Hair transplantation and its stages of development |

Hair transplantation is a procedure during which hair is transplanted. Outpatient. Under local anesthesia. Transplants are taken from the donor side such as back or side surfaces of the head (they must grow all life there) and are transplanted to the bald part. Hair transplantation went through many stages of improvement and affected two main branches, which are the field of surgical technique and the field of development of instrumentation. Currently, the results of surgery for hair restoration are staggering. Transplants cannot be distinguished from naturally growing hair even with a close study. Considering this, we would like to talk about the history of hair transplantation.

Only some people know that this field of medicine has been with us for many years. In 1939, the Japanese dermatologist Dr. Okuda described the use of auto – graphing. It was an operation to correct the skin on the head, eyebrows, eyelashes and mustaches suffering from alopecia with the help of hair grafts. Apart from Okuda, other doctors practiced similar experiments in Japan at that time, but their publications (Sasagawa 1929, Tamura – 1943) in Japanese journals remained unknown. Okuda achieved the most impressive results in hair transplantation and was a military doctor. He limited his experiences to helping those who suffered burns in the aftermath of the war in Japan. Unfortunately, Okuda died during the Second World War and this prevented the whole world from learning about his experiences.

Donor dominance

In the 1950s, doctors began experimenting. The experiment consisted of moving the follicle from a constant area, not subject to complete baldness in the problem areas. They were interested in whether the follicles would survive and for how long they would stay in the recipient area. Work continued also in Japan (Fajita – 1953). The results of hair transplantation were positive. The term for this phenomenon is the Donor Dominance. The hair follicle itself determines the further survival, regardless of the place of its growth. The next successor to the study of hair transplantation was Dr. Norman Orentreich from New York in 1959.In his work, he used a four-millimeter device with help of which he cut out the graft from the donor area and transferred it to the area of ​​alopecia. The device of this size was chosen as the optimal option for transplantation of a large number of hairs without subsequent loss of grafts due to a lack of blood supply in the center. Although the four-millimeter punch was optimal, the amount of hair per graft was 15-20 pieces. This, as you know, created an unnatural, puppet appearance of hair transplantation.

Separation of grafts

Together with this concept of hair transplantation, doctors began to perform operations for cosmetic purposes. They were far from perfect as all the first beginnings. Doctors successfully transplanted the hair from the side and back areas of the head but the results were not perfect. Almost all the operations carried out for ten years from 1960 to 1970 had similar results. Now the term “puppet head” is used to describe transplants that consisted of 15 to 25 hairs. In addition, they were transplanted at a great distance from each other. Moreover, the most terrible thing is that they stayed with the man forever. Hair transplantation with 4-millimeter islets was used up to the 80’s when the question of using single-hair transplants was raised again. The main ideologist of this technique was Emanuel Merritt, although other scientists such as Walter Jung, Carlos Uebel, and Richard Salem also worked in this direction. Technical methods gradually developed and the grafts became smaller and their number more. Currently, most doctors use grafts, which consist of 1 to 8 hair and the number of transplants in one procedure varies from two hundred to eight hundred. Although this can be considered an improvement, but such grafts will still create a slightly unnatural appearance.

Transplantation of follicular connections

The next step in the development of hair transplantation techniques is called micro grafting of the follicular connection. It has a revolutionary significance in the treatment of many forms of alopecia. Microscopic, live grafts consisting of one, two, three or four hair are transferred to any problem place thanks to this method. Because they are transplanted in their original form, the results are strikingly natural. Single grafts are used to restore the front line and create a natural fluff. By the mid-90s, doctors transplanted grafts consisting of one, two, three or four hairs each and called micro grafts. Finally, the fact that the hair grows in individual groups was taken into account. They were called “follicular connections.” Currently, many doctors transplant from one thousand to two thousand follicular joints during one procedure of hair transplantation.


For today, the most effective methods of hair transplantation are a strip and FUE. When hair transplantation occurs, hair follicles move from places where they grow in large numbers (from the back of the head) to places where they are absent (in the forehead, temples, and top of the head). Hair transplantation by follicular associations (micro grafts) gives the greatest possible naturalness effect. This method minimizes the loss of follicles during surgery. In addition, FUE is recognized as the “gold standard” in hair transplantation. Transplanted hair grows all life and never fall out. Thus, the only real way to restore hair with androgenic baldness now is hair transplantation.


Elena Andrew

Elena Blogger

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