Hair Transplants have seen a great deal of evolution since its early days. Earlier methods produced results that were not aesthetically pleasing and looked very fake. Continued improvements of the methods used during hair transplantation has led to the development of automated devices to harvest the grafts from a person’s donor site. With the introduction of these automated devices comes the question, will the human touch soon be a thing of the past when in comes to hair restoration?
Hair Restoration 101
Hair transplants work because of “donor dominance.” Hair will keep on growing, even if the follicle is taken from its original spot and moved to another area of the scalp due to the fact that follicle is genetically programed to do so. Follicles that are not usually susceptible to DHT can be transferred to areas of the scalp where the hair follicles are susceptible to DHT and continue to thrive.
While the original concept for hair restoration remains the same, the method of performing the procedure has changed dramatically over the years. Back in the 1960s, large donor areas, up to 4mm in diameter, were punched out of the scalp, then transferred to holes in areas of the scalp where hair loss was occurring. While the procedure did restore hair, the results were very visible and often unsightly.
With the development of follicular unit grafting (FUG), the results became more esthetically pleasing. Instead of transplanting large plugs, hair follicles were placed one by one (or two or three at a time) in the scalp. The surgical team performing the procedure works up close, using a microscope, and makes sure to position the hairs so that they fall in a natural pattern.
Even though FUG might produce a more natural look than earlier methods, the donor hair is removed from the scalp as a strip, leaving a fine-line scar on the back or sides of the head. The scar can be covered up with surrounding hair, but its presence can make it difficult for people to wear their hair very short.
Follicular Unit Extraction or FUE, developed about a decade ago, combines the best of FUG with the best of earlier methods. The punch method of harvesting follicles is back, except this time, the follicles are removed in single units, not in large 2 to 4 mm diameter punches or plugs. FUE eliminates the need for the strip of scalp and the resultant fine line scar. Since the punches are so small, any scars that develop are tiny, barely visible dots. People who decide to have FUE can shave their heads later on or wear their hair very short without feeling self-conscious about scarring.
Ways of Harvesting Grafts
Surgical teams who are harvesting grafts during a FUE procedure do so in many ways. One of the older methods is the manual method, which simply means that a surgical team removes each follicle at a time, by hand. The original option, manual extraction, is generally not preferred by many today for several reasons. It takes a long time and there are fewer quality grafts.
A motorized method of extraction is generally the preferred method for many doctors today. Typically, a motorized method uses a type of small drill to gently cut through the tissue and remove the follicle, without damaging it or affecting its quality. Although the process involves a tool, a motorized extraction method still relies on the human touch, as the surgical team is using the drill and deciding which follicle to extract, how much pressure to use, and what angle will work best. The process of extraction is considerably quicker than manual extraction, with a surgical team able to remove up to 400 grafts per hour.
Automated extraction can be a slightly more advanced form of motorized extraction, meaning it still needs a human to guide the device. Or it can be completely robotic, meaning the device picks the follicular units, chooses the appropriate angle, and decides how much pressure is needed to extract them. Some automated hair restoration devices can also create the recipient sites, effectively removing the doctor from the process entirely.
Human vs. Automation
It might be early to say whether automated devices will ever fully replace the human touch during a hair restoration procedure. While quickly extracting hair grafts is a worthwhile feature of automated devices, in some ways the automated devices are no faster or more accurate than a surgical team.
The art of hair restoration lies not in how well the hair is harvested, but in how well the hair is transplanted into the recipient area. While a few automated devices do create the recipient sites, not all of them do just yet. That job still falls to the surgical team, and it’s up to them to provide the human touch and to create a natural look.
Dr. Mendelsohn has more than two decades of experience performing hair transplants. He has great hopes for the future of hair restoration while recognizing that human talent and artistry will continue to play an essential role. Dr. Mendelsohn sees patients at his Rookwood office in Cincinnati. For a consultation call (513) 651-4247 (HAIR)