Advantages of manual FUE:
1) The operator gets to feel the grafts carressing the skin and conceptualise the different layers of the scalp. This in turn produces superior quality grafts.
2) The operator has better control over the speed of rotation of the punch therefore minimising the sheering forces resulting in less trauma to the grafts.
3) The operator has better depth control resulting in less transactions and also less scarring.
4) In an experienced pair of hands, manual FUE can yield exceptionally good numbers.
Disadvantages of manual FUE
1) As the punches are sharp, the transaction rates can be very high in an experienced pair of hands.
2) The learning curve with mastering manual FUE can be painfully long and a lot of practitioners tend to lose confidence in the early stages of their career as the transaction rates can be exceptionally high.
3) In patients with slightly thicker skin, manual fue can become very laborious as the punches keep getting blunt and also the operator struggles to get perfect angles.
4) In patients with different hair textures i.e afro carribean or curly hair, manual fue can become very laborious as the operator has to use a sharp and a blunt punch thereby increasing the duration of the procedure.
Advantages of Motorised Fue
1) The learning curve for the practitioner can be exceptionally short.
2) With use of blunt punches, the transaction rates can be minimal.
3) The speed of extraction has improved exponentially with the use of motorised FUE.
4) Patients with different skin and hair textures who would have been previously unsuitable for FUE are now able to undergo FUE because of automation.
Disadvantages of Motorised FUE
1) As the practitioner fails to develop a feel for the grafts, the transaction rates can be unacceptably high.
2) Some practitioners opt to leave the motor in a continuous mode to increase the speed whereby causing higher transaction rates and increasing scarring.
3) With the introduction of motorised FUE, more non medical personel are performing FUE extractions which is against the law as the lack of medical expertise can cause irrepairable damage to the patient.
4) The scarring with motorised punches can be unsightly.
5) With the increased prevalence of motorised FUE, I believe that the practitioner will lose a deeper understanding of grafts and tissue quality which they would have developed had they done manual FUE prior to motorised.
Dr. Raghu Reddy
FUE Hair Transplant Specialist
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