Recipient sites are made by using one of three instruments:
There is no “correct” hair transplant instrument – it is completely up to the physician which to choose.
In the early days of hair restoration, recipient sites were very large in order to accommodate the much larger size of grafts that were in use. This included punch plugs and mini grafts. The shear size of these incisions prevented the grafts from being placed closely to each other so dense packing was not possible. In addition, the large size of the recipient sites meant that more trauma was inflicted on the patient’s recipient scalp and more scarring would develop. Now, however, the sites are small enough that a person can comfortably wear a close-cut hairstyle without fear of being noticed. These advances in hair restoration are due to significant improvements in both the equipment and techniques involved, most notably the invention of the stereoscopic microscope in the mid-1990s, which allowed physicians to create smaller grafts. Smaller grafts, in return, allowed for smaller recipient sites. Currently, the recipient sites made for grafts harvested via FUSS and FUE alike are small enough that high densities can be achieved with minimal overall trauma and subsequent scarring.
Due to the skin’s tendency to retract once cut, recipient sites are made slightly larger than the graft itself. That way, by the time the graft is ready to be transplanted, the incision site will have shrunk to the same size. It is absolutely crucial that the graft and the recipient site are the exact same size during transplantation. The graft must fit into the recipient site as snugly as possible or else issues can arise. If the graft is not placed correctly, the following problems can occur:
As a 2005 overview notes, recipient sites have the remarkable ability to grow hair in scar tissue. However, scarred tissue is often thinner than ordinary, healthy scalp tissue, which can make graft insertions more difficult. Nonetheless, this ability to grow hair scar tissue allows physicians to perform hair transplants on disfigured patients (provided that they have a suitable amount of donor hair left).