Most of what separates one hair transplant from another happens before a single
graft is placed — in the shape of the cut that receives it. Dr. Alexander has cut his own
blades for every case since 2003.
Cut to width and to depth, one set per case, since 2003.
Why it matters
A site cut to the graft, not a graft pushed into a site.
“The best thing about the custom cut blades is you can cut them to any size you want. So what I do is I match it up according to the width of the hair follicle. And they’re also the closest thing to the shape of a hair follicle.”Dr. Scott Alexander
Most surgeons order blades in fixed sizes. Dr. Alexander cuts his to the width and depth of the
follicle in front of him, in a chisel profile that matches the base of a real follicular unit.
Four things follow from that, and they compound.
01.
Smaller cuts, more density
A blade cut to the width of the follicle makes a smaller opening, so sites can sit closer together — and can be placed between existing hairs without damaging them.
02.
Depth measured to the follicle
The blade length is cut to follicle depth. A generic blade goes deeper than the graft needs, and depth that is not needed is a blood-supply problem, not a neutral one.
03.
A base shaped like the base
The chisel profile matches the base of a follicle. A pinpoint blade has to be driven deeper to reach the same width, which is how a site ends up bigger than the graft that goes in it.
04.
The graft cannot swim
A site cut to the graft holds it at the angle it was cut. Oversized sites let grafts rotate, and rotated grafts are where unnatural angles come from.
“This stuff isn’t like rocket science. It’s all just basic common sense. But you have to have a desire to do something good.”Dr. Scott Alexander
Before placement
Every graft goes under a microscope first.
Harvested grafts are trimmed of excess tissue under magnification
before any of them reach the scalp. Grafts that were transected on the way out do not get placed.
It is slow, it is the least glamorous hour of the day, and it is the difference between a graft
that grows and a graft that was simply moved.
“We aren’t transplanting garbage. A lot of other places will just extract and then stick it in whether it’s cut in half or not.”Dr. Scott Alexander
His work
The same hands, every case.
BeforeAfter
Hairline design Drag the handle to compare.
BeforeAfter
Crown restoration Drag the handle to compare.
BeforeAfter
Frontal density Drag the handle to compare.
Actual patients of Dr. Scott Alexander. Individual results vary.
How the method is chosen
The number of grafts decides the approach.
Up to 2,000Follicular unit excision. Hairlines, temporal corners, and most first
procedures sit here.
2,000 to 2,500+A strip procedure, because at that volume it leaves less total
scarring than excising the same number of follicles one at a time.
A multi-stage planStrip first. It preserves donor supply for the sessions that
come after it, which single-stage thinking spends early.
Which one applies is decided at the exam, on donor supply and goals — not in advance.
Recognized by
Dr. Scott AlexanderSurgical hair restoration since 2003 · Phoenix, Arizona
Member ISHRS · Accepted member IAHRS · Recommended by the American Hair Loss Association
Bring your donor area. He will tell you what it can actually do.
One case a day, one surgeon, start to finish. The exam decides the door.
