FUE Failures – Follow Up

This was a question posted in the comments of this post about FUE failures:

Dr…You mention the many small dot scars with FUE – does this just come with the territory or can a good DR minimise this? I have very fine hair which I like to clip quite short and as such would never want a strip procedure. I assumed that an FUE would be ok.

It comes with the territory. All FUEs produce punctate scars. Just as in strip scars, there are some people who heal better than others. Some of these people will stretch the punctate scars. In those that stretch the scars (particularly in people with fine hair) the larger the punctate scar, the more detectable it is with a close buzz cut. Fine hair just does not hide the scars as well as a coarser hair would. With these statements, I can not state with 100% certainty that the larger scars are strictly the results of the differences in healing.

There is another variable here that should be mentioned — the size of the punch. I believe that the smaller the punch used to extract the graft, the less likely the scar will stretch. The range of punches used today are from 0.5mm – 1.5mm. I believe that the punches which are under 1mm will usually scar less than those over 1mm; however, with that said I don’t have personal experience with punches over 1mm.

Dr. James Harris, who uses 1.25mm punches with the ARTAS FUE robot, tells me that the scars are not worse than those produced by using punches under 1mm, so as I respect his opinion, I report it here for you to judge. We use 0.9mm punches with our FUE procedures.