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RO Extraction is measured by one number: transection. A follicular unit sits at an angle under the skin and curves as it goes. The punch travels in a straight line. Transection is what happens when those two paths diverge and the punch cuts through a follicle instead of around it. Everything else in extraction — punch choice, angle, depth, speed — is a way of keeping that number down.
Not all transection is equal. A follicle clipped below the bulb may still grow. One divided through the bulb is lost. A partially damaged unit can arrive with two hairs where it had three. This is why yield is counted in hairs that grow, not in grafts that were removed, and why a transected donor produces a thin result from an impressive-sounding graft number.
The variation between operators is larger than most patients assume. In a controlled side-by-side study where the same twenty donor areas were split in two, overall transection differed roughly two-fold between two instruments used by the same experienced surgeon — 23.6% against 9.7% (Josephitis & Shapiro, Hair Transplant Forum International, 2016). Technique and instrument are not interchangeable variables.
The patient never sees it. Transection leaves no mark on the donor and no sign on the day. It appears eight to twelve months later as density that does not match the number on the invoice, by which point the follicles are gone and the extraction points cannot be reused.
Related terms
- Punch diameter selection
- Graft extraction angle
- Manual vs motorized FUE
- Graft vs hair count
- Dermal papilla
For how the extraction stage fits into the whole procedure, see the FUE technique. For what the donor area can give without damage, see the donor area guide.
