A hair transplant is simply the removal of healthy hair follicles from one area of the scalp and transplanting them onto another area. We remove follicles (in their natural hair groupings) from the back of the head and transplant them to the areas where baldness and thinning has occurred. These transplanted hairs will grow continuously throughout the patient’s lifetime. But it takes much more expertise and artistry to make it look natural for the patient’s lifetime.
The ultimate hair transplant technique has to respect that each patient has a fixed amount of good genetic hair from the sides or back of their scalp that can be used to transplant in the balding area. It is of paramount importance that the hair transplant surgeon is entirely focused on ensuring every transplanted hair graft survives and grows.
Hair does not grow out of the scalp individually, one by one, but actually grows naturally in groups of one to four hairs with a fibrous sheath surrounding it. Since that is how God designed everyone’s scalp, that is how I perform a hair transplant. I transplant the single hair grafts near the front of the hair line, and the natural groups of three to four hairs farther back for density. The benefit of transplanting natural hair groupings is that you achieve a higher survival rate of the transplanted grafts and it looks completely natural.
The stereoscopic microscope is the most important innovation in hair transplants. The natural hair groups must be preserved intact during dissection to ensure increased survival and growth, and this microscope allows for it. Using the naked eye or a robotic machine can easily damage the follicular unit, which decreases the survival of the very limited donor hair. A study published in the Journal of Dermatologic Surgery showed that the survival and quality of single hair micro-grafts markedly decreases.
Any physician can “legally” perform hair transplants, even if they have little or no training. It is of utmost importance that any doctor performing hair transplants must have formal training under the strict guidance of a residency or fellowship program. Typically, a hair transplant lasts four to seven hours. Therefore, if the hair transplant physician is going to be involved in every step of the hair transplant process, he can only perform one hair transplant procedure a day.