Micrograft hair transplants—the careful transplanting of hair follicles containing from one to three hair shafts—revolutionized the way hair transplants were performed. In a very short period, men and women who had significant hair loss could have a normal looking head of hair. Today the micrograft procedure is the gold standard and simply the best hair transplant that can be obtained.

Still, there are surgeons who use outdated and even downright unsafe procedures. Thankfully they are in the minority. Still, it pays to understand these procedures and avoid them despite claims by unscrupulous purveyors that they are safe, low cost, or in their opinion, make the best hair transplant method

Punch graft Transplant

Round in shape, and containing about 15 hairs each, punch grafts consist of round “plugs” of scalp that are removed in one area and transplanted into another. At one time, several decades ago, this method was considered to be the best hair transplant procedure. However, the reason it is commonly referred to as a “plug transplant” is because it resembled the hair-plug effect on a doll’s head. There are still surgeons here and in other countries that will do this type of hair transplant but it is no longer considered the best hair transplant method and should be avoided. A strip graft is not unlike a punch graft. The difference is that strips of scalp containing from 40-50 hairs are removed and transplanted into furrows in balding areas of the scalp. The look is unacceptable.

Flap style transplants

There are two kinds of flap style hair transplants. In one, a flap of scalp containing normal hair growth is rotated from the side of the scalp to the front of the hairline. This is done my cutting the flap from the scalp on three sides and then twisting it to fit. In addition to being unnecessarily risky, the hair always grows in the opposite direction of its natural placement. There is also a permanent knot at the point where the flap pivots. The second flap procedure is known as the free-form flap because the flap is removed on all four sides so it can be placed in the direction of natural hair growth. However, unlike the other procedure, the flap is completely severed from its original blood supply and there is substantial risk that a new blood supply won’t form at the new site. While either of these flap methods are suitable for a burn victim, or someone who has significant scarring from a scalp injury, it is not the best hair transplant method for male pattern baldness or androgenetic alopecia