History of Hair Transplants

The beginning of hair transplantation in the 1950s was also the beginning of "plugs". These plugs of hair had approximately 20 hairs. They were harvested with a tool somewhat like an apple core that left a small hairless spots in an area of hairbearing skin. Recipient sites were made with the good intention of removing non-hairbearing skin and replacing it with the plugs. Unfortunately these plugs had to be placed far enough apart that they would survive. The net effect was good density of the plugs themselves with large spaces in between that gave hair transplantation a bad name for decades. To their credit, their goal was not as much a natural appearing hairline as much as just getting hair to be transplanted and survive.

Grafting techniques have advanced. Grafts have become progressively smaller. At first, grafts were divided from the plugs. Later, grafts became progressively smaller reaching the size of single micrographs and 3 or 4 hair minigrafts.

Donor sites have improved from harvesting via a tool which left a noticeable bald spot at each donor site to a technique which is performed by harvesting a strip of hairbearing scalp and closing the donor site primarily to minimize the nonhairbearing skin that remains. The hair is then divided into sheets called slivers. The slivers are then divided into follicular units or the natural groupings of the hairs in either groups of 1 or 2 micrographs or 3 or 4 minigrafts which provide more natural transplantation results than the plugs of early hair restoration.

Placement techniques have improved allowing more density and more grafts in fewer sessions. Micrographs are placed in the most visible areas of the frontal hairline, and minigrafts are placed just behind to give more density with a more natural appearance than the old style plugs.