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Saxena. Plast Aesthet Res 2018;5:5 I http://dx.doi.org/10.20517/2347-9264.2017.67 Page 3 of 7

Figure 1. The KD spreader, a modified skin spreader

Figure 2. Stretching with tensioner above the extraction site

During graft harvesting, the KD spreader provides the following advantages:
• It fits the index finger of the non-dominant hand of the user.
• Terminal portion of the device gently lifts and stretches the donor area just above the extraction site.
• Desired stretch can be achieved by pulling force at the time of scoring.
• While wearing the device, the assistant’s hand is free to hold other objects without keeping the device on
the surface, thus reducing the procedure time.

HASSLE FREE SMOOTH EXTRACTION
Lateral or upward traction is used for removal of the grafts after it has been punched.

This often is the most difficult part, particularly in a tight scalp or if the unit has hairs with divergent
angles of emergence. Upward and lateral manual traction or pressure just near the FUE site can smoothen
extraction, and the graft may be pulled out easily with forceps in one hand. The author questions when you
have to extract 1500 or 2000 grafts with this manual technique, if there increases the likelihood of fatigue to
the operator’s hand muscles.

Secondly, desired traction cannot be achieved by using manual stretching force. While I was exploring my
technique of extraction by using KD spreader, I found that use of KD spreader above the FUE site releases
the grafts smoothly, thereby increasing the speed and reducing the chances of decapping of grafts. More
importantly, this author has not personally experienced fatigue or pain in his fingers or hand. Even during
extraction in tight scalp, we have also found that this technique works exceptionally well [Figure 3].