The roots of modern day surgical hair restoration were actually cultivated in Japan in the late 1930s. It was in 1939 that Japanese dermatologist Dr. Okuda described in detail his groundbreaking work in surgical hair restoration for burn victims. He described using a punch technique to extract round sections of hair bearing skin, which were then implanted into slightly smaller round holes. These holes were prepared in the scared or burned areas of the scalps of his patients. After the skin grafts healed they continued to produce hair in the previously bald areas of scalp.
In 1943 another Japanese dermatologist refined Okuda's technique by using significantly smaller grafts consisting of one to three hairs to replace lost pubic hair in his female patients. Dr. Tamura used an elliptical incision to extract the donor tissue and then dissected each individual graft. Interestingly enough, Dr. Tamura's technique was very similar to the techniques being used today.
The groundbreaking work of both these Japanese innovators were lost for over a decade and remained completely unknown to western medicine due to Japan's role in World War II. It wasn't until years after the war that the documentation of these scientific finding were found and shared.
In 1952 a New York Dermatologist by the name of Dr. Norman Orentreich performed the first known hair transplant in the US on a man suffering from male pattern baldness. It was that day that Dr. Orentrieich essentially reinvented modern day hair transplantation.
Seven years later, after much criticism, Dr. Orentreich published his findings and set fourth his theory of "Donor Dominance" in the Annals of the New York Academy of Science. His work demonstrated that the hair from the back and the sides of a man's scalp was for the most part resistant to the balding process.
By the 1960's the field of surgical hair transplantation had forever found a place in cosmetic surgery. Unfortunately Dr. Orentiechs technique mirrored the less ascetically acceptable "puch graft" process of Okuda instead of the more natural smaller grafting techniques of Dr. Tamura.
Dr. Orentich was able to place and grow hair were there once was none, however his crude technique of hair transplantation set the stage for countless tragic outcomes and gave the field of surgical hair restoration the unfortunate reputation and attached stigma that has plagued it until very recently.
It wasn't until the mid 1990's that surgical hair restoration came out of the dark ages to produce natural looking results. The advent of follicular unit micro grafting or follicular unit transplantation and follicular unit extraction has made hair transplantation a virtually undetectable, viable option for many hair loss sufferers.
Reviewed by Paul J. McAndrews, MD