Surgical Therapy:

Hair transplantation operations were common practices during World War II. Initially, round punch grafts containing 10-15 hairs were harvested from hairy parts, and then the grafts were implanted into the round punctures inflicted in the hairless areas.

However, the donor area suffered from wounds and pain, while the implant area presented unnatural looks.

In addition, there was the problem of graft nourishment. To avoid all these, the graft size was reduced. In the following years, mini grafts containing 4-6 hairs and micro grafts containing 1-4 hairs were used.

Despite all the efforts, doll's hair look in the transplantation area could not be avoided in these practices. The shape of the graft was changed; double-bladed surgical knife was used; and grafts of thin and long strips were removed. These were used in forming the front hairline. Thus, the correction of negative aspects was aimed, at least partially.

The disappointing outcomes of hair transplantation operations prompted both the surgeons and people suffering from hair loss into a search for alternatives. Various methods such as flexing and stretching the scalp and covering with flaps were tried, but no successful results were obtained.

Today the common method of hair transplantation is the harvesting of micro grafts (with 1-2 hairs) from elliptic hairy scalp section (1.5 X 10 cm) on the back of the head and transplantation of the micro graft into the little punctures in the hairless area. During this procedure (also called stripe or strip operation), the donor area is stretched and sutured. The hairy scalp piece is then divided into smaller pieces so that each tissue piece is small enough to hold 1-2 hair roots. Therefore, a maximum number of 1000-1500 hair roots is harvested. The second session of therapy is scheduled for six months or one year later. When the scalp on the rear part of the head is flexible enough, a second incision is performed and a second elliptic hairy strip is removed. The second strip is implanted into its new location).

This is the conventional method of hair transplantation practiced in our country as well as in other countries.

The method has many drawbacks:

1. The maximum number of hair roots on an elliptic scalp strip is 1000-1500. However, it is usually not sufficient to cover the hairless area. Thus, it requires two sessions.

2. A waiting period of 6 months to a year is required for the second session.

3. On the rear part of the head, the incisions heal with two scar lines (picture).

4. The diameter of micrografts is larger than 1 mm, as a result of which thicker punctures are required in the receiving part.

In recent years, the concept of follicular unit transplantation has emerged. Hairy scalp piece is sectioned into small pieces to obtain hair roots, while the anatomic structures holding a few follicles together are protected and transplanted as a whole. Nevertheless, the problems mentioned above may arise.

With 'Follicular Unit Extraction' or 'FUE' emerging in recent years, these problems have been eliminated. The technique which is performed in only a few centers in the world has been in use in Turkey as well thanks to the efforts and more than 20 studies of Dr. Keser with patented 'Follicular Unit Extractor' designed by him.