Even the uninformed in the details of the FUE procedure have heard about the controversy between a Manual FUE Hair Transplant and one that is motorized. At some clinics, the Manual FUE Hair Transplant is strictly implemented and there are several reasons why. A manual punch allows the surgeon to assess difference in tissue resistance through feel. This is especially important in the case of splayed or curved grafts. The resistance of the hair shaft of the hair shaft is different from the surrounding connective tissue. Using a manual punch in a Manual FUE Hair Transplant allows the surgeon to feel the resistance and stop the penetration. With the motorized punch, that feeling is considerably lost, though experienced technicians are able to adapt and regain some of that feeling.
Another aspect is the heating of the tissue from the punch. With the motorized punch, especially when the punch gets dull, the machine uses force to cut. This can easily result in the torsion of the tissue and cannot necessarily be felt.
It goes without saying that hand fatigue is prevalent with the manual punch, however it is really the only guaranteed method to obtain the patient’s specific characteristics including skin fragility, graft angle and splay. Most surgeons whose preference is the motorized punch find that the transection rate is equal with both.
Most people would think that a motorized punch is much faster. However, an experienced manual punch technician can arrive at the same rate of speed. Proponents of the motorized punch tout speed as the primary reason for their preference.