# 📍 Region별 권장 Punch Depth (Foligraft 기준) ### 1. **후두부 (Occipital Safe Zone)** - 피부 두께 + 피하지방 풍부 → 가장 안정적. - **Depth: 3.5–4.0 mm** - 이유: 이 부위는 follicle 길이가 상대적으로 길어 충분히 들어가야 bulb까지 따라갑니다. --- ### 2. **측두부 (Temporal Region)** - 피부 얇고, 모발이 **acute angle**로 눕듯이 자람. - **Depth: 2.5–3.0 mm** - 이유: 너무 깊게 들어가면 바로 근막층에 닿아 transection↑. - Tip: motor 속도를 낮추고 angle을 hair shaft보다 더 평행하게. --- ### 3. **두정부 (Parietal / Vertex)** - 피부 얇지만 follicle 방향이 다양 (whorl). - **Depth: 3.0–3.5 mm** - 이유: shaft 방향은 얕아 보여도 follicle은 실제로 더 깊이 뻗는 경우 많음. - Tip: zone을 나눠서 자주 angle 재조정. --- ### 4. **하후두 / 목덜미 (Low Occipital / Nape, 보조 donor)** - Fine hair, acute angle, 곡선 많음 → 난이도 ↑. - **Depth: 2.5 mm 전후** - 이유: 모낭이 짧고 얕게 눕기 때문에 과도한 depth는 bulb transection 위험. - Tip: 초보자라면 피하는 것이 안전. --- ## ⚖️ Foligraft Depth 실무 팁 1. **Depth stopper** 활용 → region별 depth pre-set. 2. **투메슨트로 interfollicular space 확보** → 모낭이 punch lumen 안으로 잘 모임. 3. **체감 피드백**: 부드럽게 들어가면 OK, “gritty” 저항감 느껴지면 angle 또는 depth mis-match. --- ✅ **정리 (Foligraft 기준)** - **후두부: 3.5–4.0 mm** - **측두부: 2.5–3.0 mm** - **두정부: 3.0–3.5 mm** - **하후두/목덜미: ~2.5 mm** --- ## 📍 Common Causes of High Transection - **Angle mismatch**: Punch not aligned with the true subcutaneous course of follicle. - **Depth errors**: Going too shallow → only upper follicle cut; too deep → bulb transection. - **Tethering**: Strong dermal or subcutaneous attachment increases risk. - **Motorized torque**: In systems like Foligraft, torsion can twist follicles and raise transection rates. - **Inexperience or fatigue**: As noted, “every graft in FUE can potentially be transected,” especially in novice hands. --- ## 📍 Immediate Intraoperative Responses 1. **Stop and check cores** - Examine the tissue core: see where hair is cut (acute vs obtuse side) to know if angle is too flat or too steep. 2. **Adjust angle**  - If transection occurs on the obtuse side → make punch **more acute**. - If on the acute side → make punch **less acute**. 3. **Modify depth** - Set depth limiters: - Occipital 3.5–4.0 mm - Temporal 2.5–3.0 mm - Vertex 3.0–3.5 mm. - Too many shallow cuts → increase depth gradually. - Too many bulb transections → reduce depth. 4. **Slow down in high-risk regions** - Temporal & vertex zones need smaller, controlled movements. - Consider switching to manual sharp/blunt if Foligraft motor torque is cutting too aggressively. 5. **Use more tumescence** - Expands interfollicular distance and makes follicle direction clearer, reducing accidental cuts. --- ## 📍 Longer-Term Strategies - **Hybrid approach**: Motorized Foligraft for occipital bulk harvesting; manual sharp/blunt for temporal and whorl areas. - **Regular feedback loop**: Check transection rate every 50–100 grafts, not at the end. - **Training**: Practice manual feel to avoid over-relying on motorized torque, which loses tactile cues. --- ✅ **Summary**: When transection increases, immediately **check core, adjust angle, control depth, and reinforce tumescence**. In persistent cases, slow down or switch to manual two-step, especially in **temporal and vertex regions**. This way you stabilize the transection rate while still using Foligraft efficiently. ---