The frequency of hair transplantation for treatment of male alopecia is increasing, and much time is consumed in free scalp plug removal and implantation. The amount of time depends upon the number of grafts required. Plugs ranging in diameter from 2 to 4 mm are recommended since larger sizes have increased fibrosis and decreased hair growth. Composite grafts show greater survival when cooled; therefore, a method of local hypothermia and 5.5 mm scalp plugs were used in this study. The lowered temperature of the recipient site during the early postoperative days permitted the use of the larger grafts without fibrosis, hematoma, or infection and with improved hair growth. This technic allows better quality of hair growth, requires fewer hair plugs, and decreases operating time.