Hair replacement procedures have undergone many changes and improvements over the past two decades as new techniques have made hair transplantation much less invasive and also helped to ensure better, more consistent results. These changes originally during the 1980s when more surgeons began experimenting with using 'micrografts' instead of the traditional 'plugs' that were common throughout the 60s and 70s. 

Modern Hair Replacements
The modern era of hair replacement began in Japan during the 1930s and 40s, but the onset of World War II prevented the practice from being known outside the country until years later. Nonetheless, in 1939 a Japanese doctor named Okuda wrote a paper describing the use of hair-bearing skin grafts to treat traumatic alopecia on the scalp, eyebrows and upper lip. These first efforts were focused on patients whose hair loss was related to a traumatic injury, and throughout the 40s and 50s, other Japanese surgeons experienced success with using grafts to treat traumatic alopecia on other areas of the body. 

Things began to change in 1959 when American dermatologist Norman Orentreich first started experimenting with using grafts in patients suffering from androgenic alopecia, more commonly known as male-pattern baldness. Orentreich's work was extremely influential as prior to this time, it was thought that the donor hairs would not be able to grow properly in already bald areas. However, Orentreich discovered that as long as the donor hairs were taken from a healthy part of the scalp, they could grow and last just as long in the transplant area as they would have in their original location. 

This discovery quickly led to improvements in the techniques for harvesting and transplanting hair grafts to result in much more natural looking hair growth. The very first techniques were quite primitive by today's standards, but over time, microsurgical tools and techniques have enabled surgeons to implant thousands of micrografts containing one to three hairs in an effort to more accurately mimic natural hair growth. 

Early Attempts at Hair Replacements
While modern hair replacement has been around for less than 100 years, the very first record of a human hair transplantation procedure dates back to 1822. In a paper published in Wurzburg, Germany, a medical student describing how he and his professor, surgeon Dom Unger, had successfully performed hair transplants in animals and then humans. As part of the technique, he and Professor Unger were able to successfully transplant hair from one area of a patient's scalp to another in order to treat male-pattern baldness. 

As a result of his success, Unger believed that male baldness would soon be a thing of the past. Unfortunately, no one really took notice of his research for more than 100 years, this in spite of the fact that this same grafting technique eventually began to be used for traumatic alopecia. 

Still, there is no doubt that Unger was a pioneer in the world of hair replacement. From these humble beginnings in Germany nearly 200 years ago, the surgical technique has been improved over time so as to bear very little resemblance to these earliest procedures. Nonetheless, the procedure could have never reached such a point without the hard work and dedication of Unger, Okuda, Orentreich and the other major pioneers.