Modern hair transplant techniques were first developed in Japan in the 1930s where surgeons used grafts to help restore eyebrow and eyelashes as well as the scalp hair of burns victims. It did not become a treatment for male pattern baldness until the 1950s when dermatologist Dr Norman Orentreich planted the first grafts in balding areas. Techniques progressed from there and follicular unit transplantation (FUT), or strip harvesting came into existence and became the first popular method of hair transplantation.
FUT is where a strip of hair is surgically removed from the back or side of the scalp and follicular unit grafts are extracted and replanted in the balding area by the surgeon, using very small micro blades or fine needles. However, the main drawback with this method is that a scar is left in the donor area, which is visible if the patient likes to wear his or her hair short and neck flexibility is compromised.
Early FUT procedures in the 1980s had mixed success. Patients could be left with plug-like hairs, with several hairs sprouting together in unsightly individual clumps. However, techniques for replanting donor hair have improved. Thanks to the technique slowly evolving over time as surgeons became more experienced at performing the operations and shared their knowledge, leading to a much more natural blend with existing natural hair.
FUE and its development over the last ten years
A different hair transplantation method, follicular unit extraction (FUE), was first developed as a technique in the 1990s by Australian physician Dr Ray Wood and his sister Dr Angela Campbell. They felt that cutting out a big patch of skin to harvest the donor hair was unnecessarily traumatic so developed a new technique where the follicular units were taken one-by-one, directly from the donor area, with fine needles. Early FUE techniques were fairly unsophisticated and there was noticeable scarring from punch grafts used to the remove the donor hair, which ranged in diameter from 1.5mm to 2mm. However, more recently, these punches have become much smaller – between 0.6mm and 1mm in diameter, due to improved equipment – meaning that the scarring is almost indiscernible to the naked eye.
Modern day FUE treatments involve removing individual follicular unit grafts, containing one to four hairs, under local anaesthetic using tiny punches. The grafts are replanted in the donor area using a fine needle, typically over the course of one day. Most surgeons are able to transplant up to 4,000 grafts in a single day.
Talking about future perspective
A hair transplant is a skillful distribution of available hair. However, no new hair is produced. But what if surgeons could solve the problem of the limited number of donor hair follicles? Researchers are currently working on new alternative treatments:
New stem cell techniques involve retaining part of the donor hair follicle and supporting its regeneration – producing two follicles from one and doubling the extent of the donor hair. The main drawbacks so far have been related to the quality of both of the resulting hair grafts.
Hair cloning involves healthy follicle cells that are extracted from areas of the scalp where there is no baldness. These cells are multiplied (cloned) by various culturing methods and the newly produced cells are then injected back in the balding areas of the scalp where they would produce new hair. However, the method is still in the research phase and no hair transplant clinics are currently using it to my knowledge.
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