The first step in this procedure is the removal of the donor strip from the recipient site in a way that ensures minimal damage to the donor hairs and minimal scaring to the donor area after the tissue is sutured together. First, the physician wets the hair to identify the safe donor area (the portion of donor hair that is meant to last forever). Then the hair is cut short at the site where the strip is going to be removed. At SMG, we like to keep this hair a little longer for three reasons: It makes it easer to follow the angle of the hair when we make the incision; It makes it easier to handle the graft at the later placing stage; It gives a better preview of how the transplant is looking and makes it easier to do any fine tuning that is needed to create a perfect result.

Before removing the donor strip, it is important to evaluate the donor area density so the correct amount of tissue can be used and the correct amount of grafts created. At SMG, we use digital technology and advanced software to photograph and measure the donor density. We also test the laxity of the scalp in order to calculate the safe amount of tissue we can remove without causing tension or scarring. We have each patient do scalp stretching exercises before their procedure to ensure the greatest laxity possible.

Dr. Shapiro uses true, 5.0 power surgical loops to magnify the area of tissue removal in order to better follow the exact angle of the hair and prevent damage. Some clinics do not use this level of magnification, but we feel the greater the visibility and magnification, the less chance of damaging hairs. After the strip is removed, the donor area is sutured closed with a recent advancement called a trichophytic closure. This technique helps limit any scar that develops in the donor area because it allows hair to grow through the scar to minimize its visibility.