The creation of recipient sites — the openings in the scalp into which transplanted grafts are placed — is one of the most technically demanding and artistically important stages of the hair transplant procedure. It is the phase that most directly determines the naturalness and density of the final result.
Recipient sites are created using either a fine blade (typically a sapphire or steel blade), a needle, or a custom implantor device. The choice of instrument affects the size of the site and the precision with which it can be directed. Sapphire blades have become increasingly popular because of their rigidity, sharpness, and the ability to create very precise, consistent sites with less tissue trauma than steel blades.
The density of recipient sites determines the final density of the transplanted result. Sites must be spaced to allow adequate blood supply to each graft. Packing sites too densely reduces the blood supply available to each implanted follicle and reduces survival rates. The optimal density is typically 40 to 50 follicular units per square centimetre for areas of total hair loss, lower in areas where native hair remains.
The angle and direction of recipient sites is the critical artistic element. Each site must be created at an angle that matches the natural growth direction of hair at that specific point on the scalp — forward and downward at the hairline, slightly more lateral at the temples, and following the whorl pattern at the crown. Misaligned sites produce hair that grows in the wrong direction and looks unnatural regardless of graft survival.
The depth of recipient sites must also be calibrated to the length of each graft. Sites that are too shallow result in grafts sitting proud of the scalp surface; too deep can compromise vascular access to the bulb of the follicle.
Related reading
