Hair transplant surgery may either be one of the greatest choices you could ever make or among the worst, based on a variety of critically important considerations. Today, we would address the pros and cons of surgical hair regeneration, euphemistically called transplantation or hair plugs. “In reality, “autologous hair carrying skin transplantation” is the more appropriate term. This is because the actual process involves extracting skin parts from a rough region of one’s scalp (donor) and transferring it to the same person’s bald field (recipient). It does not function for skin transplantation between someone other than genetically identical twins. Do you want to learn more? Visit hair transplants in Sydney.
From one section of the scalp to another, the technique of transferring hair carrying skin tissue grafts goes back at least 50 years. A visionary surgeon called Dr. Norman Orentreich started playing with the concept of eager patients in the 1950’s. The pioneering work of Orentreich revealed a concept that became established as donor dependency, or donor identification, i.e. that hair containing skin grafts obtained from the scalp region beyond the loss pattern tended to generate viable hair even after the grafts had been transferred to places that had previously gone bald.
Over the next two decades, hair transplantation steadily progressed from a novelty to a common cosmetic treatment, mainly among late middle-age balding males. In the 1960’s and 1970’s, Dr. Otar Norwood, Dr. Walter Unger, including Dr. Emanuel Marritt in Colorado, proved that hair reconstruction could be practical and cost-effective. A quality of treatment was established that provided for fairly stable outcomes in skilled hands.
The most popular procedure at the time was the use of comparatively large grafts (4mm — 5mm in diameter) that were separately withdrawn by circular punches from the donor location. This appeared to make the occipital scalp resembling a Swiss cheese area and greatly reduced the yield usable for mobility to the top and in front of the scalp of the patient to the bald areas.
Grafts were inserted into defects that had been produced in the receiver region (bald area) utilizing significantly smaller punch tools over several surgical sessions. The patient returned after recovery for follow-up sessions where grafts were inserted in and between the prior transplants. The outcomes were always very obvious due to the relative crudity of this procedure, and the patient was left to walk about with a doll’s hair like look, particularly visible on the frontal hair line, and especially on windy days. This patients were generally very constrained in the way they could wear their hair and several people run out of donor hair well before the procedure could be finished due to the wasteful donor extraction system.
In the 1980s, hair regeneration surgery started to steadily evolve from utilizing bigger punch grafts to mini and micrografts that were narrower and smaller. Minigrafts were used behind the hair line, whereas to approximate a normal transfer from forehead to hair, one and two hair micrografts were used. The administration of donor sites has also changed from round punch extraction to strip harvesting, a much more successful procedure. Professional surgical surgeons including Dr. Dan Didocha, Dr. Martin Tessler, Dr. Robert Bernstein and others were leaders in this field. With the advent of follicular unit extraction (FUE), first suggested by the extremely talented Dr. Robert Bernstein, and outlined in the 1995 Bernstein and Rassman publication Follicular Transplantation, the idea of producing a more realistic appearance developed much further in the 1990’s.
New instruments, such as the advent of binocular or ‘stereoscopic’ microdissection, were also added in the 1990s into the mix. The surgeon was able to see precisely where one hair follicle starts and another finishes by stereoscopic microdissection. Most transplant surgeons turned away from the usage of wider grafts in favour of one, two and three hair follicular units as the 1990s advanced.