Regarding punch selection, two distinct schools of thought emerged during FUE evolu­tion, focusing on blunt and sharp dissection approaches. Jim Harris MD introduced the blunt punch, termed the “S.A.F.E. technique” [26], while the alternative approach employs a sharp punch with a “stop” to limit penetration depth. [24] This school advocates that sharp punches minimize friction and thrust force that could damage follicles. However, the choice between sharp and blunt punches does not resolve the dilemma, as various physical and technical factors inuence punch-cutting dynamics, tissue distortion, and graft injury. These factors include punch shape, diameter, tip shape, edge sharpness, location and diame­ter of dissecting edge, punch wall thickness, and punch metal type. Consequently, a diverse array of incisional techniques has emerged, employing sharp, serrated, non-serrated, dull, hybrid, trumpet punches, and other designs (Fig.3.8). Details on punch design categories, engineering, punch incision geometry, and met­allurgy fall beyond the scope of this chapter and can be sourced elsewhere. [24, 26, 29]

Overall, 8900 body FUs were harvested and transplanted in 9 sessions within 18months. According to the authors, there was a 47% transection rate (From [45])