Devices and methods for applying tension to an area of skin are provided, for example, for follicular unit removal and implant in a hair transplantation procedure. The devices may include a frame with at least two skin contact members that hold to the skin. Also disclosed are various ways to apply a force displacing the skin contact members apart, thus creating tension in the skin. The devices and methods may incorporate suction, and/or barbs or microbarbs. The frame may surround the skin area with tensile forces applied outward in multiple directions or substantially uni-directionally. Adjusting members and indicators may be provided to control and display the tensile force applied to skin. The tensioning devices and methods may be incorporated into a robotic hair transplantation system.