The Evolution of Hair Transplants

Posted by Admin on July 23, 2009
To illustrate the evolution of hair transplants, there is no better example than that of U.S. Vice President, Joe Biden. During the 1991 Anita Hill senate hearings, his hair plug surgery drew attention to some of the shortcomings evident in hair restoration techniques for the time. Though far from the ideal model of modern hair restoration possibilities, the combination of whitened hair and subsequent modern hair transplant procedures have made Biden's look more natural.

Hair transplantation began as a concept, as far back as 1939 when a Japanese dermatologist published a method of using small grafts to correct areas of hair loss. Hair restoration emerged again in the 1950’s when one physician, Dr. Norman Orentreich, began to experiment with transplanting hair from the back and sides of the head to the balding areas. The results of his experiments showed that bald resistant hairs from these “donor areas” would maintain their balding-resistant genetic character, regardless of their new placement.

In the 60’s and 70’s, hair transplants grew in popularity, but the standard technique involved using larger grafts that were removed by round punches and contained many hairs. This mode of transplantation could achieve good results, but only if a patient completed all planned sessions. Unfortunately, many patients were limited in their styling options and many ran out of donor hair before the process could be completed.

The next big step for hair restoration began in the 80’s when large punch grafts were gradually replaced by a combination of min and micrografts. Rather than punching grafts to extract hair from the back of the head, a strip of hair was removed from the donor area and then trimmed into mini and micrografts. Consisting of 4-8 hairs, the minigrafts typically were used to create fullness and density while the one, two, and three hair micrografts were used to create a refined hairline up front.

During the 90’s, hair restoration saw the gradual introduction of a procedure to become known as “follicular unit hair transplantation” or “FUT”. This meticulous and labor intensive procedure transplants hair in their one, two, three, and four hair “follicular unit groupings”, in which they grow naturally. To create natural unit grafts, physicians used high power magnification to properly visualize the follicular units in the donor tissue.

Over time, this refined but difficult to perform procedure became the accepted standard for surgical hair restoration. Some then felt that hair restoration surgery had evolved to its highest degree since hair was relocated exactly as it grows naturally. However, an “ultra refined” follicular unit hair transplant densely packs tiny grafts into very tiny incisions to create a desired level of cosmetic density after only one surgical session.


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