1950’s: In the 1950s, doctors began to experiment with relocating balding resistant hair follicles from the back and sides of the head to the balding scalp. It is the hair follicle itself that determines longevity, not where the hair follicle is located or relocated to on the scalp.

1960’s & 70’s: With this hair transplantation concept, physicians began to perform hair transplants for cosmetic improvement. And like most new developments, the first attempts were less than perfect. Doctors were successful in transplanting hair from the sides and back of the head to the top, but the results looked unnatural and obvious. These older and obsolete methods of hair transplantation practiced in the 1960’s and 1970’s nearly always resulted in a “clumped” or “bristle brush” appearance. Over the course of years the technique of hair transplantation evolved. During the 1980s, minigrafts (smaller clumps containing 5-8 hairs) were an improvement, but only served to generate smaller “plugs”. Indeed, many hair restoration procedures involve the repair and/or hairline camouflage of these “plugs” or “minigrafts”. Even more unfortunately, some hair transplant doctors still utilize these larger grafts. As techniques have improved, the grafts have become smaller and the number transplanted per session has increased.

Present: The next evolution in surgical hair restoration techniques is called follicle-unit micrografting, and it has revolutionized the approach to many forms of hair loss. With this method, many hundreds or thousands of tiny, living grafts containing only one, two, three or four hairs are inserted in closely spaced fashion over the entirety of the bald and thinning areas. These follicle-unit micrografts, which approximate the one to four hairs which naturally originate from each of your original follicles, result in a very natural, aesthetic appearance. Randomly-spaced single hair micrografts are used in the very front of the hairline to create an especially pleasing, feathered hairline.

Planning Your Surgery

Always keep in mind that hair replacement surgery is an individualized treatment

In your first meeting, your hair transplant surgeon will evaluate your hair growth and loss, review your family history of hair loss and ask about any previous hair replacement surgery. Your surgeon will also ask you about your lifestyle and discuss your expectations and goals for surgery. Medical conditions that could cause problems during or after surgery, such as uncontrolled high blood pressure, blood-clotting problems or the tendency to form excessive scars, should also be checked by your doctor. Be sure to tell your hair transplant surgeon if you smoke or are taking any drugs or medications, especially aspirin or other drugs that affect clotting.

Once you and your surgeon have agreed on the best surgery for you, your doctor will explain anesthesia, where the hair transplant surgery will take place . Make sure you understand the procedure that will be used and how long each hair transplant procedure will take. The number of sessions required depends on the individual patient, the extent of baldness and the number of grafts done at each session.

It’s also a good idea to ask your doctor to give you an idea of what you will look like after the procedure or, in the case of grafts, after each stage of treatment.

Understanding Hair Transplants

At this point a hair transplant can only be performed by harvesting DHT resistant hair from the back of your own scalp, and then transplanting it into the balding areas, or hair can be transplanted between identical twins with the same genetic makeup. Typically, men experiencing male pattern baldness will remain with a permanent wreath of hair surrounding the sides and the back of their head, this is where hair is harvested from for transplantation. This hair is genetically programmed to continue to grow even in the worse cases of male pattern baldness.

As in the case of any other medical procedure, the more you know, the better off you’ll be. Gone are the days when people willingly remained in the dark about heir own bodies, their treatments and conditions. An educated and informed person now become an active partner in his/her own health care, which not only leads to better health but also is of great advantage to the doctors because nobody knows his/her body better than they do.

The following questions and answers will prepare you to understand the procedure and methods:

Where are the donor sites?
Male pattern baldness and female pattern baldness are terms that include the word pattern. That’s because there is a pattern to the baldness. You’ve probably noticed, especially in men, that no matter how much hair they lost in the front, top, and crown areas of their heads, the sides and backs of their heads retain hair and sometimes a great deal of it. The sides and back are far less affected by the action of DHT upon their hair follicles. These areas are the donor sites from which the hair you donate to yourself is removed, along with the follicles and some surrounding tissue.

Where does the surgeon put my donor hair during the transplantation?
Once it’s been extracted, it is transplanted to the balding parts of your scalp, into tiny slits that the doctor has created with his or her surgical tools. The donated hair, hair follicles, surrounding tissue, and skin are called grafts, and each graft contains one or more hair follicles with accompanying hair, tissue, and skin. No two heads are alike, and you will see that the art of hair transplantation is just as important as its science or medical aspects.

Hair density is the number of hair follicles you have per square centimeter of scalp. Scalp laxity is the flexibility and looseness of your scalp. More grafts of hair can be transplanted when your density is high and the scalp laxity is high.

Coarse hair is bulkier and can therefore be transplanted using fewer hairs per graft since it gives more coverage of the scalp. Fine hair has less bulb and can give a very natural look but less coverage than coarser hair. Wavy and curly hair lends itself to good visual results in transplantation because a single wavy or curly hair curls on itself and can therefore cover more scalp area than can a straight hair. Curly hair also rises from the scalp and holds its shape, and these factors also give the appearance of greater coverage.

The closer your hair color is to your skin color, the better the appearance of the hair’s coverage. African hair is dark and very curly and therefore provides the least contrast against various shades of dark skin, giving the best visual hair transplant results. From a visual point of view, people with dark, straight hair and alight complexion pose the most artistic challenges in hair transplantation because they have the most contrast between their hair and skin shades.

When designing your procedure, your doctor must keep in mind your future hair loss pattern and the rate of that potential hair loss. The design of your restored hairline is crucial. Natural front hairlines vary in shape and density from person to person. Your doctor will choose the recipient sites for the transplanted hair based upon an overall design that may take more than on hair transplant session to achieve. These sessions typically take place months or even years apart, depending upon the progression of your hair loss.

The front and top of your head will receive transplanted hair first needed because these are the areas that frame your face and make the most impact on your appearance. The crown is usually the last area to receive hair (in later procedures), unless it’s your only balding area.

The number of procedures depends upon the extent of your hair loss, the projected hair loss rate, the amount of donor hair you can spare, and other artistic and medical considerations. Men can often have the results they’re looking for in just one or two hair transplant sessions in which thousands of hairs are transplanted in follicular units of one to four hairs each. Women need more sessions to achieve proper density. These sessions can last between five and ten hours each. Future sessions can follow if necessary.