There are two major techniques of transplanting the harvested follicular graft: hole versus slit method. In the “Hole” technique, punches are used to make holes over the bald areas of scalp. The punches used to make these holes can be of various sizes from 4.5mm to 0.8mm. Proponents of hole technique say that hole formation involves removal of the bald scalp hence there is further increase in the hair density. One major drawback of hole technique is visible scarring over the scalp specially with 4.5mm punches. Traditionally larger punches of size 4.5 to 3.0 mms were used to make holes but today very fine punches of sizes 0.8 to 1.2mms are used.
On the other hand slit technique uses very fine high quality blade to make slits over the bald areas of scalp. This allows easier placement of follicular grafts and better healing of the scalp with no scarring. Some argue that the slit grafts compressed with healing leading to 2-3 hairs growing from a single stalk resulting to somewhat artificial or tufted look. The grafts also have less density of hair as compared to holes. Minigrafts placed in holes seemed to remain spread out and did not have this compressed, artificial appearance. Use of micrografting technique obviated this disadvantage of slit technique. By mixing both the techniques at appropriate places one can obtain a natural hair transplant.