The infrared coagulator, a spin off of laser technology, has been used for more than a decade, first in Europe and then in the United States, for the in-office elimination of first and second degree hemorrhoids. Even more recently, it has been employed in the treatment and removal of unwanted tattoos. This device has been FDA approved for both anorectal and dermatologic applications. Within the last year, we have conducted a thorough study in our practice of the use and comparison of electrocoagulation, radiosurgical coagulation, and infrared coagulation during both hair transplantation and scalp reduction surgery. The infrared coagulator with its multiple-sized tips and pinpoint accuracy has proven to be superior (especially in a wet field) in providing excellent hemostasis, allowing minimal blood loss, and in allowing the clearest visual field in performing both hair transplant and scalp reduction surgery. Because no ground or antenna plates are necessary for the use of the device, it is extremely safe and effective and thus minimizes both patient risk and electrical shock. Its excellent effect in a wet field (it's used in bleeding hemorrhoids) as well as its uncumbersome size and versatility, makes it the ideal instrument for use during hair transplant and scalp reduction surgery. The device has been tested in the treatment of arteriovenous fistulas in the donor area of the scalp as well and has proved to be quite safe and effective. This paper presents a study encompassing 110 patients undergoing either hair transplant or scalp reduction surgery. Each different modality of coagulation is utilized for the various transplant or scalp reduction sessions on the same patient. Comparisons of effectiveness and postoperative complications are made. Detailed results and photographs are presented.

The linear punch creates recipient sites that avoid compression and allows for more hairs per graft without compromising naturalness. Healing is comparable to micrografts alone. It is the authors' opinion that a linear or elongated slot incision accommodates grafts created from donor strip harvesting more naturally than slits, small round incisions or punctures. The linear graft created is the precise size and shape to the recipient slot incision to which it is placed. This technique helps us avoid the old adage, "Trying to fit a square peg into a round hole." As stated by Unger, a slot incision created by a Ultrapulse laser produces superior results to those seen with conventional slit grafting (Dermatol Surg 1995;21:759-65). This approach is cost efficient and cosmetically appealing to the patient without the fear of the old "cornrow" appearance.

BACKGROUND. As the field of hair transplantation changes radically almost month to month, one goal remains essentially unchanged-satisfy the patient. Mega sessions of only one to three hair grafts either by slit or laser produce a natural but thin result, while the more traditional circular punch grafting can produce a thicker but unnatural result. OBJECTIVE. To introduce a new type of recipient site that has the width of a micro graft but can vary in length. When linear grafts are placed into these new recipient sites, they produce strips of hairs that heal quickly and naturally. When using the multiblade knife for donor strip harvesting, the shape of grafts change from the traditional round grafts to a narrow linear strip of hair. Current methods of slit receptor sites accommodate these grafts better than circular punch sites when grafts with a small numbers of hairs are used. Unfortunately, with either larger slit grafts or later densifieation, slit grafts often tend to compress creating a pitted or tufted appearance. It is the authors' opinion that by creating a slot incision and removing some tissue, a more