The Follicular Unit Extractor
The problem with the traditional punch-graft technique was that larger grafts were cosmetically unacceptable, but as one decreased the size of the punches, the damage caused by the harvesting process increased in an almost exponential fashion. The reason for this was that the harvesting technique was essentially performed "blind." The surgeon could only approximate the orientation of the punch to be perfectly parallel to the hair follicles (since he could not see what was going on below the surface of the skin).
The smaller the punch-graft, the greater the follicular damage from even the slightest deviation in the angle of the punch. Another problem was that the punch could not recognize the natural follicular groupings in the scalp and also could not differentiate between hair bearing and bald skin.
In order to limit damage from blind harvesting, the techniques of single-strip harvesting and stereo-microscopic dissection gradually evolved (It's popular predecessor, harvesting with a multi-bladed knife, was also a form of blind harvesting and caused follicular transection analogous to the punches). However, all strip harvesting requires a relatively long (although thin) incision in the back of the scalp and meticulous dissection of the harvested tissue once it is removed. The latter is especially true if individual, naturally occurring follicular units are to be used in the surgery.
The controlled extraction of follicular units from donor tissue without a linear incision has been out of the reach of today's surgical techniques. By incorporating the new technology discussed above, with instruments designed to extract the follicular units directly from the donor site, the complexity of today's surgery with its significant labor involvement will be eliminated.
Direct follicular unit extraction should increase both the quality and simplicity of the process and, as a result, reduce the cost to the patient. Hair transplantation performed with the Follicular Unit Extractor and the Carousel will parallel the advances of minimally invasive surgery in other fields.
The Follicular Unit Extractor is still in a prototype phase.
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