An approach to any FUE hair transplant patient should follow a methodical thought process focused on how to efficiently and safely remove grafts from the donor area.
All patients are slightly different. Some have short hair follicles. Some have long hair follicles. Some have fine hair. Some have coarse hair. Some have minimal follicle splay. Some have significant follicle splay. Some have large follicular groups. Some have small follicular groups. Some have tight attachments between the adipose and the outer root sheath. Some have weak attachments. Some have weak attachments between the outer root sheath and the inner root sheath. Some patients have loose, rubbery skin. Some patients have firm, rubbery skin. Some patients have firm soft skin and some have loose soft skin.
When you begin to understand the complexities and variability between all patients, it is possible one begins to recognize that there is no one method that is successful in all patients. We need variability to successfully harvest grafts from all patients. No one approach will work equally well in all patients.
We must rationally approach each patient. What parameters, settings, and variables might we consider in each type of patient.
The PCID is the only machine that offers such variability. The options are limitless with the PCID. The variability allows us the capacity to find the optimal approach in any patient. All other machines built to perform FUE have a single approach. All other machines lack the precision in depth control along with functional precision offered by the PCID.
The PCID has a limited maximal RPM of 4000. Generally speaking extractions are best performed with a sharp punch and a rotational speed of 1250 rpm to begin with. As the punch dulls, the RPM may be gradually increased. Other machines lack precise rotational speed control. One of the most important abilities of the PCID is to control the rotational speed precisely.
The PCID offers numerous optional settings. One may extract with a continuous rotation or a continuous oscillation or one may perform intermittent extractions using the hard wired or blue tooth pedal. The PCID offers a Ramp to change from one speed to another over a set amount of time or to change from an oscillation arc to another oscillation arc over a period of time. Rotation may be set an initial speed and terminate at a second rotational speed. The duration in time between this Ramp may be individualized.
In oscillation mode one may set a continuous oscillation angle or arc and a continuous number of cycles per minute. Alternatively, both the Arc and the CPM may be adjusted over a Ramp time. The Arc is the cumulative angle of movement to each side. For example an Arc of 100 degrees is equivalent to a 50 degree movement to the right followed by a 50 degree movement to the left for a total of 100 degrees of movement. The minimum Arc necessary to incise skin is typically 60 degrees. One may set the CPM anywhere between 4 CPM and 1000 CPM. A higher speed greater than 700 CPM can create too much hand piece movement. Sometimes it is better to begin with a slower speed.
One may also begin with rotation and follow this with oscillation after incising partially into the skin. We call this setting roto-oscillation. The rotational speed may be precisely set followed by oscillation of a desired magnitude and frequency.
The PCID is best suited for use of the surrounded punches. These punches are very sharp and incise skin cleanly with minimal axial force. The optimal way to excise grafts is to use a very light axial force while allowing the punch to incise the skin around the follicular unit. Other punches may also be used with the PCID.
The PCID comes with a one-year warranty due to problems due to normal wear and tear. The PCID includes complimentary software upgrades.