Motorized and Manual Hair Transplantation

Since FUE became a suitable hair transplantation technique, FUE removal tools have undergone significant changes and improvements as motorized and manual hair transplantation. FUE practitioners now use a variety of extraction tools, punches and techniques to collect follicular units. Hair restoration physicians performing follicular unit excision cannot see under the surface of the scalp and therefore have to rely on their own experience.

Preferred extraction means to carefully collect follicular units from the donor area while minimizing transection and follicle damage. FUE hair transplantation extraction devices can be organized into several categories: manual extraction tools, motorized extraction devices and robotic or automatic FUE systems. In addition, these are classified according to staples that contain sharp tools or sharp tips and vary in size.

What are motorized and manual hair transplantation

Manual hair transplantation

Advanced manual extraction devices are generally considered to be “original” hair transplantation tools since these were the first devices used in follicular unit excision procedures. A stapler is a metal hand-held device used in manual hair transplantation, with a handle at one end and a hollow cylindrical needle (“stapler”) at the other end.

During a hair transplant with a manual stapler, a doctor inserts a follicular unit graft for extraction, passes the manual stapler through the handle, places the hollow needle around the follicular unit, and pushes the instrument into the scalp. This motion pierces the scalp around the follicular unit and allows removal. Physicians can use tools with “blunt” or “sharp” tips and choose from a variety of staple sizes.

Many manual hair transplant surgeons believe that the precise “feedback” and control provided with a manual punch (compared to motorized devices) makes this extraction method ideal. However, using manual devices is often more tedious and time-consuming for the hair transplant surgeon, and as a result, the amount of hair that can be transplanted in a single day or session is less than that of motor devices.

Motorized hair transplantation

Like manual tools, motorized hair transplanters collect follicular units with sharp or non-sharp stapling. However, the hollow punch is attached to a small motor rather than a manual handle and is typically operated by a button or a foot pedal in the device. Depending on the motor, the staple is continuously rotated in one direction or released back and forth in opposite directions.

When placed around a follicular unit, the rapid rotation of the motorized punch allows the hair transplant surgeon to perform rapid scalp puncture and graft separation without using hand power. Given these innovations, modern motorized instruments have become extremely effective and allow physicians to harvest and transplant multiple grafts (more than 700 per hour) with low transfection rates and high yields.

Advantages and disadvantages of manual hair transplantation

Advantages Disadvantages
Provides more tactile feedback. More fatigue and human error.
Improves the position/angle of the follicle. Less grafts extracted per hour.
Reduces the heat, torsion, and friction associated with motorized devices. Increases the risk of follicular damage.

Advantages and disadvantages of motorized hair transplantation

Advantages Disadvantages
Transplants more grafts in less time. Generates more heat, torsion, and friction.
Reduces the number of sessions. Reduces tactile feedback.
Minimizes fatigue and human error. Increases the risk of follicular damage.