. Grafts can be transected with the punch, completely or partially as the punch travels below the surface of the skin. The results a clinic delivers has a direct bearing on the number of grafts that can be harvested in one piece without partial damage to individual follicles of the graft unit. Hence this variable of transection rate when honestly quantified determines the skill you can expect and the result that will follow in a particular clinic that you are researching.
What is FUE?
In Follicular Unit Extraction (FUE) technique of hair transplantation method, the hair is harvested from the hair donor area of the person one by one and placed in the required area of the scalp to eliminate baldness. This is the most preferred technique these days because of the minimal damage, minimal visible scarring and discomfort as compared to the other hair transplant technique- follicular unit strip surgery (FUSS) or Follicular Unit Transplantation (FUT).
What is Transection?
Transection will happen as a part of the FUE process. It is the destruction of the hair bulb or shaft as part of the transplantation process. The transection rate is one of the most dependable factors for considering the success of a hair transplant. The higher is the transection rate the lower will be the success of the treatment.
Complete Transection Rate:
Complete transection of graft occurs when all its follicular units are split from the roots. These grafts cannot be transplanted. hence if this count is low in numbers, it does not affect the transplant since these were not used. However, an increased complete transection rate determines the number of grafts available for transplanting. Hence the area coverage( & not density) may decrease.
Partial transection rate:
It is almost impossible for anyone to complete the FUE treatment with zero transection rates. Though complete transections are occasional, partial transection is expected due to the very nature of the procedure since all grafts units may not be in alignment. Partial transection rates if high will lead to decreased density of growth and in turn adversely affect the result.
Does FUE have higher transection rates or graft wastage rate than FUT?
Complete transection is not complete wastage of a graft in FUE. It only indicates that the graft roots are intact and they will live to be harvested on another day! This is unlike graft wastage of FUT technique where the graft is harvested out of the body and hence has to be discarded and is a complete loss. In FUE the dissection is simultaneous and takes place in the body (in vivo) and if the graft is cut, the root is retained in the body with full growth potential.
What is an acceptable Transection Rate in FUE?
No clinic can ever have a zero-sum transection rate.
Any clinic or surgeon with a transection rate of 2-5% can thus be considered as the right option for your procedure.
Also, you need to know that transection rates vary from one racial group to another and from one patient to the next. It is never constant.
The TR (transection rate) that a clinic lays claim to is only an average.
What determines Transection rates in FUE?
1. The surgeon determined transection rates
To decrease transection, the surgeon should be well-rested, not fatigued (due to multiple cases in a day), should be doing harvesting regularly and of course is skilled and has a history of giving good results since a period of time.
2. Technique determined transection rates
Different types of techniques used to perform FUE include Isolation technique, Automated FUE, and Robotic FUE. Each of these methods has its risks and advantages. It is ultimately the comfort of the surgeon with a particular technique which will determine his outcomes. Manual harvesting may give low transection rates for one doctor but another may not be experienced in it. Those who have been traditionally doing manual harvesting fear switching to micromotised harvesting out of fear of enhanced transection rates since the feel and process are much different.
Also, the use of magnification during harvesting, graft separation and plantation affects the damage to grafts and enhance or reduce transection rates. The ideal magnification for various procedures varies from 4x to 12 x.
3. Patient determined transection rates
Each patient has different hair characteristics. A patient with afrotextured hair may have transection rates that may scale upto even 50-70% and many times call for abandoning the procedure. In such cases, FUT is advised.
After going through the factors that can cause FUE transection, here is a brief info on how a surgeon performs Follicular Unit Extraction. In the FUE process, a hollow metal drill or a punch ( 0.7 to 0.85 mm in diameter and 3 mm in depth only) is used to harvest the hair from the permanent donor zone of the scalp. The surgeon needs to make sure that he places the punch in a manner that parallels the emergent angle of the hair shaft and centers emerging follicles eccentrically with a cephalad bias. After the extraction of the grafts, they are sorted under magnification and placed into graft holding solution in custom made receptacles with compartments for separating singles, doubles, triples, etc. This is how FUE harvesting and extraction takes place.
The only way to minimise FUE transection is to use proper tools during the transplantation procedure. Using blunt, reused or improperly made tools will always result in higher transection rates.
The acceptable transection rate is 3-5%. The transection rate above this percentage denotes the failure of the FUE method performed. So, try to choose the clinic that has the transection rate between 3-5% to see the immediate positive effect of the FUE treatment on your scalp. Enquire the risks involved in the surgery before you opt for FUE treatment.
Will a Clinic tell me honestly hat their transection rates are?
If you have researched will before asking this question, yes the reply will be honest in most cases.
To reduce Transection Rates, Opt for the best hair transplant clinic only
For best results, zero-in on the clinic where only an experienced doctor himself performs FUE treatment and has a proven track record. For good results churned out for a long time by the clinic means low transection rates. Never opt for FUE in a FUT clinic and the vice versa.
There are so many variables in hair transplant so you need to choose a reputed surgeon who has laid down protocols and is seen to be producing good results.