Patients surveyed said that they had fewer complications and the best results with the micrografts, which the respondents did not even begin to receive until 1991, and they said that the results were better with minigrafts than standard grafts, apparently an increasingly outdated mode of operation.
"Micrografts are going to become the benchmark, not only to improve the hairline, but actually for the area behind the hairline. Micrografts are going to be used more commonly and effectively because of the things we've shown already in the paper," Adler tells WebMD.
When comparing the more modern "strip" method of harvesting to the older "punch" technique, the researchers found a "significantly" lower rate of complications for strip harvesting.
But among the larger, more established types of surgery, such as scalp flap and scalp reduction, there were negligible differences in postoperative conditions or aesthetic results for patients during the last two decades. Adler acknowledges that not much has changed in these procedures over the last two decades.
This all goes to "suggest", writes Adler, "that the newer procedures are significantly better." But he cautions that the types of procedures compared require additional evaluation. The paper touched on laser hair transplantation surgery, a newer method. "It's a matter of looking at new technology critically before accepting it as the standard, which really means newer is not really [always] better," Adler tells WebMD.
For the future, Adler says cloning hair will be one of the turning points because it "will make a lot of candidates out of noncandidates."
For the present, though, things are looking up: "The recoveries are much faster, there's less pain, there's less bleeding, and less risk of scars all combined with an increase of aesthetic result, or a natural appearance. When you combine those it's hard to beat," Adler says.
The study was sponsored by a grant from the International Society of Hair Restoration Surgery in Schaumberg, Ill.