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Updated: Jul 5, 2026

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Survival of densely packed follicular unit grafts using the lateral slit technique
Thomas Nakatsui1, Jerry Wong, Don Groot
1Division of Dermatology, University of Alberta, Edmonton, Alberta, Canada. tnakatsui@drnakatsui.com
Background:
The use of densely packed follicular unit grafts (>30 grafts/cm(2)) is a highly debated issue, with some claiming decreased survival rates. Those who perform dense packing routinely do not believe they have seen any impaired survival. However, no prior study has rigorously analyzed densely packed areas to assess survival rates.
Objective:
In this study, the authors assessed the survivability of densely packed (>70 grafts/cm(2)) follicular unit grafts using the lateral slit technique.
Methods:
This study was a strictly observational study in one patient. Several 1-cm(2) areas tattooed on the mid scalp were grafted at densities ranging from 23 to 72 grafts/cm(2) using the lateral slit technique. The area surrounding the observation sites was transplanted at a density of 30 to 40 grafts/cm(2).
Results:
Examination of the most densely packed area (72 grafts/cm(2)) at 8 months posttransplant revealed that the number of implanted grafts showing growth was 98.6% whereas the least densely transplanted area (23 grafts/cm(2)) revealed a growth rate of 95.6%.
Conclusion:
This is the first study that demonstrates high growth rates in densely packed follicular units using the lateral slit technique, even at densities of 72 grafts/cm(2). These data are in contradistinction to previously performed studies using older methodologies.
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