Recipient sites refer to the precise location where the prepared follicular units are placed. Recipient sites are made by making small incisions to fit the exact size of the patient’s follicular units. Dr. Gabel prefers to create lateral slits (also called coronal or horizontal slits) vs perpendicular slits. The reason being that lateral slits have the advantage of giving the maximum degree of control over the direction that the hairs will ultimately grow and also the precise angle that they will emerge out of the skin.
The lateral slit technique allows Dr. Gabel to provide maximal density and coverage, as the hairs tend to fan out over the surface of the scalp in a layering effect, giving the illusion of higher density, and ultimately a more natural appearance. The perpendicular technique (also referred as the sagittal technique) can result the hairs to stick up giving an unnatural appearance to the transplanted hair.
The angle that the hair exits the scalp is absolutely critical in achieving a natural appearing result. In the frontal hairline and the central crown areas, the hairs exit the scalp in a very acute angle. In the mid-scalp region, the hairs exit the scalp in a forward angle, but not as acute as in the frontal scalp. Utilizing the lateral slit technique, Dr. Gabel is able to specifically create an opening for the follicular units at the exact angle for the particular area that is being transplanted.
In order to make the lateral slits, Dr. Gabel will make custom cut blades that exactly fit the follicular units of the patient. Follicular units vary in size from the small single hair follicular units to larger 4 or 5-haired units. After the follicular units are prepared, Dr. Gabel will measure the size of each follicular unit and make a custom cut blade for the various sized grafts. Utilizing this method allows Dr. Gabel to precisely match the follicular unit graft to the size of the slit opening. Once the size opening is precisely fitted, Dr. Gabel is able to make more openings in a given space to maximize graft density and create a more natural result. Additionally, healing is also improved when grafts fit perfectly into the recipient sites, where they are able to maximize oxygenation, which promotes faster healing, and increases graft survival.