No-Shave Long Hair Follicular Unit Excision Using an All-Purpose Skin-Responsive Device
Clinical Summary
View sourceWhat was studied
Retrospective analysis of 152 patients across five clinics (Aug 9, 2021–Apr 11, 2023) undergoing no-shave long-hair FUE with a recess-free, skin-responsive device (UGraft Zeus), assessing graft transection rate (GTR), shaft breakage rate (SBR), graft excision rate (GER), and patient/surgeon feedback by donor difficulty (SFS class) and skin/hair features.
Key findings
Overall GTR ranged 2.2%–4.3%, SBR was 12.2%, and mean GER was 440 grafts/hour; among 129/152 with ≥6-month follow-up, 57.4% were “very happy” and 42.6% “satisfactory,” with no “unhappy” ratings. Compared with 19G, 18G punches achieved higher speed (578 vs 439 grafts/hour, p=0.02) but higher GTR (5.1% vs 3.8%, p=0.003); thicker/firm skin and higher SFS class were associated with higher GTR/SBR and longer movement duration, whereas hair curliness had less impact.
Study limitations
Retrospective, multicenter series with no control group and variable surgeon experience and settings; only 129/152 had ≥6-month satisfaction data, and the Afro-textured cohort was small (n=6). Potential bias from device-developer involvement despite exclusion of the lead author’s cases; reported GTR figures show internal inconsistency (range 2.2–4.3% vs a 4.6% value mentioned in discussion).
Clinical implications
A recess-free, skin-responsive device enabled no-shave long-hair FUE with low GTR/SBR and faster harvesting; plan torque and movement by SFS class and skin firmness more than curl. Using 19G may reduce transection versus 18G at the cost of speed.
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