The roots of modern day surgical hair restoration can be found in pre-World War II Japan with Japanese dermatologist Dr. Okuda’s groundbreaking work in surgical hair restoration for burn victims. In 1952, a New York dermatologist by the name of Dr. Norman Orentreich performed the first known hair transplant in the U.S. on a man suffering from male pattern baldness. It wasn’t until the mid 1990s, however, that surgical hair restoration made hair transplantation a virtually undetectable, viable option for many hair loss sufferers.
The most common surgical treatment for hair loss is hair transplantation which transfers grafts of skin and hair from the back of the scalp to areas of baldness or thinning. Candidates for hair transplant surgery are those individuals with hair loss that have sufficient donor hair from the fringe of the scalp to transplant to the balding area.
Micrografts and minigrafts are a new modification. As few as one or two hairs are transplanted with each graft and the number of transplanted grafts can total up to 1,000). This technique provides a more natural hairline but requires more grafts. Micrografts are small grafts containing 2-3 hairs that are placed behind the hairline to provide a gradually increasing hair density. Minigrafts contain 4 or more hairs and are placed well behind the hairline so that the single hair and micrografts can blend naturally into the density provided by these larger grafts.
The number of hair transplant sessions or scalp reductions required depends on the amount of hair loss. It will take six to eight months before the quality of the new hair can be properly evaluated to see if additional procedures are needed.
Some procedures including fiber implants and tunnel grafts are not safe and have not been approved by the Food and Drug Administration. Surgeries to avoid include:
Hair flap surgery – a flap of hair bearing skin is moved from the side of the scalp to the front hairline by cutting it on three sides, thus not separating it from its’ blood supply or severing it completely from the scalp. The procedure is major surgery and is performed in a hospital. A flap is one inch wide and approximately three to seven inches long. It has to be twisted in order for the hair bearing side of the flap to end up facing outward from the head once it shifted over and stitched into the surgically removed balding area. An unsightly “knot” will always form where the flap has to be twisted. Other serious problems include necrosis- a very real chance of partial or complete death of the flap, leaving a horrific scar, infection, permanent shock loss and extreme scar in the donor area, loosened skin in the forehead and, absence of hair behind the newly created frontal airline.
The free-form flap is created when all fours side are cut and the flap is completely removed from the donor area so that it’s new position in the balding area can be set in a direction of natural growth. This is not a procedure recommended for men/women with common hair loss and should be reserved for severely disfigured patients, such as burn or accident victims.
