The Trivellini multiphase system: how the instruments are designed

The multiphase system is the FUE extraction approach Roberto Trivellini describes in his 2018 article in the ISHRS Hair Transplant Forum International [1]. We summarize it here so you know what the course covers. This is a summary of the author's description, and he also discloses owning the company that makes the device: that article has no comparative data, and we do not invent any.

The idea: each layer, a different motion

Instead of using one motion for the whole path of the punch, the system chains phases with different cuts according to the layer of the scalp. According to the article, in the sequence described:

1. Rotation (about 200 ms) to cross the epidermis and superficial dermis.
2. Oscillation (about 300 ms) to reduce friction against the follicle.
3. The graft moves into the punch, helped by the follicle's stored energy and suction.
4. The motor stops at around 500 ms and suction lifts the graft while the punch advances through the fat.
5. The graft is removed with forceps.

Available modes are rotation, oscillation, vibration and asynchronous oscillation, which can be combined and adjusted in power and duration.

Instruments

• Straight, hollow-shaft handpiece, which the author presents as designed for hair transplantation rather than adapted from a dental instrument.
• Punches in several sizes and edge types.
• Suction pump at 650 mmHg, which immobilizes the skin around the punch. That is why the author advises against traction and deep tumescence.
• Foot pedal or SmartReact, which starts the motor when the punch is over the follicular unit.
• Bed that allows head flexion to align the handpiece with the hair's exit angle.

Other elements of the method mentioned in Roberto's own documentation, such as the octagonal Ring Punch, the T-Fast Multi-Implanter and mixed stick-and-place, are explained in the course.

What it claims and what it does not

The author claims less transection and more speed [1]. That is his claim about his own device, and the article provides no comparative study. We do not promise results: we explain the reasoning of the method so you can judge it and try it under your own supervision.

Why knowing it matters

If you are worried about transection and graft quality, understanding the reason for each phase lets you adjust parameters with judgment instead of copying values. It is also the natural complement to Long Hair FUE. It is in the online course; for questions about your settings, book a 1:1 session.