In the late 1930’s, the cultivation of World War II, a Japanese doctor named Shoji Okuda operated the first hair transplant. He used small punches, like the current FUE method, to remove segments of hair bearing skin from the sides and back of the head which then were transplanted into the bald scalp, eyebrow or any other body part. When the war broke out, the Dr. Okuda’s work was unfortunately forgotten but was given recognition in the new century (mid- 2000’s).
Nearly 2 decades after the then unknown conception of hair transplant in Japan, a dermatologist in New York started doing experiments regarding moving hairs to bald spots of the scalp. Dr. Norman Orentreich began using large diameter punches to transplant dozens of hair follicles to balding regions. His work was praised by his colleagues and an industry was born. He coined the term “ the principle of donor dominance” where the healthy hair follicles continue to grow and thrive even when implanted in an unhealthy scalp. The results were promising but there was an issue in terms of the esthetic result. Due to the large punch drill being used (size 4mm in diameter) the results look like “doll’s hair” as they were “plugged” in the transplanted area.
Then came the 80’s as improvement of hair restoration practice continued. A group of doctors started doing mini-grafting – a technique using smaller grafts cut from a strip of tissue rather than punched out directly from the back of the scalp . Other physicians began using micro-grafts to add density or restore the frontal hairline. The technique had slowly surpassed the practice of the plug technique and became a common procedure of hair restoration. Further procedures were introduced – scalp reductions and flap but likewise presented unnatural results.
Pioneered by Dr. Bobby Limmer in the 1990’s, he then performed a hair transplantation technique called “Follicular Unit Transplantation”. He took a strip of skin from the donor area then dissected it into follicular units. It was known as the “Limmer method”. The method reduced the amount of scarring of the back of the scalp to one linear scar. The results were ground-breaking and aesthetically appealing thus making it perfect for hair restoration.
Across the sea, Dr. Masumi Inaba, a Japanese dermatologist, developed a technique to extract single hair follicles from the skin and became the innovator of Modern Follicular Unit Extraction. In the new millennium, Doctors. William Rassman and Robert Bernstein further improved the method and made it the “Gold Standard” in hair transplant. They coined the term – “Follicular Unit Extraction” but recently changed into “Follicular Unit Excision”.
While certain robotics systems such as the Neograft and ARTAS Robot System have entered the hair transplant world, their results and abilities have not met the high standards of an FUE transplant performed by a trained medical surgeon like Dr. Anil Sharma. The world is still watching and observing how these systems would provide better yielding results. We await what the future will bring with the likes of the AI robotic systems and hair cloning to the hair restoration industry.