Since the 1950‟s many changes and advances have been made to enhance the results of hair transplantation; in summary here is a brief explanation of the evolution in surgical hair restoration techniques.
Scalp Reduction – This is considered to be an aggressive form of hair transplant surgery, removing the bald skin from the top of the scalp and pulling the sides and back up, thus reducing the size of the bald area. Scalp reductions were never a popular form of hair replacement and were used mainly in the 1990‟s, but due to the potential complications in performing a scalp reduction it never became main stream.
Flap Surgery – The cutting out of a bald area of skin along the hair line normally, then the same cut but of a hair bearing area from the sides, this “flap” remains attached to the skin and is twisted to sit in the area removed and then sutured.
The flap procedure is aggressive and can be very painful with a high potential for the hair not to grow. Flap procedures invariably will leave severe scarring in the donor and recipient and an unnatural orientation of hair growth along the hair line.
Mini-grafting – This technique evolved from the first “plug grafting” techniques and was being per- formed in the 1990‟s. This involved the use of small groups of hair, an improvement of the 30-40 hair groups once used
The technique was a significant improvement in performing a more natural looking hair line, although it did leave larger spacing between each group of hairs but was the first real step to the techniques of today with refined Follicular Unit grafting, FUT and FUE