Devices and methods for applying tension to an area of skin, in particular for follicular unit removal and implantation in a hair transplantation procedure are provided. The devices (20, 130, 160, 180, 200, 240, 253, 260, 290, 310) may include a frame (22, 132, 162, 204, 262, 292) 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 therebetween. The devices and methods may incorporate suction that helps the skin contact members securely hold to the skin. Barbs (28, 72, 98, 116, 194, 172, 152) or microbarbs also may be used to help secure the skin contact members to the skin. The frame may surround the skin area with tensile forces applied outward in multiple directions. Adjusting members and indicators (52) may be provided to control and display the magnitude of tensile force applied to skin. "The tensioning devices and methods may be incorporated into a robotic hair transplantation system. A tool (242) for compression of the flexible frame is also disclosed.
