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The Science Behind Hair Transplants — and Why You Should Consider One

by Brett Tortorello 12 months ago in aging

Modern medicine provides numerous options for those looking to restore their full head of hair.

Losing your hair sucks, but it’s a common ailment that affects an increasing percentage of adults. While hair loss is commonly associated with old age, it affects a significant number of younger adults as well. An estimated forty percent of men will experience hair loss by the time they reach their mid-thirties. While much more common in men, hair loss also affects women. Permanent or temporary hair loss is especially prevalent in women over the age of forty and women who have recently given birth. Regardless of age or gender, however, hair loss is often a cause for concern in anyone affected by it. Thankfully, modern medicine provides numerous options for those looking to restore their full head of hair, from topical medications to laser therapy to hair transplant surgery.

The Science of Hair Loss

The underlying causes of hair loss can vary widely and are not fully understood. Male pattern baldness is believed to be related to a particular type of male hormone, but it is not known why some females also experience pattern baldness. A number of medications can cause temporary or permanent hair loss as side effects. Hair loss can also be triggered by trauma (such as friction or excessive hair pulling) as well as a number of otherwise unrelated infections like folliculitis or syphilis. These make up just a few of the many potential causes for hair loss.

Although we may not have all the answers as to why some people begin to lose their hair, dermatologists have developed effective treatments for those wishing to restore their luscious locks. If you begin treatment in the early stages of hair loss, there are several non-surgical steps you may take to prolong the life of your follicles. Topical medication like Minoxidil (aka Rogaine) and oral medication like Finasteride (aka Propecia) both serve as effective treatments for thinning hair, giving a needed boost to your follicles.

These sorts of medication can only go so far, however. Once part of your scalp is completely bald and devoid of follicles, Minoxidil and Finasteride are useless. If you reach this stage of hair loss, surgery is the only way to bring life back to your scalp. Thankfully, dermatologists have been perfecting hair restoration surgery for many years.

The Old Way

While the concept of performing surgery to treat hair loss dates back at least to the late 1800s, the history of modern hair restoration surgery dates back to the mid-20th century. In the early 1950s, Dr. Norman Orentreich, the father of modern hair transplant surgery, completed the first successful hair transplant after graduating from the New York University School of Medicine. By 1961, he had completed approximately 200 successful hair transplants. His method involved a series of small skin grafts taken from the back of the scalp and replaced in balding areas.

This method allowed new, natural hair to grow in the recipient location, but with a noticeable drawback. The “donor” scalp was removed using a sort of round punch, which led to the transplant “plugs” looking notoriously like doll’s hair. In the decades since Dr. Orentreich first pioneered this method, dermatologists have worked to reduce the size of the grafts required for the surgery. By the 1980s, stereo microscopes allowed us to take a big step forward in reducing the invasiveness of the procedure, but surgeons continued to work to find the most refined and efficient techniques for performing hair transplant operations.

The New Way

We’ve come a long way from the early days of punching holes in the backs of scalps. To get an idea of how effective modern hair restoration treatments can be, allow me to share a look inside an example of a successful modern hair transplant clinic: the Hair Restoration Center of New York and New Jersey. Since 1990, they have used a wide variety of surgical and non-surgical methods to treat patients suffering from premature hair loss. The Follicular Unit Transplant surgery offered by the Hair Restoration Center is the modern version of the method pioneered by Dr. Norman Orentreich.

To perform a Follicular Unit Transplant (FUT), a narrow strip is removed from the back of the scalp. This part of the scalp is known as the “safe area” because it reliably grows hair for most of a lifetime, even in individuals suffering from baldness. This extraction leaves a small hairless patch on the back of the scalp, but the location is much less conspicuous than the recipient bald spot. Furthermore, the patch is likely to be hidden with just a little bit of hair growth from the surrounding areas at the back of the head.

Using microscopes, the surgeon identifies the follicular units and removes them, storing them in a preservative solution until they are needed. The next step involves examining the bald scalp and placing a number of strategic incisions. The follicular units are then placed one by one into the incisions. The transplanted hairs will soon fall out as a result of the surgery, but the follicular units remain and will soon grow hair in a natural manner, practically undetectable as implants.

Once the scalp has healed and the transplanted follicular units have had time to regrow their hair (a period of approximately six to ten months), the end result should be a full, natural head of hair. This method of FUT surgery has been the gold standard for many years, but the most forward-thinking dermatologists have moved on to an even more advanced method of transplanting follicular units.

The Future

In recent years, we’ve seen glimpses of what the future holds for hair restoration surgery. While the general concept of Follicular Unit Transplant surgery remains, there are now specially designed robots which can greatly increase the level of precision with which dermatologists can operate. These robots, such as the ARTAS robot utilized by Dr. Herbert Feinberg at the Hair Restoration Center, use artificial intelligence to identify optimal hair for transplanting.

Unlike manual FUT surgery, the ARTAS specializes in a new method called Follicular Unit Excision (FUE). Rather than remove a strip from the back of the scalp, the robot identifies and extracts follicular units directly from the scalp using a small punch (much smaller than the sort originally utilized by Dr. Orentreich). This method is less invasive than traditional FUT surgery, allowing for a quicker recovery time and reducing the risk of long-term nerve damage. While FUE surgery can be performed manually, the ARTAS is able to harvest the donor follicular units with micron-level accuracy, allowing for greater precision than manual surgery. The result is a near-flawless operation that requires neither a scalpel nor stitches and leaves no linear scar as evidence of your surgery.

If you are struggling with hair loss and have been unable to treat it with topical means, then it may be time to consider hair transplant surgery. The days of plugs are long behind us at advanced practices like the Hair Restoration Center. A skilled dermatologist like Dr. Feinberg can help guide you on the path to restoring your hair, whether that path includes FUT or FUE surgery or one of the many non-surgical methods the Hair Restoration Center has at its disposal. Request a virtual consultation today to learn more about what hair restoration method is best for you!

Brett Tortorello
Brett Tortorello
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Brett Tortorello

I’m a middle aged man currently working as a Shift Supervisor at Bob’s Furniture. I’m thinking about opening up my own restaurant some day, but my real passion is expressing myself through writing.

See all posts by Brett Tortorello

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