The History of Hair Transplants

Alopecia is a widespread phenomenon that affects people of all genders and enthnicities. While some forms of alopecia are temporary and will resolve over time with medication and/or dietary changes. Others, however, can be permanent and can only be resolved with hair surgery.

You might be surprised to learn that hair transplants are no new invention. On the contrary, the surgeries available today are the direct result of decades of research and refinement. In this article, we’ll be looking back in time at the medical breakthroughs that led directly to the FUE and DHI techniques used today.

Summary

1. Beginnings in Asia
2. The Origins of the Strip Technique
3. The New York Advancements of the FUT Method
4. Towards More Natural Hair Transplants in the 1980s
5. 1990s: the Beginnings of the FUE Transplant
6. Current State and Future of Hair Transplant
7. Conclusion

Beginnings in Asia

The history of hair transplantation dates back to 1930 in Japan. The dermatologist Dr. Masao Sasagawa is considered to be the first to attempt to transplant hair follicles into human skin. Sadly, Sasagawa passed away shortly after beginning his studies into hair transplantation.

Nine years later, another Japanese dermatologist, Dr. Shoji Okuda, described a new method of hair transplantation. Okuda used dermal punches, not unlike today’s FUE technique, to remove skin from the sides and back of a patient’s scalp, and then grafted the extracted follicles into the healed skin of burn victims. In his work, Okuda successfully transplanted grafts in the scalp, eyebrows and upper lips of his patients.

Okuda’s transplants used hair follicles that were two to four millimeters in diameter, much larger than those used today. As a result, the outcome of his treatments were primitive by comparison to what we have come to expect today, and often resulted in scarring. Unfortunately, the outbreak of the second world war delayed the further development of what would later become the punch technique.

The Origins of the Strip Technique

Luckily, the war didn’t delay progress in the field of hair transplantation for long. In 1943, a fellow Japanese dermatologist Dr. Hajime Tamura began work on a technique which involved taking a spindle-shaped strap of scalp and dissecting it into smaller grafts for implantation.

This technique is a clear forebear of the FUT (Follicular Unit Transplantation), which was the primary method of hair transplant surgery in the latter part of the twentieth century. Though Tamura’s research was published in many Japanese medical journals, it went largely unnoticed by the Western world due to the war.

The New York Advancements of the FUT Method

The FUT technique was established in earnest in the United States in 1959, when dermotologist Dr. Norman Orentreich discovered that areas at the back of the head were not affected by hereditary alopecia. In cases of androgenetic alopecia, commonly known as hereditary hair loss or male/female pattern baldness, the hair at the back at the head remains intact.

From this capillary ring Orentreich extracted the roots of the hair, which he then transplanted to the bald areas. The American doctor used a metal cylinder to take four-millimetre grafts from the donor area. He then transplanted these into the bald areas where they grew back rapidly.

Effect on the industry

These discoveries marked the beginning of the era of aesthetic hair transplant surgery. These techniques remain in use today, though many contemporary hair surgeons increasingly favour more modern approaches. Nevertheless, the techniques in use at Elithair and other clinics worldwide could not have been made possible without the methods developed by Orentreich and Okuda.

These methods would become the standard for hair transplants for the next 30 years, with little significant progress made in the field during this time.

Towards More Natural Hair Transplants in the 1980s

Though hair could be grafted using the punch method during this time, it proved an unpopular option. At this time, the results were often unnatural-looking, with many referring to the outcome of punch method transplants as the “Barbie doll” effect. To mitigate the doll-like placement of the grafts, many surgeons began using increasingly smaller micrografts, comprising of one to four hair follicles.

The use of micrografts further popularised the procedure. However, for many patients, the results still did not give them the natural outcome they wanted.

Dr. Carlos Oscar Uebel

The Strip Method received further development in the 1980s thanks to the work of Brazilian physician Dr. Carlos Oscar Uebel. Uebel developed a method of extracting a contiguous band from the donor area instead of individual grafts or “plugs”. Uebel extracted the band with a scalpel, which he then used to divide the band into smaller grafts for implantation into the recipient areas.

The Discovery of Follicular Units

The story of hair transplant continued thanks to Dr. Bob Limmer. He made a discovery – probably by chance- when looking at grafts under the microscope. He could see that the hair, by nature, does not grow individually but in small groups.

These follicular units consist of one to three – or in exceptional cases, four – hair follicles. This discovery allowed for a much more natural appearance, as the implantation of follicular units gave a much more seamless result than previous techniques.

1990s: The Beginnings of the FUE Transplant

In the 1990s, most hair transplant institutes replaced the “punch” method with that of the “strip”. At the same time, Australian doctors Dr. Angela Campbell and her brother Dr. Ray Woods discovered a new way to extract hair follicles. They made this breakthrough by observing that cutting large bands of the scalp caused unnecessary pain to the patients.

The Current State and Future of Hair Transplants

The FUE hair surgery technique developed by Campbell and Woods was improved by the doctors Coen Gho (Holland), Robert Jones (Canada), and Dr. John Cole (USA) shortly after the turn of the millennium. They improved the process of their Australian colleagues by adapting it for mass use.

Today, hair restoration is big business, and the ways in which surgeons approach hair transplants are still evolving.

Robotic transplantation

The latest advances have also led to the development of Artas, a robot specialized in hair transplants. Also new advances in postoperative dermatology allows better treatment of the affected skin areas.

Instead of a scalpel, they used of thin needles and thus perfected the extraction of follicular units. This method, more comfortable for patients, is now known as the FUE hair transplant (Follicular Unit Extraction). It became popular in the early 2000s, and has become the technique of choice all around the world.

Conclusion

From the beginnings in Japan, to the many years of development that followed, the hair transplant techniques enjoyed by patients today are the result of decades of hard work and scientific breakthroughs led by doctors all over the globe.

Thanks to the work of those who paved the way for this procedure, the FUE has become the gold standard of extraction techniques. When paired with a DHI hair transplant, it provides a natural outcome with no pain.

Dr. Balwi, our head surgeon, is amongst the pioneers of this technique. He and his team have done more than 20,000 capillary surgery interventions with the FUE method, thus gaining great experience in the field.

Do you have more questions or are you suffering from hair loss issues? Then feel free to to contact our friendly team that will answer all your queries. They can even offer a free and non-binding hair analysis.