Use of 45-degree implanter angulation with bevel-to-skin orientation to enhance follicular entry

Srishti Agarwal; Rajprakash Bhaskaran; Murugesan Krishnan; Parthiban Saketheraman

doi:10.57662/am.2026.18733

Use of 45-degree implanter angulation with bevel-to-skin orientation to enhance follicular entry

Authors

Srishti Agarwal Postgraduate student, Department of Oral and Maxillofacial Surgery, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, SIMATS, No.162, Poonamallee High Road, Vellapanchavadi, Chennai, Tamilnadu, 600077
Rajprakash Bhaskaran Professor, Department of Oral and Maxillofacial Surgery, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, SIMATS, No.162, Poonamallee High Road, Vellapanchavadi, Chennai, Tamilnadu, 600077. https://orcid.org/0000-0001-5802-0002
Murugesan Krishnan Professor & HOD, Department of Oral and Maxillofacial Surgery, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, SIMATS, No.162, Poonamallee High Road, Vellapanchavadi, Chennai, Tamilnadu, 600077
Parthiban Saketheraman Professor, Department of Periodontics, Sri Venkateshwaraa Dental College and Hospital, No.13A Pondy-villupuram main road, Ariyur, Pondicherry – 605102

Keywords:

Implanters, 45 degrees, Density, FUE.

Abstract

Background: Implanting the follicular units precisely is crucial for the ultimate result of follicular unit extraction (FUE) hair transplantation. The angle of implantation and the position of the implanter bevel are extremely important for reducing follicular trauma and obtaining natural hair direction.

Objective: This study aims to assess whether the use of implanters angled at 45 degrees with bevel-to-skin orientation can improve follicular entry and early clinical outcomes as compared to the traditional perpendicular implantation technique.

Materials and methods: In this randomized, split-scalp clinical trial, FUE hair transplantation patients had their scalp divided into two equal halves. Implantation on the test side was done with implanters angulated at 45 degrees with bevel-to-skin orientation while the control side was implanted with a conventional perpendicular method. Both operative parameters such as ease of follicular entry, graft resistance, follicular popping, and implantation time and early post-operative follicular integrity were evaluated.

Results: The 45-degree angulation method demonstrated superiority in the ease of follicular entry, less graft resistance and follicular popping, as well as a shorter implantation time compared to the conventional method. Early post-operative evaluation showed improved graft stability and more favorable hair angulation on the test side without any increase in complications.

Conclusion: Implanter angulation at 45 degrees with bevel-to-skin orientation successfully improves follicular entry and the overall efficiency of the operation in FUE hair transplantation and may improve early clinical outcomes.

Author Biography

Rajprakash Bhaskaran, Professor, Department of Oral and Maxillofacial Surgery, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, SIMATS, No.162, Poonamallee High Road, Vellapanchavadi, Chennai, Tamilnadu, 600077.

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