title: Comparative Study of a Novel Tool for Follicular Unit Extraction for Individuals with Afro-textured Hair.
abstract: Hair transplantation involving patients with tightly curled Afro-textured hair using follicular unit extraction (FUE) employing conventional rotary punches frequently leads to unacceptably high transection rates. These patients are unsuitable candidates for FUE hair transplantation. Transection rates were observed during FUE in a case series of 18 patients with tightly curled Afro-textured hair using different punches.
  
  
  METHODS
  Three different punches were sequentially used in patients to extract follicular units with several needle gauges until satisfactory transection rates occurred: conventional sharp and dull rotary punches, followed by a 2-pronged curved nonrotary punch.
  
  
  RESULTS
  In all instances, the curved nonrotary punch had the best transection rate of <5%. Sharp and dull rotary punches completely failed or had excessive transection rates in 8 patients. The dull rotary punch performed better than the sharp rotary punch in 9 patients in whom it was used with few restrictions compared to 5 patients in whom there were more restrictions.
  
  
  CONCLUSIONS
  A curved nonrotary punch configured to accommodate the curliness of tightly curled Afro-textured hair can overcome high transection rates experienced using conventional sharp or dull rotary punches. Limitations of this study include it being a small, retrospective case series, and that the new technique that could require additional training by current FUE hair transplant practitioners.
authors.affiliation: Dermatology Division, Department of Medicine, University of California at Los Angeles, Calif.; and FineTouch Dermatology, Inc., Redondo Beach, Calif.
authors.forename: Sanusi
authors.initials: S
authors.lastname: Umar