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

A B

C D

Figure 5. (A) Terminal portion skin hook gently lifts and spreads the most superficial part of skin while another hand grasps the graft
using forceps; (B) graft gently slides inside slit while slit is elevated and dilated by the KD spreader; (C) the KD spreader is released and
the graft positioned in place; (D) three people performing implantation without overcrowding

After discovering these issues, I concluded that to clear the learning curve, beginners would benefit from a
[5]
user-friendly device that they would provide maximum visualization . In addition, grafts need to be kept in
hydrating solution as much as possible and during implantation there should not be overcrowding of hands.

I also noticed that fine motor skills for gentle insertion of the graft develop with time and many beginners
are discouraged after failure during initial attempts.

The KD spreader gives beginners the opportunity to exert tissue spreading force as per tissue requirement.
It enables them to dilate the slit and get maximum visualization before graft implantation. Since the KD
spreader is worn on the index finger, it also avoids overcrowding of the hands in the transplantation site
[6]
when working simultaneously with another implanter .
The upper surface of the KD spreader has a shielded magnet that allows for attachment and detachment
of the plates [Figure 4]. This device has another unique feature: at the time of implantation, it provides an
opportunity to pick follicular units of your choice as grafts immersed in graft holding solution and placed
in a row. This also increases the speed and precision of repetitive graft transfer and placement because grafts
and incisions are in the same field of view.

During implantation, the KD spreader works as follows [Figure 5]:
• The implanting operator, who wears the device on the index finger of the non-dominant hand, can adjust
the grip.