What is Sapphire FUE?

What is Sapphire FUE? That’s a great question but there isn’t a simple answer. This is because “sapphire FUE” isn’t just one thing. Sapphire FUE is several things and while each part is different the sum of the parts is not what it seems. 

Sapphire FUE Claims

Let’s look at what clinics that offer Sapphire FUE claim are the benefits. 

  1. Almost all of the websites that offer Sapphire FUE claim that sapphire blades are antimicrobial or have antibacterial properties.
  2. Sapphire blades are smaller than stainless steel blades. This insures that incisions are made with greater accuracy.
  3. The use of sapphire blades means less tissue damage.
  4. The anatomy of the sapphire blade allows hair transplant surgeons to inject less tumescence, which is a special fluid used to lift the skin from the bone.
  5. Sapphire is harder and more durable than stainless steel blades. SS blades become dull and damage tissue more.
  6. No neighbouring follicles are damaged.
  7. It does not induce allergic reactions like stainless steel can.
  8. The greater effectiveness of this method is due to the blades making smaller channel openings, thus allowing more dense transplantation. 
  9.  It’s highly unlikely for the follicles to become dislodged after the hair transplantation.
  10. Sapphire FUE is different than “classic” FUE.

Sapphire FUE Facts

So let’s start from the top and examine in closer detail if these claims are true, or not true.

Claim #1 - Sapphire blades are smaller than stainless steel blades. This ensures that incisions are made with greater accuracy.

The Facts. This one is confusing to patients. It implies that differences measured in the sub millimetre range are significant enough to reduce accuracy. But accuracy of what? I’m not sure myself but we have to assume the claim is referring to accuracy of making recipient site incisions. Accuracy is determined by eye/hand coordination. The only time the size of the tool makes a difference in accuracy is if one tool is the size of a hammer and the other tool is the size of a pin head. This is a silly claim that is only designed to mislead.

Claim #2 - The use of Sapphire blades means less tissue damage. 

The facts - How are they defining tissue damage? When a blade cuts into the skin, it cuts not only skin, but blood vessels so we have to use a little common sense. Assume we have a sapphire blade and a stainless steel blade that are the same size. Both will cut the same size wound and both will cut the same vessels as they are plunged into the skin thousands of times. The same amount of general tissue is being cut. Where is the additional damage caused by stainless steel blades vs. Sapphire blades? It doesn’t exist. If it does, the difference is so small it would be impossible to quantify for the long term, much less to any measurable difference for the patient. 

Claim #3 - The anatomy of the sapphire blade allows hair transplant surgeons to inject less tumescence, which is a special fluid used to lift the skin from the bone.

The facts - This makes ZERO sense. Tumescence is the act of injecting saline solution into the upper level of the skin to inflate it. Saline solution is not special because it is nothing more than refined salt water. Really, it’s no different than what people use to rinse their eyes when they wear contact lenses. When the incisions are made into the skin after it has been tumesced those incisions will be closer together after the saline solution drains out of the area and the skin contracts back to it’s normal state. So, basically, the claim is that by using sapphire blades, every precaution that should be taken when creating density using any other tool, and there are several, can be thrown out the window. Ummm, NO!

Claim #4 - Sapphire is harder and more durable than stainless steel blades. SS blades become dull and damage tissue more. 

The facts - It’s true. Sapphire is VERY hard. The only thing harder than sapphire is diamond. But this is also irrelevant. Stainless steel, and all metal cutting edges, will get dull after not a lot of use, depending on what that use is. For making recipient sites, stainless steel blades become dull after about 50 to 150 cuts, depending on the skin type. Clinics that use SS blades will have about 50 blades pre-cut and ready to go when they’re needed. It’s a common practice to swap out the dull blades for the fresh sharp blades multiple times during the surgery and this avoids the very issue the claim is making. SS blades are also super cheap, literally costing pennies each, so it makes no difference how many are used for surgery. Sapphire blades get dull as well, but not nearly as fast. They also cost a LOT more than SS blades so the fewer the clinic uses, the better. Each sapphire blade can cost up to 100 US dollars a piece.

Claim #5 - No neighbour follicles are damaged

The facts - This cannot be claimed just because a tool is being used. If a tool cuts, it can damage neighbouring hairs. It’s just that simple. Remember the balloon trick? Sometimes clinics will do this when they’re making incisions between existing hairs so that the spaces are bigger and the chance of transecting neighbouring hairs is reduced. 

Claim #6 - Sapphire FUE does not induce allergic reactions like stainless steel can. 

The facts - This is kind of silly. There is such a thing as metal allergies with metallic implants, such as hip or joint implants but having an allergic reaction to stainless steel blades, or needles for that matter, in hair transplant surgery just isn’t a thing. This is a ridiculous attempt to scare people aware from something that simply doesn’t exist. 

Claim #7 - The greater effectiveness of this method is due to the blades making smaller channel openings, thus allowing more dense transplantation. 

The facts - I think “greater” in this context is relative but this brings us back to the size differences between stainless steel blades and sapphire blades. Are sapphire blades truly smaller than stainless steel blades? Interestingly enough, I made a similar comparison between stainless steel blades and syringes that are also commonly used for recipient site creation about fifteen years ago. In the video, I used a micrometer to measure the width of a blade that I had cut myself but I also measured the thickness.  Let’s take a look.

Twenty three hundredths of a millimetre thick. Think about how thin that is. 

So how much thinner is a sapphire blade compared to a stainless steel blade? You tell me.

My friends at Prohair Clinic in Belgium sent these photos to me because they’ve also been hearing about the magical qualities of Sapphire FUE and they knew I’d like to see a direct comparison, because they know how much of a hair geek I am. Thanks, guys!

In this first image you can see that they’re about the same width. ProHair Clinic didn’t send me the exact dimensions, but just use your eyeballs. I think I mentioned before that the stainless steel blades can be cut to be more narrow depending on the graft size and I know they can be cut as narrow as .5mm, which is smaller than anyone would really want to go. Here’s a photo of the original blade cutter, the same that I used in the video.  I have no idea why anyone would want to go smaller than .5mm as it is completely unnecessary so if a sapphire blade is more narrow than .5mm, it is a waste of money for the clinic. In fact, anything below .7mm is almost just as much of a waste. 

sapphire blade vs stainless steel blade

This second image shows the real story. Does the sapphire blade look smaller than a standard stainless steel blade? 

sapphire FUE blade

That sapphire blade is really pretty, but it isn’t smaller than a stainless steel blade, so this fact alone debunks almost every other talking point about about the advantages of sapphire blades. In fact, using the logic applied to the supposed benefits of sapphire blades being smaller, maybe incisions will heal faster if they’re made with stainless steel blades? 

Claim #8 - it’s highly unlikely for the follicles to become dislodged after the hair transplantation.

The facts - What they’re talking about here is the shape of the bottom of the incision. If you look at this blade, the tip is in a V shape, meaning the bottom of the cut will have the same shape, so the argument is that the graft will become lodged into this V shape and not pop out. . In reality, there is no evidence that a V shape holds a graft in better than a non-V shape. In fact, it may lead to compression of the graft if the sizing isn’t correct. When you look at the shape of a typical follicular unit, the base of the graft is not in a V shape. It is more of a flat rectangular shape for some grafts and others may even flair out. So what is Compression? It happens a graft is placed into an incision that is too small for the graft and it leads to reduced blood flow because of the unnecessary pressure on the graft and the incision. The graft doesn’t die but the hairs eventually grow out looking more coarse and wirey than when it was growing in the donor area. The real reason why grafts pop after placement has to do with blood pressure. If the patient is a “bleeder” then grafts will pop, which means the techs have to place them back into their incision and this can lead to damage through excessive handling. The shape of the incision really has nothing to do with popping and it comes down to how each clinic manages their patient during surgery, which is too deep of a subject for this video.

Claim # 9 - Almost all of the websites that offer Sapphire FUE claim that sapphire blades are antimicrobial or have antibacterial properties.

The facts - Every patient that goes to a reputable hair transplant clinic is operated on in a clean environment. This means that medical standards are followed to prevent infection of the patient during the procedure. This includes proper attire, gloves, autoclaves to heat up the instruments to kill any microbes, antibacterial iodine washes, etc. Because needles and stainless steel blades are already sterilized in autoclaves or in their packaging, there is a very VERY low risk of infection if all protocols are followed. This is one of the things I look for when I review a clinic. But with the claim that sapphire blades are antibacterial? I’ll let you figure out that one.

Claim #10 - Sapphire FUE is different than classic FUE.

The facts - Sapphire FUE is simply FUE, as you’ll find in any clinic, anywhere in the world where grafts are removed from the donor area by using some sort of punch and placing those grafts into incisions or slits made in the area of hair loss. FUE, by definition, is the removal of grafts with a small punch. It has nothing to do with the type of punch being used. It has nothing to do with what tool is holding the punch. It has nothing to do with motors or robots and it has nothing to do with the incisions made to place the follicular units or grafts once they’re harvested. In fact, by the logic of the clinics that promote Sapphire FUE, a strip surgeon need only start using sapphire blades to make the recipient site incisions and then they could call it “Sapphire FUT” or “Sapphire Strip” or some other nonsense. The “sapphire” in Sapphire FUE is different only in that the practitioner is using a blade made of sapphire gemstone, and not stainless steel. The gemstone is artificially created and is considered to be industrial grade, not “precious” like you’d find in jewelry as it is transparent and does not carry the typical colour one thinks of when discussing rings or necklaces. 

Is Sapphire FUE Really Better?

So in the end, which is better? Sapphire blades? Stainless steel blades? What about syringes or needles? Well, there is one important aspect of recipient site creation that hasn’t been mentioned. When a graft is inserted into an incision, does that incision heal faster because the incision is small or because the graft inserted into it is also small? Remember, the graft is filling the incision regardless of what size the incision may be so if you take the same size graft and insert it into an incision made specifically for that size graft, the nature of the graft holding that incision open makes the healing time relatively the same across the board.  This means that the tool doesn’t really matter. As long as the tool helps to get to the same goal as the other tools, and the result looks natural, has an acceptable density and doesn’t leave visible scarring, then that is all that should be strived for and in toady’s world of more and more inexperienced and bad clinics opening up on a daily basis, this outcome is more and more valuable by the day. The tool, is only as good as the hand that wields it and a sapphire blade is just as good as a needle which is just as good as a stainless steel blade, etc. etc. Choose your clinic based on their consistency of putting out high quality results and their desire to educate you about the downsides of surgery as well as the upsides and don’t be easily swayed about one tool making the results so much better than another tool. If any clinic is telling you otherwise, ask them this one question.

If you say that great results can only be achieved with your tool of choice then how come how come clinics that use other tools also get great results? Watch them stutter and stumble to try and answer your question.

Leave a Reply