Hair Replacement: The Next Generation

Coming soon to a scalp near you?

From the WebMD Archives

Today's options for hair growth have gone through a major evolution since 1952 when hair transplantation surgery was first pioneered.

Treatments have shifted from unnatural-looking transplants to sophisticated new drugs and improvements in hair transplant surgery, and cloning individual hair cells. David Orentreich, MD, a professor of dermatology at Mount Sinai School of Medicine in New York City, and others who specialize in the field of hair restoration say that the future looks even brighter than the present. Orentreich's father Norman first pioneered hair transplantation surgery.

"I started practicing in 1984 and hair transplant surgery has changed completely since then too -- from large to small grafts," says Orentreich. "The large-graft technique was state-of-the-art back then," he says.

According to estimates form the U.S. Food and Drug Administration (FDA), 40 million men and 20 million women experience hair loss. In 2003, 31,737 people, 88% of them men, underwent hair transplants; up 9% from 2002, according to statistics from the American Society of Plastic Surgeons.

"The history of hair transplantation is not much different than that of cardiac surgery," he says. "First there was the coronary bypass surgery and hundreds then thousands of doctors started doing them and pretty soon the operation evolves and moves forward," he says.

To perform a hair transplant, surgeons such as Orentriech obtain skin grafts with hair follicles from places on the scalp that are still growing hair (typically the back or side of the head) and transplant them into the balding areas where it will continue to grow. Today, surgeons use smaller grafts which contain anywhere from one to five hair follicles per graft; this helps give the scalp a more natural appearance. By contrast the larger grafts had 15-20 hair follicles; they looked artificial with the appearance of rows of hairs. These are known as hair plugs.

Small or micrografts are also called follicular grafts and "look better, heal faster, and involve much less discomfort," Orentreich tells WebMD.

In the case of hair transplantation, going from large grafts of hair to small grafts "was the watershed that made this procedure so much more natural and because of this, more people doing better transplants today," he says.