Hair Restoration History

• A Japanese dermatologist named Okuda performed the first true hair restoration surgery by the use of small auto-grafts (auto means “from self”) of hair bearing skin for the hair loss restoration of scalp, eyebrows and mustache areas in 1939.

• In 1943, Tamura published an article on the use of hair restoration surgery for the reconstruction of the female pubic area in Japan.

• Fujita in Japan used a similar technique to bring about the hair loss restoration of scars, eyebrows, eyelash defects, and pubic areas in 1953.

However, because of the Second World War, the contribution of Japanese dermatologists and surgeons (which were in Japenese) the development of hair transplant techniques was not recognized until many years later.

In 1959, New York dermatologist Norman Orentreich reported that hair-bearing scalp (auto-grafts) could be successfully transplanted from the back of the head to the balding front and top. For his hair loss restoration experiments he also took biopsies of scalp on the sides of the head of balding men and transplanted these into balding areas.

Based upon the hair loss restoration experiments of Orentreich, hair restoration surgeries were carried out all over the Western world using 20-30 hair follicles in each punch graft during (1960s & 1970s).

The 3-4mm (millimeter) round plug grafts used in the initial years of hair restoration surgery, were thought to be optimal size grafts in terms of density (hairs per square mm) and also in terms of blood flow (nourishment) to the tissues of the graft.

There was the problem of blood nourishment to the center of the graft and also there was problem of scarring as the graft contract it slightly bulges out giving a peculiar signs ‘toothbrush appearance’

Dr. Nordstrom was the first to start 4 to 6 follicles in hair grafts. AndDr. Headington was the first to start single follicle hair transplant. And  Dr. Limmer was the first to start stereoscopic microscopic dissection for follicular unit.

Follicular unit hair transplant is a long procedure requires 6-8 hrs of the procedure.it requires careful dissection of the follicles with the help of the trained staff. Single follicle hair graft has about 85% survival and 3 follicle hair grafts has very high about 115% survival rate.

Three and four unit hair transplant

Single follicular unit comprising three and four follicles has an advantage that there are less chances of failure, more density can be assured to the patient  and easy for the technician to separate.With the idea of three and four follicle in single unit now a more natural hair restoration can be done with single follicle units can be placed in front and two follicles and three follicles graft behind to give the concentration