Patients with curly, Afro-textured hair may have lower transection rates in follicular unit extraction using a curved nonrotary punch compared with the traditional sharp or dull rotary punches, according to study data published in Plastic and Reconstructive Surgery Global Open.
Umar, MD, conducted a retrospective study of 18 patients of African descent who underwent a follicular unit extraction procedure between January 14, 2014, and November 14, 2015. Umar tested each patient with sharp rotary punches (18-, 17- and 16-gauge), dull rotary punches (17- and 16-gauge), and curved nonrotary punches (17- and 16-gauge) until a satisfactory transection rate (set at < 10%) was attained with each.
The curved nonrotary punch was a novel prototype in which the two tips of the hook-shaped punch plunge subcutaneously in a quick arc-like motion to track the longitudinal axis of the curled hair follicle shaft. After the punch is pushed to the base of the follicle or deeper, the follicle is freed from the skin either entirely or can be extracted with microvascular forceps.
“Most patients with the most tightly curled hair are of African descent but these individuals are not a homogenous group, with variation in degree of curliness between groups from different countries,” Umar wrote. “Variations also exist in the same individual when hair is taken from different scalp regions.”
For eight of the patients, the sharp and dull rotary punches were completely unsuccessful or had excessive transection rates. Nine patients with few restrictions had successful rates with the dull rotary punch compared with five patients who had more restrictions; however, all 14 of those patients had the best transection rate (< 5%) with the curved nonrotary punch. Sharp and/or dull rotary punches only had complete success in four patients.
The author noted that while the curved nonrotary punch had better transection results in these patients, the conventional rotary punch may have greater success in patients who are of ethnically mixed heritage (eg, African-Americans or Caribbeans) and those from out-of-Arica migration transition zones (Ethiopians and Somalians) whose follicles are less tightly curled and skin is thinner. – by Talitha Bennett
Disclosure: The author holds U.S. patents, has additional patent applications for the UGraft and UPunch technologies described in this article, and is employed by FineTouch Dermatology, Inc.