I love this video I shot of Dr. Lupanzula for two reasons. The first reason is because I really enjoyed filming Dr. Lupanzula in action. His skills with hand held manual FUE extraction are phenomenal and he really knows what he's doing. It was a real joy watching him in action. The second reason is because the video gives me the opportunity to teach you about something you most likely have never heard of; what it means when you hear about FUE transection rates.
FUE transection rates are not a full representation of the facts when a clinic tells you what their transection rates are. Why? Because there are two kinds of transection rates and one is more important than the other.
Partial transection is how we refer to a graft where some of the hairs are transected but others remain intact and viable. You can see one in the video above and Dr. Lupanzula explains how this can be beneficial for some cases. Partial transections actually allow for additional camouflage of any dots that form in the donor zone, which is common to all FUE procedures regardless of what anyone tells you. If a partial transection occurs, and the doctor knows what he's doing, then the situation achieves two goals; a hair is transplanted and a hair grows through the extraction point of the donor zone. It is said that this also allows for the picking and choosing of single hairs vs. multiple hairs in a graft because a single hair graft can be produced on demand.
The second type of FUE transection is full FUE transection. This means that all hairs in a follicular unit are destroyed transversely due to the cutting instrument, blade or needle, slicing through the entire graft. I call it the complete emulsion of a graft because it usually means that the graft and the tissue are done, nothing will grow and even if left in the donor zone it will still leave a void. There is some discussion that when left in the donor zone these grafts can recover and continue to produce viable hair but when you're dealing with thousands of grafts in a day the speed at which one needs to work would, in my opinion, negate this possibility on any predictable or reliable scale.
All the discussions regarding FUE transection that I've taken part in or overheard during conferences indicate that full transection rates are lower than partial transection rates which would make sense if you think about it. When a clinic usually reveals what the transection rate is for any given FUE hair transplant procedure they are talking about their full transection rates because it sounds better. After you read this article you should be sure to ask any doctors or consultants you speak with what their real transection rates are and if they say they don't know what you mean, break it down by asking for their full and partial transection rates. If they say that they are the same, or that there is no difference share this article with them and then ask again.
Why you should care. You should care about what transection rates really mean because the hyper-sensitive hair restoration market devours anyone that appears to be less qualified than the next guy based on the tiniest, most unimportant details that have a lot of marketing power but little to no actual medical validity. The sweet spot for hair restoration transection rates, with FUE and FUSS, is in the 2% range so if a clinic says they have a 5% transection rate, they may as well be saying every one of the technicians has Zika and the surgical instruments are cleansed in the blood of rabid baboons. The reality of surgical hair restoration is that if you have a 10% transection rate or better then you're doing a good job regardless of procedure and quite frankly I think a lot of clinics actually are in this range whether they want to admit it or not.
Ultimately it is up to you to decide but when every clinic you speak with says they have a 2% transection rate you need to stop and ask yourself why. Ask them if they are actually calculating each case and then giving you an average of those cases or are they just pulling numbers out of the air so they don't sound less qualified than the competition? Ask them if this is including full AND partial transection rates. I've seen clinics throw away grafts. I've seen clinics have patients where the grafts were easily damaged, would "pop" or even explode from the lightest touch. Take it from me, there is a lot of shit that happens that you never hear about.
This leads me back to Dr. Lupanzula. He does calculate his transection rates and he does take the time to educate his patients and this is only one of the reasons I'm happy to work with him and the team at Medikemos Clinic.