History of Surgical Restoration and Medical Treatment for Hair Loss in Men and Women

A Time Line of Hair Loss Treatments from New York Specialist Dr Gary Hitzig

Learn the history of hair loss and baldness treatment for men and women from one of the best leading New York experts. As most are aware of non-medical treatments with Rogaine and Propecia the following details nearly 50 years of surgical hair loss treatments due to male pattern baldness and other causes. For more information about how Dr. Gary Hitzig can assist New York City and Long Island male and female residents; contact or visit his NYC or LI hair loss treatment centers.

1959 - Plugs: The first paper on free skin graft hair transplantation was published in the United States. The paper noted that small circular skin grafts removed from a healthy hair bearing area of the scalp would continue to grow vigorously when transplanted to a bald area of the scalp. Each graft measured about 1/4 inch across and included 10-20 hair follicles. These were the "plugs" that were first associated with hair transplantation.

1970's - Larger Sessions: Refinements in surgical instrumentation, including hand engines and spacing templates, allowed the placement of more smaller sized circular grafts in a single session. The grafts were approximately 1/8 inch across, and were removed from the donor site one plug at a time.

1980's - Minigrafts and Micrografts: Hair follicles are now removed in strips from the donor site at the back of the head, and individual grafts are prepared from the strips. Dr. Hitzig  introduces the running lock stitch for donor site closure to enhance patient comfort and accomplish a better cosmetic result in the donor area. Hair grafts become smaller again, in the form of minigrafts having 3-6 hair follicles, and micrografts having 1-3 hair follicles.

1990's - Micro Mini Graft Hair Transplant Mega Sessions: The problem with dense packing micro-minigrafts was in placing hundreds of them close together to achieve acceptable density. Rather than making small circular holes, many physicians would make stab wounds called slits, and insert the micrografts into the slits. In some cases the growth of the scalp tissue would push the hairs together as they grew out from the slits, making all the hairs appear as if they were growing from a single hole. This tufted hair effect, called graft compression, led to single hair micrografts, which could not be affected by graft compression. More importantly graft survival was unpredictable due to the amount of graft handling and trauma as well as limited blood supply to feed thousands of grafts closely placed together.
 

Exclusive micro- minigrafts involved extensive graft preparation and handling, and a tremendous increase in labor. Even with teams of 8-10 medical assistants working with the surgeon for 8-10 hours straight on a single patient, only a few thousand grafts could be placed at one time.

The cosmetic results were natural, however the density was poor, and the risk of graft failure increased due to extra handling dense packing of the individual grafts. Sometimes failure rates of 30-50% were observed, and even under the best megasessions are difficult to thicken later without damaging even more of a patient's existing hair.

1993 - Laser Hair Transplants: Laser hair transplantation showed initial promise at solving the graft compression problem associated with minigrafts and micrografts. The laser was used to vaporize a narrow slot in the scalp for the hair graft. By actually removing tissue, the laser reduced the risk of graft compression, and a more natural result was possible. Advances in laser technology have since allowed for rapid and precise recipient site creation, with  minimal thermal damage to the surrounding tissue. The problem with laser transplants is that even with recent advances in laser technology, the laser seals the blood vessels that are critical for nourishing the grafts when they are first transplanted. As a result, laser transplants heal more slowly, and have unpredictable growth.

1995 - Linear Grafting: Dr Hitzig introduced the Linear Punch, a surgical hand tool developed specifically to  duplicate the shape of a laser slot, but with the advantage of not compromising the blood flow to the grafts at the initial healing stage. In addition, the Linear Punch allows the surgeon greater flexibility in angling the recipient sites so that the new hairs will lay in the most natural direction. Linear slot micrografting has the best characteristics of all hair transplant methods: the natural appearance of laser transplants, the rapid growth and predictable healing of slit grafts, and density superior to megasessions, but with less labor and lower costs for the patient.