Surgeon pain points
Transection and graft quality: the problem FUE surgeons worry about most
Why transection is the central worry in FUE extraction, what it depends on and what you can do to understand and adjust your own technique with judgment.
By Trivellini Academy Team · · 2 min read
A transected graft is a follicle that no longer serves as intended. Every FUE surgeon knows it, and most monitor it daily. This article explains what it usually depends on and what you can do to understand your own technique, without promising figures nobody can guarantee.
What causes it
Transection has no single cause. It usually combines:
- Angle and direction: a punch that does not follow the follicle's axis cuts what it should surround.
- Depth and layer: what works in the epidermis is not best in the fat.
- Friction and traction: pulling the skin or the graft adds tension.
- Motor parameters not adjusted to the patient: laxity, hair caliber, density.
- Fatigue and pace, at the end of a long session.
Why it is hard to correct
You see the result when you review grafts, but the cause happened earlier. Without a parameter log and a second pair of eyes, it is easy to keep repeating the same gesture. And whoever depends on technicians for that phase loses even more visibility, as explained in the article on depending on technicians.
A way to think about the problem in phases
Dr. Trivellini's multiphase system starts from one idea: split extraction by layers and adapt the motion to each (rotation to cross, oscillation to reduce friction, suction to lift the graft). His 2018 article claims this reduces transection [1], but that is the author's claim about his own device, with no comparative data. What is valuable for your training is the reasoning, which you can bring to your practice and verify with your own records.
What you can start doing
- Record parameters and transection rate per case, to have your own data.
- Change one variable at a time.
- Review grafts with a fixed routine.
- Compare your technique with someone who can watch it.
How the academy helps
The online course explains the reasoning of each phase; the AI tutor answers syllabus questions, without clinical advice; and the 1:1 session lets you review your material with Dr. Trivellini. It is training and promises no clinical results.
How each market option solves it
- ISHRS: sessions from several speakers, including on transection and quality control (July 2025 webinar) [2], without individual follow-up.
- Live surgery and hands-on courses: you see the technique at the operating table.
- Manufacturers: training tied to their equipment.
Overview in the hair transplant training market.
Frequently asked questions
- Does the multiphase system eliminate transection?
- No. The author states less transection with his system, without providing a comparative study. The academy promises no clinical results.
Sources
- R. Trivellini, "The Trivellini System and Technique", ISHRS Hair Transplant Forum International 28(5), 2018 (accessed 15 October 2026)
- ISHRS, Spanish Webinar of July 2025 (9 July 2025) (accessed 15 October 2026)
Educational content for healthcare professionals. It is not medical advice and promises no clinical results.
