The old method of hair transplantation involved taking circular plugs of donor scalp from the back and sides of the head, each containing 10-15 hairs per graft and placing them in circular holes in the bald area.This procedure resulted in a “doll’s hair” or “rows of corn” appearance that was quite noticeable.
Today, the new techniques of mini/micrografting yields a much better appearance. A section of donor scalp is removed from the back and sides of the scalp. (This donor area is chosen because it is genetically programmed to remain throughout one’s lifetime.) The donor area is closed and stitched and the piece of scalp is sectioned into small grafts (minigrafts = 3–5 hairs, micrografts = 1–2 hairs).
The micrografts are placed at the new hairline while the minigrafts are placed behind to give a less “pluggy” look.
Hundreds of grafts are done at each time separated by several months to let the hair grow. If too many grafts are done at one time, some feel the hair growth is reduced due to crowding of the grafts and lower blood supply.
The transplanted hair initially falls out several weeks later because the blood flow to these grafts has been interrupted. Visible hair growth begins in about three months at a rate of 1/4 to 1/2 inch per month. Nine to twelve months after each session the hair is long enough to comb. Multiple sessions are required within any area in order to achieve density.
The results of this procedure depend upon several factors, such as hair density and texture, balding pattern, and hair color. Careful hairstyling is essential for the best effect in hair graft transplantation. The main advantages of this method include its simplicity, small incidence of complications and reasonable results for some individuals. The cost of grafts appears to be lower than for a Flap, but this is misleading: The payments are spread out over time because it takes many procedures over a long period of time to complete the surgery.
There are multiple disadvantages to this procedure. The texture of the transplanted hair is always different (it is kinky or wiry), and the density of the transplanted hair is not as great as patients would like except in unusual cases of very small areas of baldness. It is more like “see through” hair, in that the scalp is often easily visible through the sparse transplanted hair. It is also very expensive: two thousand grafts sounds like a lot but in reality only produces a small amount of coverage.In patients where the baldness is more extensive, grafts have to be spread over a greater area with a less desirable result. The process usually takes at least two years initially and needs to be continued to give additional density to keep up with continued hair loss. Some patients may ultimately require more grafts than they have donor area available.