Even today, if you ask the average person to describe hair transplantation surgery, the term "plugs" or "doll's hair" will eventually be uttered. Hair transplantation surgery got a bad rap because of early restoration techniques—one that it deserved. Thousands of hair transplantation surgeries were performed using techniques that left patients with sparse, unnatural looking hairlines. While patients were no longer bald, it was clear to even the most casual observer that the hairline had changed (and often not for the better).
Sadly this negative connotation persists to this day, but it is no longer deserved. The advent of follicular unit transplantation has changed the entire process. While the procedure is long, sometimes lasting the whole day, the results are superb. The development of the follicular unit transplantation approach reflects the combination of astute clinical observation and basic scientific research.
This knowledge was lost to the war but then rediscovered a few decades later. About the same time of this rediscovery, scientists described the follicular unit: a group of one to four hairs that has its own nerve and blood supply. It was noticed that if this follicular unit was kept intact, the transplanted hair survived very well. Earlier surgeries broke up these units, explaining why earlier surgeries were such relative failures.
This discovery of the follicular unit is both a coup and a bane to surgeons. They finally have the power to provide excellent looking hair replacement treatment, but the process is painstaking. Each follicular unit has to be harvested from an area of the scalp that resists pattern baldness, like the back or sides of the scalp. The follicular units must be removed in such a way that they do not make the harvested area look moth-eaten or Swiss cheese-like.
However, once harvesting is complete, the flexibility and quality of follicular unit transplantation is unmatched. The hairline can be shaped to look natural (which, curiously, is slightly irregular rather than straight). The follicular units survive and grow as they would in their former location on the scalp.
The procedure is performed under local anesthesia so the patient is awake during the entire procedure. This means the procedure is far safer than it would be with general anesthesia, but it also affords the patient the power and freedom to determine how the hairs are placed on the scalp. If the hairline should be changed, the patient can direct the placement of the follicular units to a degree. Obviously this leads to high rates of patient satisfaction.