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Facial Plast Surg Clin North Am. 2013 Aug;21(3):437-47. doi: 10.1016/j.fsc.2013.05.009.

An analysis of follicular punches, mechanics, and dynamics in follicular unit extraction.

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  • 1Private Practice, 1070 Powers Place, Alpharetta, GA 30009, USA. Electronic address:


Success in follicular unit extraction requires an understanding of forces, fluid dynamics, instrumentation, and individual patient variation. Sharp punches require a lower axial and tangential force to dissect follicular groups. The angle of hair emergence and the size of a punch influence the wound size and the depth of an incision. A procedure must be individualized based on surface follicular group characteristics; hair splay; and strength of attachment between the outer root sheath, inner root sheath, and adipose with regard to hair follicles.

Copyright © 2013 Elsevier Inc. All rights reserved.


Follicle splay; Follicle transection; Follicular dissection; Follicular unit extraction; Follicular unit punch; Hair transplant; Hair transplant surgery; Punch size; Serrounded punch; Trephine

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