Over the past 8 years, I have explored and now ultimately embraced the beauty of the punch instrument when dealing with bald scalp.

The punch instrument is tiny, encompassing 0.75 mm, 1 mm, and 1.25 mm, and do not at all look like the old 4 mm punch instruments that were used during the old plug graft era. The reason that punch instruments can be leveraged so effectively for hair transplants is simply put they remove bald scalp. Think of it this way, when you transplant hairs from the donor hair, the hair follicle is transplanted with a tiny cuff of skin around it. In essence, you are transplanting not only hairs to the bald area but also additional bald scalp and thereby increasing the total surface area of baldness. The punch instrument allows you to diminish total bald scalp by removing bald scalp from the recipient area when hairs are transplanted into it.

Punch instruments are by their very nature harder to use since you must ensure that the angles are correct, that the blood supply underneath is preserved, and that the cores that are created are all removed before transplantation. When a surgeon is inexperienced, the results can be unnatural or risk poor growth. In experienced hands, the results can be amazingly natural, significantly denser, and total effective bald area for a patient actually reduced rather than increased. In the right patient by the right surgeon, the punch instrument can be a transformative work of art.

Samuel M. Lam, MD, FACS, a board certified hair transplant surgeon in Dallas, Texas. To learn more about Dr Lam’s hair transplant procedures, or to schedule a consultation please call 972-312-8105, or visit hairtx.com for more info. To ask Dr Lam a question about hair loss or hair restoration please visit our hair transplant forum.