BACKGROUND: In 2004, Sharon Keene introduced a video microscope to the hair transplant field and discussed about the benefits such as ergonomics, quality assurance, and easy teaching. In 2009, our clinic set up digital video microscope systems. CCD-chip-loaded hand-held digital video microscope was connected to a 19-inch high definition (HD) LCD monitor. We compared the transection rates and graft-cutting time of two graft-dissecting methods to decide which one is more efficient. METHODS: Two technicians performed follicular unit graft dissection via two different methods of video microscopic and a combination of video microscope for slivering and loupe magnification for graft-cutting. All the procedures were recorded on high-definition digital video camera and cross-checked on the video clips. RESULTS: The transection rate of digital video microscope use was 2.2% while the combination method with 1.6%. For comparison of graft-producing time, the combination method could produce about equal amount of grafts in 186% faster the time. CONCLUSIONS: The work efficiency was greater with the combination method. The total graft productivity was nearly 2 times larger while the transection rates of two methods showed very close results.