Hair Transplant

Pros & Cons

Hair Transplant – Pros & Cons

Depending on a number of critically important factors, hair

transplant surgery can either be one of the best decisions
you will ever make or among the worst. Today we're going
to discuss the pros and cons of surgical hair restoration,
euphemistically called hair plugs or transplantation. In fact,
the more accurate description is "auto logous hair bearing
skin transplantation". This is because the actual procedure
involves harvesting sections of skin from a hairy part of
one's scalp (donor) and moving it to a bald area (recipient)
of the same person. Skin transplantation between anyone
other than genetically-identical twins does not work.
Hair Transplant – Pros & Cons

The technique of moving hair bearing skin tissue grafts from

one part of the scalp to another dates back at least 50 years. In
the 1950's a pioneering surgeon by the name of Dr. Norman
Orentreich began to experiment with the idea on willing
patients. Orentreich's groundbreaking work demonstrated a
concept that became known as donor dependence, or donor
identity, that is to say that hair bearing skin grafts harvested
from the zone of the scalp outside the pattern of loss
continued to produce viable hair even though the grafts had
been relocated into areas that had previously gone bald.
Hair Transplant – Pros & Cons
During the next two decades hair transplantation gradually evolved
from a curiosity into a popular cosmetic procedure, primarily among
balding men of late middle years. In the 1960's and 1970's
practitioners including Dr. Emanuel Merritt in Colorado, Dr. Otar
Norwood, Dr. Walter Unger showed that hair restoration could be
feasible and cost effective. A standard of care was developed that, in
experienced hands, allowed for reasonably consistent results. At the
time the most common technique involved the use of relatively large
grafts (4mm -- 5mm in diameter) that were removed individually
from the donor site by round punches. This tended to leave the
occipital scalp resembling a field of Swiss cheese and significantly
limited the yield that was available for movement to the bald zones
on top and in front of the patient's scalp.
Hair Transplant – Pros & Cons
Over the course of multiple surgical sessions, grafts were placed into
defects that had been created in the recipient zone (bald area) using
slightly smaller punch tools. After healing the patient returned for
follow up sessions where grafts were placed in and amongst the
previous transplants. Because of the relative crudity of this technique,
results were often quite apparent and the patient was left to walk
around with a dolls hair like appearance, particularly noticeable at the
frontal hair line, and especially on windy days. Such patients were
usually quite limited in the manner they could style their hair and,
because of the wasteful donor extraction method, many persons ran
out of donor hair long before the process could be completed.
Hair Transplant – Pros & Cons
In the 1980's hair restoration surgery gradually began to evolve from
the use of larger punch grafts to smaller and smaller mini and
micrografts. Minigrafts were used behind the hair line, while one and
two hair micrografts were used to approximate a natural transition
from forehead to hair. Donor site management also evolved from
round punch extraction to strip harvesting --- a far more efficient
technique. Pioneers in this area were skilled surgical practitioners such
as Dr. Dan Didocha, Dr. Martin Tessler, Dr. Robert Bernstein and others.
The concept of creating a more natural appearance evolved still further
in the 1990's with the advent of follicular unit extraction (FUE), first
proposed by the highly gifted Dr. Robert Bernstein, and described in
the 1995 Bernstein and Rassman publication "Follicular
Transplantation.”
Hair Transplant – Pros & Cons

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