When Was the First Hair Transplant? The History of Hair Transplant Surgery

People have attempted to reverse the causes of hair loss for thousands of years. A balding crown, hairline recession and other hair loss conditions were permanent for most men and women in the past. However, advancements in surgical techniques led to hair transplant procedures that mirrored natural-looking hair.

But this didn’t happen overnight. It took decades, from the first hair transplant to the latest cutting-edge techniques such as micrografting. Below, we cover the incredible transformation that’s helped millions of people restore their hair worldwide.

In this guide:

• Early Hair Loss Treatments
• When Was the First Hair Transplant?
• Evolution of Modern Techniques
• Development of Micrografting
• Future Hair Transplant Advancements

Early Hair Loss Treatments

Hair transplants might be new, but hair loss isn’t. For millennia, people have dealt with balding and other forms of hair loss. In ancient civilisations, people turned to everyone from alchemists, witchdoctors, and other herbalists for a treatment for hair loss.

Some historical treatments included¹:

• Herbal Remedies. Natural plant-based treatments were reported to increase and stimulate hair growth. These include saw palmetto, nettle root, and ginseng. These herbal remedies are likely to be somewhat effective. However, they couldn’t fully reverse hair loss, only forestalling the inevitable.
• Animal Products. Past peoples would apply mixtures of animal fat and ashes to their scalps to restore their hair. Bear fat, in particular, was a popular ingredient in these remedies.
• Scalp Massages. Massaging the scalp improves blood flow to the area, supporting the health and longevity of hair follicles. Ancient peoples realised this, integrating it into their hair loss treatments. It’s a common and highly effective practice.

Of course, the most common remedy was simply to wear a wig. This became exceedingly popular in 17^th-century Europe. A wig or toupee was a standard means of masking baldness. However, the practice of wearing wigs became almost ubiquitous. It’s partly why lawyers continue to wear wigs – a holdover from a previous era.

When Was the First Hair Transplant?

Wigs, animal fats, and herbal remedies only get you so far. Yet, for centuries, this was all that was available. It wasn’t until the 1930s that the first hair transplant was performed.

In the late 19^th century, surgeons began to experiment with taking bands of tissue from one part of the head and shifting them to the bald area. Known as scalp flaps, this allowed the original blood supply to continue in the bald area. Turkish physician Dr Menahem Hodara performed the first example of this skin grafting surgery in 1897. However, this primitive technique wasn’t popular due to the poor results.

Modern techniques were pioneered in Japan in the ’30s. Here, a dermatologist called Dr Sewon Kak developed a technique that would transplant follicles from areas of high growth to areas of low growth. It’s the same fundamental principle surgeons continue to use to this day. The procedure primarily involves repairing damaged eyebrows, but it was not used to treat baldness. It involved punching a hole in the skin to remove and implant the grafts. Yet, despite its success, it was largely unknown for decades.

Evolution of Modern Techniques

Despite several procedures, no surgeon had effectively tackled male pattern baldness. The first hair transplant surgery for the condition was performed by Dr Norman Orentreich in 1952 in New York City. Previously, dermatologists assumed that if hair was transplanted into the balding regions, it would face a similar fate. Thus, transplanting hair was regarded as ineffective. Dr. Orentreich proved this view wrong.

The medical community were initially astonished. His attempts to publish his work were rejected until the landmark study was finally published in 1959². He coined the term “donor dominance” to explain why transplanted hair continues to grow despite being inserted into balding regions – hair on the back of the head is in the “permanent zone,” being immune to hair loss.

Building on this concept, Dr Walter P. Unger defined the “Safe Donor Zone,” where follicles could reliably be extracted for hair transplantation³. He confirmed that any hairs from this region would continue to grow as they previously would have done.

During this time, hair transplants primarily involve 2-4 mm “plugs.” This involved transplanting a collection of follicles, leading to a doll’s head-like appearance. It wasn’t until the 1980s that Dr Carlos Uebei popularised strip excision in Brazil⁴. This paved the way for the newer “micrograft” technique.

Development of Micrografting

Micrografting was the dawn of the latest cutting-edge techniques. Pioneered by Dr B. L. Limmer, it involved extracting smaller and smaller “micro-grafts” that continued 1-2 hairs⁴. These hairs are hole-punched from the back of the scalp and inserted into tiny incisions at the recipient site.

So-called follicular unit transplantations continued to evolve and become ever more precise. Surgeons could now extract hundreds and later thousands of individual follicles, inserting them one by one into the hairline. Gone was the doll-like appearance. Now, each hair transplant could be unique, with surgeons able to control the hair density, angle, and shape.

Currently, two forms of micrografting are popular:

1. FUT (Follicular Unit Transplantation): Involves surgically removing a strip of scalp from the back of the head, dissecting it into individual hair follicles, and transplanting these follicles into balding areas, typically leaving a linear scar.
2. FUE (Follicular Unit Extraction): Involves individually harvesting hair follicles directly from the scalp using a small punch tool, which minimises scarring and allows for faster recovery, making it ideal for patients who prefer shorter haircuts.

FUE is the most advanced of the procedures. With the minimally invasive technique, patients experience little to no scarring and a much faster recovery time.

But simply removing and implanting hair follicles doesn’t necessarily mirror the natural hairline. The “lateral slit” technique, developed in the early 2000s, allowed transplant surgeons to orient 2 to 4 hair follicular grafts to splay out over the scalp’s surface. The result was that hairs lie better on the scalp, improving coverage of bald areas.

Future Hair Transplant Advancements

What comes next? Almost a hundred years since the first hair transplant surgeries, the end result is almost unrecognisable from the early days. While modern hair transplants are extremely natural-looking, often improving the appearance of the original hairline, there are still some issues.

The primary challenge is finding suitable hair follicles. Usually, surgeons rely on follicles extracted from the back of the head. However, if this isn’t a suitable site – for example if a person has had a previous hair transplant – then other body areas might be selected.

Advancements in hair cloning might finally cure baldness once and for all. When people go bald, they don’t actually lose their hair. Instead, the hair shrinks until it is no longer visible. This occurs because the dermal papillae at the base of the follicle begin to fail or are thinned by the hormone dihydrotestosterone.

Researchers believe they can extract healthy follicles from intact dermal papillae early on⁵. Dermal papillae are then isolated and multiplied. Instead of a follicle transplant, the dermal papillae can be injected back into the balding areas of the scalp, restoring your original hair. It’s a groundbreaking procedure that may be possible in just a few years. Until then, FUE and FUT hair transplant surgery remains the gold standard.

Experience Award-Winning Hair Transplantation from The Treatment Rooms London

At The Treatment Rooms London, we excel in tackling male hair loss with cutting-edge hair transplant techniques. Our expert team delivers personalised solutions designed to restore a full, robust head of hair, boosting both your looks and self-esteem. Proudly recognised as the Hair Restoration Clinic Of The Year 2023, we offer excellence in every procedure.

If you’re grappling with hair loss and in search of a professional, caring setting, contact us today. Book your consultation at The Treatment Rooms London and learn how our customised treatments can profoundly impact your life.

References

1. Hair Transplant Global. The History and Evolution of Hair Transplant Surgery. Available at: https://www.hairtransplantglobal.com/the-history-and-evolution-of-hair-transplant-surgery/
2. Orentreich N. Autografts in alopecias and other selected dermatological conditions. Annals of the New York Academy of Sciences. 1959 Nov;83(3):463-79. Available at: https://nyaspubs.onlinelibrary.wiley.com/doi/abs/10.1111/j.1749-6632.1960.tb40920.x
3. Unger W, Solish N, Giguere D, Bertucci V, Coleman W, Loukas M, Unger R. Delineating the “safe” donor area for hair transplanting. The American journal of cosmetic surgery. 1994 Dec;11(4):239-43. Available at: https://journals.sagepub.com/doi/abs/10.1177/074880689401100402
4. Shiell RC. A review of modern surgical hair restoration techniques. Journal of cutaneous and aesthetic surgery. 2008 Jan 1;1(1):12-6. Available at: https://journals.lww.com/jcas/fulltext/2008/01010/a_review_of_modern_surgical_hair_restoration.6.aspx
5. BBC Science Focus. Scientists might soon cure balding. Here’s how. Available at: https://www.sciencefocus.com/the-human-body/cure-for-balding