In my 18 year hair transplant career, I have been seeing numerous old 4mm Punch grafts.
It was rare to see any grafts without transection. There are times I even see the graft without any hair.
Initially I believed using the new FUE 1mm punch would yield a much higher transection rate, but after I visited Dr.James Harris at Denver last year, I completely changed my mind.
Seven hair transplant physicians attended the workshop. Dr.Harris taught us how to align the angle, where the scalp entry point is, how to tighten the scalp and how to control the punch speed. He watched us perform the procedure and corrected our mistakes one by one. He was such a good teacher, he could tell us how the grafts would turn out before we did it, by observe our alignment. By the end of the workshop, everyone had reduced the transection rate dramatically.
Now I changed my attitude toward FUE. I recognized it as a completely different method now, even though it is still a blind procedure but the transection rate might be reduced dramatically via adequate training and practice.