Follicular-unit extraction with the SAFE system: a dull dissecting-tip FUE device
by James A Harris

Hair Transplant 360 (Advances, Techniques, Business Development & Global Perspectives), Volume 3

by Samuel M Lam
About Video

This video shows various steps of follicular-unit extraction with the SAFE system: a dull dissecting-tip follicular-unit extraction device. This video displays dull versus sharp: beginners only, transsection rates—10% vs 28%, and robot experience. Powered SAFE system: single step dissection—provides for a higher rate of graft extraction—500-700 grafts/hour, >95% patients candidates, recommend test procedure in African Americans. This video illustrates preparation for powered follicular-unit extraction: magnification—4.5X to 6.5X is optimal using quality loupes, and working distance based on comfort, usually 10-12 inches, patient position—prone for occiput, lateral decubitus for temporal areas, donor areas—shave hair to 1-1.5 mm in length. This video shows magnification: 5 power. Follicular unit graft dissection: adjust rotation speed if needed in small increments to increase or decrease speed. Initially dissect 4-5 grafts and evaluate for burials and transections. Adjust entry angle if needed—there may be difference of 10 to 20 degrees between the hair exit angles and the subcutaneous course of the follicles with the exit angles being more acute. Engaging the punch: the initial contact of the punch with the skin should be with the punch rotating. Engagement: allowing the punch to enter the skin before advancing. With the punch aligned to the unit, place, the punch on the skin with slight force perpendicular to the skin surface for an instant before advancing the punch. This video on engagement of the punch: the first two attempts illustrate proper punch engagement, third attempt shows immediate advancement of the punch without engaging the skin first. The punch slides across the surface and transects the graft. Hinds for power dissection: let the drill do the dissecting—DON’T force the handpiece, begin with lower speed settings, ensure that the speed setting allows the drill to slow down as the punch is advanced—with experience the speed can be increased. Review of steps: superior skin traction, align tip to match exit angle and direction of targeted hair, engage the punch, advance the punch to dissect, check for graft elevation. The ZEN of FUE: pattern and flow, innate recognition of follicular unit changes weight and balance, repetition of steps—each dissection is a procedure and transection and burials require a change of technique.

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