Follicular Unit Hair Transplant Milestones
1984
Headington (Arch Dermatol)
“Transverse Microscopic Anatomy of the Human Scalp”
Importance: First histologic description of the follicular unit.
1993
Rassman and Pomerantz (J of Aest and Rest Surg)
“The Art and Science of Minigrafting”
Importance: First to stress the importance of accurately quantifying donor density and assessing hair supply in the surgical planning of a hair transplant. Densitometry made hair assessment in hair transplantation truly “scientific.”
1994
Limmer (Derm Surg)
“Elliptical Donor Stereoscopically Assisted Micrografting as an Approach to Further Refinement in Hair Transplantation Microscopic Dissection”
Importance: Stressed the importance of using single strip harvesting and stereo-microscopic dissection in generating small micro-grafts in order to avoid follicular transection and damage.
1995
Bernstein and Rassman (J of Aest and Rest Surg)
“Follicular Transplantation”
Importance: This is the first paper on Follicular Unit Transplantation. The authors state that the ideal hair restoration surgery should consist of performing the entire transplant using only naturally occurring, individual follicular units and that these units should be used in large numbers. The paper details the advantages of using follicular units exclusively in the restoration and introduces the term “follicular unit” into the hair transplant literature. Follicular Transplantation
1996
Bernstein (ISHRS, Nashville)
“Follicular Transplantation”
Importance: Presented the theoretical basis of follicular transplantation and showed clinical results of using Follicular Transplantation in large sessions.
Seager (ISHRS, Nashville)
“Dissection with binocular Stereoscopic dissecting Microscope”
Importance: Helped to popularize the use of the microscope by showing a video of microscopic dissection of follicular units.
1997
Bernstein and Rassman (Derm Surg)
“Follicular Transplantation: Patient Evaluation and Surgical Planning”
Importance: Details the management of the patient using follicular transplantation including “Diffuse Alopecia.” It explains how to identify, at a young age, those who would not be good candidates for surgical hair restoration in the future. Patient Evaluation and Surgical Planning
Bernstein and Rassman (Derm Surg)
“The Aesthetics of Follicular Transplantation”
Importance: Aesthetic issues including hair distribution, hairline design, crown restoration, and racial variations. These pared articles have been referred to as the “Bibles” of Follicular Unit Transplantation.” They established the foundation for the art of using follicular units in surgical hair restoration. Aesthetics of Follicular Transplantation
Bernstein (ISHRS, Barcelona)
“The Art of Follicular Transplantation”
Importance: Quantified the clinical characteristics of follicular units and described the art of weighting and distribution of follicular unit implants for the best cosmetic results.
Bernstein-Beehner-Arnold (ISHRS, Barcelona, Spain)
“Which Is Best?”
Importance: Bernstein debated the advantages of Follicular Unit Transplantation over Total Micrografting and Blend techniques in front of 450 hair transplant surgeons at the international meeting. This debate put FUT firmly on the map.
1998
Bernstein et al. (Derm Surg)
“Standardizing the Classification and Description of Follicular Unit Transplantation and Mini-micrografting Techniques”
Importance: Bernstein leads a group of 21 hair transplant surgeons to establish a nomenclature and standards for describing small graft transplants. It specifically serves to differentiate the technique of follicular unit transplantation from mini-micro grafting cut to size. The name Follicular Transplantation is changed to the more descriptive Follicular Unit Transplantation. Standardizing Hair Transplantation
Bernstein and Rassman (Derm Surg)
“Dissecting Microscope versus Magnifying Loupes with Transillumination in the preparation of Follicular Unit Grafts”
Importance: The first bilateral controlled study quantifying the advantage of the microscope in follicular unit graft dissection.
Bernstein – Unger (ISHRS, Washington, D.C.)
“Standard Grafts – Is there a place?”
Importance: Bernstein debated the advantages of Follicular Unit Transplantation over large-grafts hair transplant techniques at the ISHRS for an audience of hair restoration surgeons from around to world. He argued that the versatility and naturalness of this new hair replacement technique rendered the older, large-graft procedures obsolete. Hair Transplant Debate
1999
Bernstein and Rassman (Dermatologic Clinics)
“The Logic of Follicular Unit Transplantation”
Importance: The first monograph on the rational behind both the conceptual and
technical aspects of Follicular Unit Transplantation. The Logic of Follicular Unit Transplantation
2002
Bernstein and Rassman (Dermatologic Surgery)
“The Art of Repair in Surgical Hair Restoration – Part I: Basic Repair Strategies; Part II: The Tactics of Repair”
Importance: These paired articles defined the state-of-the-art in correcting the cosmetic problems that resulted from outdated techniques and/or poor surgical planning. Basic Repair Strategies Tactics of Repair
Rassman and Bernstein (Dermatologic Surgery)
“Follicular Unit Extraction: Minimally invasive surgery for hair transplantation”
Importance: This paper introduced Follicular Unit Extraction into the medical literature and was instrumental in popularizing the procedure in the United States. The paper also identified significant patient variability and describes a test to help determine which patients are appropriate candidates. Follicular Unit Extraction