Answer:
There are essentially three major methods of transplanting hair to bald areas of the scalp.
1. Composite grafts
a. Punch which may be round or square
b. Strip grafts
2. Scalp grafts
3. Scalp reduction
PUNCH GRAFTS
Healthy highly motivated patients with moderate hairline recession with dense hair of good quality are considered good candidates for the procedure. They are even better candidates if they are over 30 years of age and the pattern has been more or less established. Under local anesthesia using a special punch device, after shaving the donor area to determine the angulation of the shaft, punch grafts are removed and trimmed. In the recipient area a punch that is 0.25mm smaller than the donor punch is used to remove the bald plugs from the recipient site .This is important because the graft contracts slightly and recipient enlarges slightly.
Square punch grafts use a square trephine and on an average produces 25% more hair than the round technique. However it is thought that the slight advantage of the square graft is outweighed by the disadvantages of the greater complexity of the technique.
Strip grafts involve excising a full thickness strip of skin and placing it in the frontal hairline. Grafts can be lost due to infection movement from inadequate fixation. This is a more involved procedure and areas of alopecia may develop in the graft itself.