History of Treatments

Hair transplant procedures have evolved a long, long way since they began in the early 1950's.

  • Hair Restoration Evolution

    Hair Restoration Evolution

    Hair transplant procedures have evolved a long, long way since they began in the early 1950's. The "corn row" or "doll's" hair look that was associated with hair transplantation has evolved into today's "follicular unit" procedure that, when done right, is undetectable even by a hair stylist.

    The Concept of the Hair Transplant is Born

    During the past several decades superstition, old wives tales, and guess work has gradually been replaced by science.

    The early 1800's is renowned in hair restoration circles as the age of the con men. There were hundreds of hair restoration treatments released and many lasted well into the late 1900's. These "cures" were marketed by "doctors", whose only skills were those of fast-talking and nerves of steel (as well as bravery, considering they were conning hardened cowboys and outlaws!).

    The salesmen hawked their products from the safety of their side shows and "Wild West" spectaculars. They used endless tricks to get people to buy their products, such as rubbing grease into people's hair, to make it look thicker.

    In 1939, a Japanese dermatologist, Dr. Okuda, published a revolutionary method in a Japanese medical journal that would lay the ground work for modern hair transplantation.

    This method involved using hair transplant grafts to correct lost hair from various areas, including the scalp, eyebrow, and moustache areas. However, this study didn't make an impact in the Western Hemisphere due to the interruption of World War II.

    Hair Restoration Comes of Age

    In the late 50's one physician in particular, Dr. Norman Orentriech, began to experiment with the idea of relocating or transplanting the hair on the back and sides of the head to the balding areas.

    Dr. Orentriech's experiments showed that when bald resistant hairs from the back and sides of the head were relocated they maintained their bald resistant genetic characteristic regardless of where they were transplanted.

    This principle, known as "Donor Dominance", established that hair could be transplanted from the bald resistant donor areas to the balding areas and continue to grow for a life time. This laid the foundation for modern hair transplantation.

    The Scientific Era of Hair Restoration

    During the 60's and 70's hair transplants grew in popularity. However, the standard of care used larger grafts that were removed by round punches and often contained many hairs.

    This now outdated hair transplant technique could achieve good results with a full look if a patient completed all planned sessions. However, a patient was typically limited in the manner they could style their hair.

    Patients who stopped short of completing all planned sessions were left with hair transplants that looked obvious and unnatural. Such uncompleted hair transplant results are some times referred to as "Barbie doll hair" or "corn rows".

    Many who have had these older techniques now refine or complete their bad hair transplants with today's very refined techniques to achieve a natural look that they can style in any manner.

    Continue reading Hair Restoration Evolution - Hair Loss Solution

  • Hair Loss from Cavemen to Hair Cloning

    Hair Loss from Cavemen to Hair Cloning

    Hair has always been an important symbol of status throughout history. Whether it signified social, financial, gender, or professional status, hair has come to be considered a sign of success. And this idea appears to go all the way back to the cavemen.

     A few years ago, the frozen body of a man on the Austrian-Italian border was discovered by scientists. Upon examining the clothing and weapons found on the specimen, they were astounded to find that the body was from the Neolithic Age, making him more than 5,000 years old. They had previously thought that the body was only a few years old, based on his trimmed beard and short hairstyle. So even during prehistoric times hair care was in practice.

    Even 4,000 years ago, the ancient Egyptians were searching for a hair loss cure. One “cure” used around 1500 B.C. in Egypt called for reciting a magic spell to the sun god and then swallowing a mixture of onions, iron, red lead, honey and alabaster.

    Around 1100 B.C. in ancient Egypt it was popular to rub the fats of various animals onto the scalp, including those of the lions, hippopotamuses, crocodiles, ibex, serpents and geese.

    Another recipe for growing hair prepared for the King of Upper and Lower Egypt included toes of a dog, refuse of dates, and a hoof of an ass. Of course, these “cures” failed to re-grow hair.

    But with baldness regarded as shameful in ancient Egypt, men and women were willing to put such things on their head in the hope they would work. During these times it was believed that baldness stood for the public announcement of a man’s loss of virility.

    The Gospel on hair loss

    Yes, hair loss is even mentioned in the Bible. According to this Old Testament passage God does not condone ridiculing the bald.

    Kings 2: 23 “From there Elisha went to Bethel. As he was walking along the road, some youths came out of the town and jeered at him. "Go on up, you baldhead!" they said "go on up, you baldhead!" He turned round, looked at them and called down a curse on them in the name of the Lord. Then two bears came out of the woods and mauled forty-two of the youths. And he went on to Mount Carmel and from there returned to Samaria.”

    As a hair loss sufferer you can take solace in knowing that today you have treatments for hair loss only dreamed of by the Kings of ancient Egypt and the emperors of Rome.

    Hair loss and attempts to stop or reverse it have been around for centuries.

    How mankind has treated hair loss over time.

  • Ancient Greece – The quest for a hair loss “cure” continues.

    The quest for a hair loss “cure”

    It was Hippocrates, the “Father of Modern Medicine”, who first recognized a connection between hair loss and the sexual organs. Hippocrates’ studies of eunuchs (men castrated before puberty) observed that these men did not suffer from hair loss.

    We know today that this is due to the absence of testosterone, which is normally converted into dyhydrotestosterone or DHT – the active ingredient in baldness. In March 1995, Duke University researchers came to the conclusion that " . . . while castration may be a cure, it is not commercially acceptable."

    Hippocrates had a personal interest in finding a cure for baldness as he suffered from hair loss. He developed a number of different treatments including a mixture of horseradish, cumin, pigeon droppings, and nettles to the scalp. This and other treatments failed to work and he lost the rest of his hair. The area of permanent hair on the back and sides of the head (from which donor hair is taken for hair transplants) is also known as the “Hippocratic wreath.”

    Ancient Rome and Hair Loss

    Moving from Greece to the Roman Empire, we find that Julius Caesar employed a variety of methods to hide his thinning hair. In addition to the laurel wreath that he wore, he first grew his hair long in the back, and then combed it forward over his bald spot. Yes, the “Comb Over” is ancient.
    Learn how man has treated hair loss up to modern times.
    Being a Eunuch – the sure way to stop baldness

    In the 1940’s, the studies of Hippocrates and Aristotle were continued. Both men had concluded that eunuchs always kept all their hair.

    This finding was backed up by the work of Dr. James Hamilton.

    He discovered that certain male hormones (missing in eunuchs) were critical to the development of male pattern baldness.

  • From big wigs to surgical hair restoration

    From big wigs to surgical hair restoration

    The Era of the big Wig

    Soon after the Middle Ages wigs became popular for women. Then in the 1600’s the flamboyant and incredibly vain King Louis XIV of France lost his hair from a severe illness and took to wearing gigantic wigs thus setting the fashion for most men of his day.

    These enormous creations featured such items as cages with live birds and could weigh up to 20 lbs.!

    By the 1700’s England made another contribution to bad hair loss concealers. This was the age of the long, curly, and powered wigs. Even today, English judges and lawyers continue this practice. Thus the expression for those in authority – “Big Wigs.”

    The“Snake oil” Years

    The early 1800’s is renowned in hair loss circles as the age of the con men. There were hundreds of so-called “hair loss solutions” and many lasted well into the late 1900’s.

    These treatments were marketed by fast-talking “doctors,” skilled only in bravery and possessing nerves of steel considering they were conning hardened cowboys and outlaws!

    The salesmen hawked their products from the safety of their side shows and “Wild West” spectaculars. They used endless tricks to get people to buy their products, including rubbing grease into their hair to make it look thicker.

    The “Modern” Era of Hair Loss Solutions

    During the past several decades, superstition, old wives tales, and guess work has gradually been replaced by science.

    In 1939, a Japanese dermatologist, Dr. Okuda, published a revolutionary method in a Japanese medical journal that would lay the ground work for modern hair transplantation.

    This method involved using hair transplant grafts to correct lost hair from various areas, including the scalp, eyebrow, and moustache areas. However, this study didn’t make an impact in the Western Hemisphere due to the interruption of World War II.

    Hair transplants are born.

    In the late 50’s one physician in particular, Dr. Norman Orentriech, began to experiment with the idea of relocating or transplanting the hair on the back and sides of the head to the balding areas.

    Dr. Orentriech’s experiments showed that when bald resistant hairs from the back and sides of the head were relocated, they maintained their bald resistant genetic characteristic regardless of where they were transplanted.

    This principle, known as “Donor Dominance”, established that hair could be transplanted from the bald resistant donor areas to the balding areas and continues to grow for a life time. This laid the foundation for modern hair transplantation.

    During the 60’s and 70’s surgical hair restoration grew in popularity. However, the standard procedure used large grafts that were removed by round punches and often contained many hairs.

    Completed Result after Multiple Sessions of Large Grafts

    This now outdated technique could achieve a full look if a patient completed all planned sessions. However, a patient was typically limited in the manner they could style their hair.

    Patients who stopped short of completing all planned sessions were left with hair loss solutions that looked obvious and unnatural.

    Such uncompleted hair restoration results are some times referred to as “barbie doll hair” or “corn rows”.

    Many who have had these older techniques now refine or complete their hair transplants with today’s very refined techniques to achieve a natural look that they can style in any manner.

    From big wigs to surgical hair restoration

    The Era of the big Wig

    Soon after the Middle Ages wigs became popular for women. Then in the 1600’s the flamboyant and incredibly vain King Louis XIV of France lost his hair from a severe illness and took to wearing gigantic wigs thus setting the fashion for most men of his day.

    These enormous creations featured such items as cages with live birds and could weigh up to 20 lbs.!

    By the 1700’s England made another contribution to bad hair loss concealers. This was the age of the long, curly, and powered wigs. Even today, English judges and lawyers continue this practice. Thus the expression for those in authority – “Big Wigs.”

    The“Snake oil” Years

    The early 1800’s is renowned in hair loss circles as the age of the con men. There were hundreds of so-called “hair loss solutions” and many lasted well into the late 1900’s.

    These treatments were marketed by fast-talking “doctors,” skilled only in bravery and possessing nerves of steel considering they were conning hardened cowboys and outlaws!

    The salesmen hawked their products from the safety of their side shows and “Wild West” spectaculars. They used endless tricks to get people to buy their products, including rubbing grease into their hair to make it look thicker.

    The “Modern” Era of Hair Loss Solutions

    During the past several decades, superstition, old wives tales, and guess work has gradually been replaced by science.

    In 1939, a Japanese dermatologist, Dr. Okuda, published a revolutionary method in a Japanese medical journal that would lay the ground work for modern hair transplantation.

    This method involved using hair transplant grafts to correct lost hair from various areas, including the scalp, eyebrow, and moustache areas. However, this study didn’t make an impact in the Western Hemisphere due to the interruption of World War II.

    Hair transplants are born.

    In the late 50’s one physician in particular, Dr. Norman Orentriech, began to experiment with the idea of relocating or transplanting the hair on the back and sides of the head to the balding areas.

    Dr. Orentriech’s experiments showed that when bald resistant hairs from the back and sides of the head were relocated, they maintained their bald resistant genetic characteristic regardless of where they were transplanted.

    This principle, known as “Donor Dominance”, established that hair could be transplanted from the bald resistant donor areas to the balding areas and continues to grow for a life time. This laid the foundation for modern hair transplantation.

    During the 60’s and 70’s surgical hair restoration grew in popularity. However, the standard procedure used large grafts that were removed by round punches and often contained many hairs.

    Completed Result after Multiple Sessions of Large Grafts

    This now outdated technique could achieve a full look if a patient completed all planned sessions. However, a patient was typically limited in the manner they could style their hair.

    Patients who stopped short of completing all planned sessions were left with hair loss solutions that looked obvious and unnatural.

    Such uncompleted hair restoration results are some times referred to as “barbie doll hair” or “corn rows”.

    Many who have had these older techniques now refine or complete their hair transplants with today’s very refined techniques to achieve a natural look that they can style in any manner.

  • Modern Hair Transplants

    Modern Hair Transplants

    In the 80's hair restoration surgery as a hair loss solution evolved dramatically, as the large punch grafts were gradually replaced with a more refined combination of mini and micrografts. This "combination mini micrografting" hair transplantation procedure no longer used the punch to extract the bald resistant grafts. Rather a strip of bald resistant hair was surgically removed from the back of the head and then trimmed into mini and micrografts.

    Typically the minigrafts (4-8 hairs) were used to create fullness and density, while the one, two, and three hair micrografts were used to create a refined and feathered hairline in front. This combination procedure also normally used more grafts, several hundred grafts per session, rather than the approximately 50 to 200 large grafts of the original punch graft procedure.

    Follicular Unit Hair Transplantation (FUT) the "Gold Standard"

    Follicular Unit Hair Transplantation - Step by Step

    The 90's saw the gradual introduction of a very refined surgical procedure hair loss solution now known as "follicular unit hair transplantation" or "FUT". This exacting and labor intensive procedure transplants hairs in their naturally occurring one, two, three, and four hair "follicular unit groupings" in which they grow naturally.

    To create such natural follicular unit grafts, which mimic the way hair grows naturally, typically requires the use of high powered magnification. Such magnification enables the surgical technicians to properly visualize the follicular units in the donor tissue. They are then able to isolate them and cut them into 1, 2, 3, and some times 4 hair follicular unit grafts.

    The Age of Natural Hair Transplant

    Critical to the ultimate success of the follicular unit hair transplant procedure was the introduction of the binocular microscope by Dr. Bobby Limmer of San Antonio Texas in the late 1980's. Dr. Limmer found that by using the microscope he and his staff were able to successfully isolate and trim the naturally occurring follicular units into individual grafts.

    For his part in pioneering the use the microscope in graft dissection and the follicular unit procedure Dr. Bobby Limmer was awarded the "Platinum Follicle Award" by the International Society of Hair Restoration Surgery in 1996. Many physicians now fondly refer to him as the "Godfather of Follicular Unit Hair Transplantation".

    Dr Bobby Limmer
    Dr Bobby Limmer
    Dr Bernstein
    Dr Bernstein

    While Dr. Limmer pioneered the use of the microscope in trimming follicular unit grafts, it was Dr. Robert M. Bernstein, in collaboration with Dr. Bill Rassman, who pioneered and advanced the concept of large sessions of all follicular unit grafting. These large follicular unit sessions enabled patients to achieve both naturalness and density.

    Dr. Bernstein, who coined the name "follicular unit hair transplantation", tirelessly advocated for its adoption in ground breaking articles and lectures that are today recognized as benchmarks in the advancement of this procedure. Click to read these ground breaking hair restoration articles and papers.

    In recognition of his many contributions in both conceptualizing, pioneering and advocating "follicular unit hair transplantation", Dr. Bob Bernstein was awarded the "Platinum Follicle Award" by the International Society of Hair Restoration Surgery.

    Over time the merits of this refined but difficult to perform procedure became accepted and the follicular unit hair transplant procedure has become acknowledged by most hair restoration physicians to be the "Gold Standard" for surgical hair restoration. Click here to see video of a Follicular Unit Hair Transplant procedure.

    Some feel that hair restoration surgery has evolved to its highest degree now that it relocates hair exactly as it grows naturally. However, even the "Gold Standard" in hair transplantation has continued to evolve by becoming even more "ultra refined".

    Today some leading hair restoration surgeons, including all members of the Coalition of Independent Hair Restoration Physicians, perform an ultra refined follicular unit hair transplant procedure using very tiny incisions that enable them to safely "dense pack" tiny grafts when appropriate. This ultra refined follicular unit procedure is a hair loss solution that enables patients to achieve cosmetic density in a given area after only one surgical session.

  • The Future of Medical Hair Restoration

    Hair Restoration Future

    Today's evolutionary high point - Ultra Refined Follicular Unit Transplantation

    By relocating these carefully prepared bald-resistant follicular units, physicians doing "follicular unit hair transplantation" recreate a natural pattern of hair in the balding areas.

    To do this properly is a very time consuming and exacting process. It requires a team of meticulous medical technicians working hand-in-hand with the hair transplant surgeon in a very lengthy surgical procedure.

    Ultra Refined Grafting - Smaller Blades, Smaller Incisions, Smaller Grafts

    Today's micro surgical blades, like the size of hair grafts, have become ever smaller and now enable hair transplant surgeons to safely make more tiny graft incisions in a given area then ever before. Surgeons are then able to "dense pack" select areas with as many as 40 to 60 follicular unit grafts per square centimeter. This graft density is as much as twice that of the standard follicular unit hair transplant procedure.

    Such high densities of transplanted hair typically produce the appearance of fullness even after only one surgical session. Patients also experience rapid healing and no visible skin distortions due to the tiny size of these incisions.

    Ultra Refined Follicular Unit Grafting - Hard on the clinic but easy on the patient.

    Ultra refined follicular unit grafting raises the bar for physicians and their staff. This delicate and demanding hair transplant procedure requires more skill and careful attention to be performed properly. The smaller and more tightly packed incisions require more closely dissected follicular unit grafts that are carefully trimmed under microscopes. These small and densely packed incisions are also more difficult to place the grafts into.

    This procedure also requires more careful patient selection, as "dense packing" of grafts is not appropriate for all patients.

    Ultra Refined Follicular Unit Transplantation - the new "Gold Standard"

    In the hands of a highly skilled physician and staff the Ultra refined follicular unit hair transplant procedure can achieve excellent new hair growth that is so natural that it is undetectable even under close scrutiny.

    While the standard micro "follicular unit" hair transplant does produce natural looking results, its ability to achieve high density in only one surgical session is limited. Thus patients may have to do subsequent surgical sessions in a transplanted area to achieve a full look.

    The many patient benefits of this new ultra refined procedure are significant and include:

    • The ability to get excellent hair density in only one surgical session.
    • Minimal trauma in the graft recipient area with rapid post surgical healing.
    • Little or no visible pitting or distortions in the transplanted areas.
    • More natural direction and angulation of the transplanted hair.

    All physician members of the Coalition perform Ultra Refined Follicular Unit Hair Transplantation.

    While many hair transplant physicians perform quality follicular unit hair transplants, only some of them are capable of performing large sessions of ultra refined follicular hair transplantation. However, all members of the Coalition of Independent Hair Restoration Physicians perform ultra refined grafting with excellent results.

    The Future of Surgical Hair Restoration

    The amount of hair you can transplant is ultimately limited by the amount of hair follicles you can safely relocate from the bald resistant donor area at the back and sides of your head.

    Some day it may be possible for physicians to create multiple hair follicles from one original follicle. This process typically called Hair Multiplication or more incorrectly Hair Cloning is currently being investigated by several research scientists and hair restoration physicians.

    If and when this process is successfully developed patients would no longer be limited by the finite amount of bald resistant hairs that can be relocated from their donor area. Hair multiplication would result in a virtually limitless supply of hair available for hair transplants.

    This would be especially good news for men or women with extensive baldness and a very limited supply of donor hair. Even those with extensive baldness would theoretically be able achieve thick full heads of hair.

    However, experts believe that we are at least ten years away from hair multiplication being available, if even then. But perhaps some day scientists will be able to use gene therapy to halt the balding process without drugs or surgery.

    Learn about modern hair loss drug treatments that work.