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Hair Transplantation 101


Medically Reviewed On: October 15, 2003

By Christine Haran

It's not hard to spot a man with a bad hair transplant. The transplanted hair looks unnatural, as if it were plugged into the head. What few people realize, however, is that it's likely they've also seen a man or woman with a good hair transplant. The trick is that a good hair transplant is virtually undetectable.

Hair transplantation has changed dramatically over the last decade. "It's almost unfair to call it the same the same thing, it's so different," says Robert Haber, MD, president of the International Society of Hair Restoration Surgery, an educational organization, and an assistant professor of dermatology at Case Western Reserve School of Medicine in Pittsburgh. "There have been huge improvements in every aspect of transplantation."

New techniques

In the transplant procedure, hair is taken from a donor area, usually at the back or sides of the head, and moved to the area where there is hair loss. While donor hair used to be harvested and transplanted in large bunches of 10 to 20 hairs, surgeons now transplant tiny bundles of three or four hairs that grow together in what are called follicular units.

"Surgeons used to use instruments called punches, which looked like cookie cutters, to make circular incisions in the head, and it gave the appearance of a doll's head," says Dr. Ivan Cohen, an associated clinical professor of dermatology at Yale University School of Medicine and a hair transplant surgeon in private practice in Fairfield, Conn. "With new techniques, we take hair from the back of the head in tiny strips and then separate it into follicular unit. We then use tiny needles to plant the hairs back into the scalp."

This technique, known as follicular unit transplantation, is most widely used transplant approach. Some surgeons, however, use a technique called follicular unit extraction in which hair is removed and transplanted with a 1-mm punch that can grab the follicular unit. Follicular unit extraction is considered most appropriate for people with limited hair loss, athletes who need to resume activity right after surgery, and those whose scars widen over time.

With the new techniques, experts say most people with pattern baldness who have a sufficient amount of donor hair are good candidates for hair transplantation. This includes people with any kind of hair type, and women, who are having more and more transplants.

Surgeons note that a large part of their practices is devoted to corrective work, which usually involves repairing old transplants by dividing the transplanted hair into follicular units and re-transplanting it.

Realistic Expectations

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