Evidence-Based Hair Transplantation

January 2010

Andreas M. Finner

hair transplantation androgenetic alopecia follicular unit transplantation strip excision follicular unit extraction stereomicroscopic dissection hair transplant male pattern baldness female pattern baldness FUT FUE

Studysummary This review discusses hair transplantation as a permanent treatment for androgenetic alopecia, emphasizing the importance of stabilized hair loss, skilled surgical teams, and realistic expectations, while calling for more quantitative evidence from controlled trials.

Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer

Hair transplantation was considered a permanent solution for androgenetic alopecia in both men and women, particularly effective when hair loss was medically or spontaneously stabilized. The procedure involved follicular unit transplantation, which placed natural hair bundles into recipient sites to increase density and coverage, making transplanted hair indistinguishable from natural hair. Key factors for success included realistic expectations, a favorable donor-to-recipient area ratio, and a skilled surgical team. Techniques such as strip excision and follicular unit extraction were used for graft harvesting, with methods like stereomicroscopic dissection reducing hair damage. The creation of a natural-looking hairline was tailored to individual characteristics. However, more controlled trials were needed to evaluate specific techniques within the procedure.

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Research cited in this study

21 / 21 results

research Follicular Unit Transplantation

28 citations , November 2008 in “Facial Plastic Surgery”

This article reviews the development of follicular unit transplantation for hair replacement, highlighting its ability to provide natural-looking results with minimal recovery time, but results depend heavily on the skill and planning of the practitioner.

research Hair Loss in Women

129 citations , October 2007 in “The New England Journal of Medicine”

This article discusses the evaluation and management of a 45-year-old woman with diffuse scalp-hair loss and reports no new clinical findings.

research Minimal Scars for Scalp Surgery

10 citations , January 2007 in “Dermatologic Surgery”

This study reported that a new surgical technique resulted in minimal scars visible to the naked eye in most cases, suggesting a significant improvement over conventional closure techniques.

research Effects of Finasteride (1 mg) on Hair Transplant

30 citations , March 2006 in “Dermatologic Surgery”

In this study of men with androgenetic alopecia, daily finasteride 1 mg alongside hair transplant improved scalp hair density and growth of nontransplanted hair compared to placebo over 48 weeks.

research Hair Transplantation: Current Concepts and Techniques

30 citations , October 2005 in “Journal of Investigative Dermatology Symposium Proceedings”

This article reviews modern hair transplantation techniques, noting that while many innovations have improved natural-looking results and expanded candidate eligibility, some may have hidden drawbacks, and it reports no new results.

research Recipient Area Hair Direction and Angle in Hair Transplanting

13 citations , May 2004 in “Dermatologic Surgery”

This article outlines a method for achieving natural-looking hair direction and density in hair transplants using specific parting and incision techniques, without accelerating hair loss in the recipient area.

research Intricacies of the Single-Scar Technique for Donor Harvesting in Hair Transplantation Surgery

6 citations , May 2004 in “Dermatologic Surgery”

This article discusses various techniques to achieve a cosmetically attractive single donor scar in hair restoration surgery, reporting no new clinical findings.

research Principles and Techniques Used to Create a Natural Hairline in Surgical Hair Restoration

46 citations , May 2004 in “Facial Plastic Surgery Clinics of North America”

This article discusses techniques for creating natural-looking hairlines in hair restoration surgery and reports no new clinical results.

research Hair Transplanting: An Important but Often Forgotten Treatment for Female Pattern Hair Loss

43 citations , October 2003 in “Journal of The American Academy of Dermatology”

This article explains why modern hair transplant techniques can be effective for women with pattern hair loss, despite this being underrecognized.

research Androgenetic Alopecia: Combining Medical and Surgical Treatments

15 citations , October 2003 in “Dermatologic Surgery”

This study found that combining drug therapy with hair grafts can regress male androgenetic alopecia from Hamilton type V to type III.

research The Potential Role of Minoxidil in the Hair Transplantation Setting

31 citations , October 2002 in “Dermatologic Surgery”

This article reviews expert opinions on combining pharmacologic treatments like minoxidil with hair transplantation, reporting improved hair density and regrowth in patients with partially functioning follicles.

research Follicular Unit Extraction: Minimally Invasive Surgery for Hair Transplantation

153 citations , August 2002 in “Dermatologic Surgery”

This paper introduces the Follicular Unit Extraction procedure and its accompanying FOX Test, finding that 60% of tested patients were suitable candidates for this minimally invasive hair transplantation method.

research A Method for Evaluating and Treating the Temporal Peak Region in Patients with Male Pattern Baldness

4 citations , May 2002 in “Dermatologic Surgery”

This article describes a technique for evaluating and treating the under-addressed temporal peak areas in hair restoration surgery to improve cosmetic harmony with the frontal hairline.

research Hair Transplantation: Management of Donor Area

14 citations , February 2002 in “Dermatologic Surgery”

Best hair transplant results happen when tissues are least damaged.

research A Technique for Hair-Grafting Between Existing Follicles in Patients with Early Pattern Baldness

21 citations , August 2000 in “Dermatologic Surgery”

This source reports that hair surgeons can now regularly and significantly reduce damage to existing hair follicles in early-stage pattern baldness patients, helping preserve hair during treatment with finasteride or minoxidil.

research Follicular Unit Hair Transplanting: End of the Evolution or a Good Thing Taken Too Far?

3 citations , February 2000 in “Dermatologic Surgery”

The document concludes that hair restoration has improved with follicular unit transplantation, making it more scientific and precise.

research Regarding the Death of Density Debate

2 citations , December 1999 in “Dermatologic Surgery”

Achieving original hair density with transplants is unrealistic; skilled practitioners are essential for the best results.

research The Logic of Follicular Unit Transplantation

77 citations , April 1999 in “Dermatologic Clinics”

This article reviews how new observations have revolutionized surgical hair restoration and highlights the logical applications and prior illogical judgments that delayed this advancement, without reporting new results.

research Methodology of Follicular Unit Hair Transplantation

11 citations , April 1999 in “Dermatologic Clinics”

This review covers different hair transplantation techniques and compares their cost-effectiveness and potential results but presents no new research findings.

research Standardizing the Classification and Description of Follicular Unit Transplantation and Mini-Micrografting Techniques

33 citations , September 1998 in “Dermatologic Surgery”

This article proposes a classification for small graft transplants that includes technical factors to improve communication and facilitate comparative studies, reporting no new clinical results.

research The Density Issue in Hair Transplantation

32 citations , September 1997 in “Dermatologic Surgery”

This study found that mini-micrografting and plug methods achieve comparable hair density, but mini-micrografting requires fewer sessions due to its dense graft packing.