The surgeon harvest a strip of scalp tissue from ‘permanent zone’ of donor hairs, which contains healthy and strong hair follicles under direct visualization or “open technique” that we first reported to minimize follicular transection to as 1-2%. Strip is slivered under binocular stereomicroscope to prevent hair follicle injury or transection. Each graft contains between 1 to 4 hairs, these hair grafts will later be placed into the tiny incisions made by the surgeon on the recipient area. The wound is closed with double trichophytic technique and the stitches are removed in 10-14 days. Most patients can resume their works a few days after surgery without the donor wound being noticed when the hair length are kept at least 3 cm. The scar is almost unnoticeable in majority except those who prone for wide scar.