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imageHair transplant is the most common cosmetic surgery procedure in men; at our center, we perform nearly 40 transplants a month, with nearly 450 procedures in a year. Current techniques of hair transplant are well established and several authors have had remarkable results using the current techniques of microfollicular hair transplant. Orentreich described hair transplant, Shiell has reviewed current techniques in his paper, whereas Rose reviews the latest innovations in hair transplant including Neograft and robotic procedures. We present our modifications to the process based on our experience of more than 1000 cases in the last 3 years.Microrefined microfollicular hair transplant is a procedure with innovations at each step of the standard microfollicular hair transplant procedure to improve results.The steps of the procedure are as follows:beveled incisions on both ends of the strip to take the graft transection rate to less than 1%;dissecting the strip in a way to leave a layer of fat on top of the galea;slivering of the strip under magnification to ensure less than 1% hair wastage;harvesting of 300 to 400 grafts with follicular unit extraction for the anterior hairline;microzigzagging of all the slits;graft preparation to ensure bare minimum fat at the level of the roots;during implantation, handling of the grafts with the hair end and not the root end; andfast processing and coordinated efforts to reduce operative time to approximately 4 to 4.5 hours for large cases (5000–6000 follicles) and 2 to 2.5 hours for smaller ones.

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