Surgical hair restoration has evolved rapidly over the past 10 years. Patient outcome is paramount. Current developments in hair transplantation focus on using the most appropriate harvesting techniques to use this finite resource effectively and to relocate it quickly and efficiently to achieve the optimum effective aesthetic coverage. To date,follicular unit transplantation has afforded surgeons the greatest efficiency in hair trans-plantation. These units are unlikely to become smaller, so surgeons must look at what other means are available to improve the final result.