Hair Plugs: How has Hair Transplantation Evolved?

transplanted hair plugs
  1. What are hair plugs?
  2. Does this treatment still exist?
  3. The differences between hair plugs and modern day hair transplantation methods
  4. Can you switch from hair plugs to a modern hair transplant?

Today’s hair transplant technology has the power to restore patients’ hair with natural, seamless results — but it wasn’t always this way.

Anyone affected by hair loss before modern techniques became available had fewer options, and the results of their surgery would be far less impressive than we expect now.

One of the most well-known forms of hair transplant surgery involved “hair plugs”, and some people still (incorrectly) use this term when discussing hair transplants today.

But what is this method, when were they invented, and how has hair transplantation evolved since?

What are hair plugs?

The “hair plugs” technique was one of the earliest types of hair transplant, created in the 1950s. The first procedure was performed by Dr. Norman Orentreich, a dermatologist based in New York.

Dr. Orentreich also worked with Estée Lauder on developing its Clinique skincare products in the ‘60s and ‘70s, but his restoration surgery is generally what he’s best known for.

His technique involved extracting tiny, round portions of skin and hair follicles from the back of the head. These would be inserted into one or more balding areas on the scalp to restore growth.

This method was revolutionary at the time, but the results were less than impressive in some cases.

This photograph, depicting a hair transplant performed in 1965, shows the noticeable distance between the “plugs”.

hair plugs method by dr Norman Orentreich

As hair loss expert Spencer Stevenson told The Telegraph, “the transplanted hair would grow bunched together in unnatural looking groups, spaced unnaturally apart, rather than blending in with your remaining hair.”

This lack of precision led to uneven, inauthentic growth that could be compared to the fake hair inserted into a doll’s head.

transplanted hair plugs

Does this treatment still exist?

You may still find surgeons performing hair plug transplants but they’re simply not worth considering — you have much more effective options to choose from instead.

This method is outdated and unnecessary: it’s highly likely that patients would find the results disappointing compared to those that can be achieved through more advanced treatments.

What are the differences between hair plugs and modern day hair transplantation methods?

The three main options available to people experiencing hair loss today are:

  • FUE
  • FUT
  • Stem cell hair transplant

Let’s take a close look at each:


Follicular Unit Extraction (FUE) is the most popular technique today. This is a minimally invasive solution for different types of hair loss, from mild hairline recession to male or female pattern baldness at an advanced stage.

How does it work?

FUE hair transplant involves carefully extracting donor hair follicles from the back and sides of the scalp with a micropunch. These are prepared for implantation before being inserted into the target areas with great care.

What results can you expect?

This kind of hair transplant typically create natural hair growth that blends seamlessly with surrounding hair. Surgeons aim to match the growth pattern as accurately as they can for maximum satisfaction.

What are the potential side effects?

  • Swelling
  • Bruising
  • Itching
  • Bleeding

How much does it cost?

The surgeries in the UK can start from around £3,300 and continue up to £15,000 depending on the number of grafts required. But more competitive hair transplant prices are available at reputable clinics offering treatment outside the UK.


Follicular unit transplantation (FUT) is a less popular option than FUE but still widely available.

How does it work?

During an FUT procedure, a surgeon will cut a strip of skin from the back of the head and harvest its follicles. They will implant these into incisions on the scalp’s balding areas.

What results can you expect?

FUT should provide a satisfactory standard of hair growth and coverage in thinning/balding areas. However, it will leave a visible scar on the back of the head that you may feel unhappy to show off.

In this case, you would need to grow your hair to cover the scar, which may limit your freedom to wear your hair exactly as you want to. 

scarring in the donor area after FUT hair transplant

What are the potential side effects?

  • Swelling
  • Bruising
  • Follicular inflammation
  • Bleeding
  • Numbness

How much does it cost?

FUT procedures are typically cheaper than FUE and stem cell hair transplants, as they’re quicker and easier to perform.

This method in the UK is available for between around £3000 to £12,000, though the costs may be higher based on the extent of work involved and the clinic’s rates.

Stem cell hair transplant

This technique is one of the most advanced on the market, but it’s still in its infancy — which may put some prospective patients off.

How does it work?

Stem cells will replace damaged or diseased cells to help tissue and organs function properly.

During this kind of hair restoration, a surgeon will take stem cells from hair follicles via a punch biopsy. This requires a cutting-edge tool capable of removing a tissue sample with incredible precision. 

This tissue sample will be inserted into a centrifuge to separate the stem cells from the skin. These isolated cells will be injected into one or more areas affected by hair loss. These will replace hair follicles that no longer produce hairs and cultivate new growth on the scalp.

What results can you expect?

The results appear to be similar to those achieved with FUT or FUE. One study found that hair density increased by 29 percent within six months of treatment.

What are the potential side effects?

  • Scarring
  • Bleeding
  • Swelling

How much does it cost?

Little information on this kind of hair restoration costs is available at the time of writing, but one procedure covered in the media was priced at £2,000.

Can you switch from hair plugs to a modern hair transplant?

Old hair plugs can be removed surgically and replaced via an FUE, FUT, or stem cell hair transplant procedure.

Patients who have undergone a hair plug treatment will be astonished by the difference in their hair growth following a more advanced procedure. The hair will look more natural and blend with existing hair on the back and sides of the scalp.

If you have hair plugs that you’re unhappy with, you may want to book a consultation at a hair clinic to discuss your options. A skilled surgeon should be able to transform your hair with a state-of-the-art technique.


What does it mean?

The term “hair plugs” refers to an outdated hair transplantation technique: transplanting round pieces of tissue and hair from one area of the scalp to another. The results were largely unnatural, unconvincing, and far inferior to those that can be achieved today.

How does the process work?

The hair plug process involves removing multiple plugs of tissue and hair from areas with healthy growth, and inserting them into thinning/balding spots.

What is the main difference between this and modern day hair treatments?

The main difference between hair plugs and modern hair transplant treatments is that results are now far more natural. The unnatural spacing and lack of cohesion in hair plug procedures was known to create an effect similar to fake hair inserted into a doll’s head.