Over all cosmesis of the donor region has always been a much different story. The initial donor harvests involved punching out plugs ranging from 2.5 mm to 5 mm in size using a hollow punch called a trephine. When I first began doing hair restoration surgery, I was taught to harvest the donor area by removing 4mm plugs from the donor area using a hand engine and a 4mm punch called a trephine. This technique left an undulating scar in the donor region that was often quite fine. We later advanced to performing a strip harvest using a variety of knives because the yield and efficiency of a single procedure was greater. Unfortunately, the donor scar was generally more noticeable.

We have always left a detectable donor region due to the linear donor scar, however. In our offices we utilize several new technologies to minimize the width of the donor scar, but we cannot eliminate it entirely. While we have collectively performed over 10,000 successful donor strip extractions with a patient satisfaction over 99.99999999%, we recognize our inability to leave the donor region as undetectable as the recipient area. Furthermore, we cannot predict the size or width of the scar and we recognize that some individuals will form a wider scar than other individuals. Only with the development of follicular isolation have we had the ability to leave the donor region with an equally undetectable result as the recipient region. The ability to leave the donor region as natural as the recipient area is a powerful tool that very few physicians have recognized yet.

Until recently any donor excision has branded the patient for life with a linear strip scar. These results in a potential exposure of the hair restoration procedure to the hair stylist, loved one, or the casual observer if the hair is cut short or lost due to illness or medication such as chemotherapy for cancer. While the probability of exposure in the hands of a skilled hair restoration surgeon is unlikely, it can occur. In addition, there are those that later in life desire to shave their head. In this instance it is impossible to conceal the results of strip excision. Other individuals wish they had not had a hair transplant procedure later in life. Therefore, it is advisable to offer procedures that allow an individual to conceal their hair restoration attempts later in life especially if the patient is in his early 20s and might have a greater probability of desiring alternative hair styles later in life. We have found that younger individuals are more likely to loose more hair as they age and they are more likely to desire alternative hair styles such as a shaved head. Furthermore, younger individuals are more likely to wish they had not elected to have hair restoration surgery and therefore, will benefit from effort to conceal there procedure.
We will expound on these issues in our section on indications for CIT.

This procedure is known by many different names including follicular unit extraction (FUE), the Woods Technique, the Top Up technique, and most recently Hair Transfer (HairXFER). There are many differences between the different techniques.