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Hair Transplant Procedures – A Primer

Today hair transplant procedures closely resemble the original methods of using skin grafts to treat burn victims. The current method actually dates back to 1939 when Dr. Okuda, a Japanese dermatologist, would use these skin transplants to reintroduce hair to burnt areas of the scalp. He would select round grafts that contained follicles and discovered that when they were transplanted, the follicles would continue to grow. Dr. Okuda’s original research was temporarily lost but Dr. Norman Orentreich of New York City discovered a similar method during the 1950s.

Hair transplants to reverse or recover from balding have made great strides. Several decades ago most procedures left men (and sometimes women) with artificial graft-like transplants that looked worse than the toupee's they were intended to replace. Now many companies like Bosley have trained clinicians' with proven successful procedures making transplants look and feel natural.

Procedure Length

The hair transplant procedures of today are similar in nature to the ones originally done by Dr. Okuda and Dr. Orentreich but they have been modernized somewhat. For more accurate results, individual grafts are done involving smaller quantities of follicles and this means that the procedure can be somewhat lengthy. It is likely to expect a procedure that involves 1500 grafts to take around 6 hours. The good news is that the patients are lightly sedated so that they can sleep during the procedure and most surgeons will provide movies or similar entertainment to watch.

Best Candidates

Because of the nature of a hair transplant, the ideal candidate will need to have sufficient donor hair on their head. In most cases, the surgeons will remove three to four inches of the scalp containing follicles and the area that the hair is removed from must be able to recover. A candidate must also understand that the transplant will not perform a miracle or prevent future loss; instead it will simply counter the appearance of the current hair loss.

Procedure Itself

Surgeons use local anesthesia during transplants and they will begin by cleaning the scalp and numbing the donor area. After this, the surgeon will remove the donor scalp containing follicles of a similar nature (ideally from the back of the head) and put it aside to sew the scalp shut. The surgeon will then divide the removed scalp into tiny grafts (usually 500 to 2,000) that each contain no more than several hair follicles. The area where the grafts will go is cleaned and numbed and then the surgeon creates small slits and places the grafts in these.


It is normal for patients to experience scalp tenderness after a transplant and many take pain medication. After the procedure, the patient will need to keep the area covered with a surgical dressing for several days. Two or three weeks following the surgery the hair which was transplanted will fall out and this is completely normal and it allows the new hair to begin to grow. Most of the time, however, there is 60% new growth between six and nine months after the procedure.


The type of hair and scalp that a patient has can impact the procedure greatly. If the scalp is more flexible, it is easier for the surgeon to harvest the graft and close the scalp afterwards. The type of hair will generally determine how many grafts are needed as thick or coarse hair requires fewer grafts than fine hair. In addition, curly or wavy shafts, usually achieves more fullness after the procedure than straight hair.
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