Hair Plugs: Procedure, Risks and Success Rates in 2023

  1. What are hair plugs?
  2. Is it still available?
  3. Hair plugs vs. modern techniques
  4. Benefits
  5. Side effects
  6. Are you a good candidate?
  7. Can you switch to a modern technique?

Hair plugs were a critical stage in the evolution of hair restoration procedures. Surgeons used this technique for decades after the late dermatologist Dr. Norman Orentreich created it in the 1950s. During the treatment, surgeons removed sections of hair and skin from the back of the scalp and implanted them into balding zones.

Hair transplantation has improved significantly since, and achieves more convincing, natural-looking results.

However, people may still refer to any type of modern hair restoration technique as “hair plugs” without realising that several options are available.

But are hair plugs still implanted into scalps today?

In this post, we’ll look at Dr. Orentreich’s pioneering work on hair plugs and why surgeons no longer rely on this technique.

How do hair plugs work?

When Dr. Orentreich implanted the first hair plugs in the 1950s, it was a huge step forward in hair restoration. But the results were generally unimpressive, especially when compared to the incredible feats that modern surgeons achieve.

Specialists punched out round pieces of skin (the “plugs”) containing multiple hair follicles from the back of the patient’s scalp. Each plug was approximately 4 millimetres across.

Surgeons then inserted the plugs into balding areas as needed: the more severe the hair loss, the more plugs required. However, this technique cultivated a hairline that looked unnatural and resembled a doll’s scalp.

Doctors continued to hone the process, though. Grafts became smaller over time, and led to more natural, realistic hair restoration. As a result, hair plugs were less popular by the start of the 21st century, and were replaced by the FUT hair transplantation method.

FUT involves cutting a section of skin from the rear of the scalp to extract its follicles, then preparing them for implantation into target areas.

FUE is an updated take on FUT, and tends to be the most popular of the two techniques.

hair plugs method by dr Norman Orentreich

Do surgeons still perform hair plug treatments?

Surgeons no longer offer traditional hair plugs — they’re likely to offer patients a more effective, reliable solution instead. The latest techniques offer crucial improvements, such as:

The shorter duration of modern hair transplant procedures is one of the most important improvements. Surgeons can complete today’s procedures within 4 to 8 hours (on average), whereas full hair plug implantation took around 16 weeks to complete in extreme cases.

Hair plugs vs. modern hair transplant techniques

Let’s explore the differences between FUT, FUE, stem cell hair transplants and hair plugs:


This method emerged in the mid ‘90s, and became a popular replacement for hair plugs at the start of the next decade.

Surgeons start this procedure by removing a strip of skin from the back of the head, then harvesting its follicles. They prepare these for implantation, then insert them into areas affected by hair loss.

Surgeons can create a more natural aesthetic by transplanting individual follicles instead of hair plugs. At UK clinics, this method tends to be cheaper and faster to complete — though specialists in Europe offer more competitive rates on FUE treatments.


FUE hair transplantation technique is a more modern hair transplant technique than FUT. Surgeons remove individual follicles directly from the scalp instead of taking a strip of skin. This reduces the risk of visible scarring.

FUE offers various advantages over hair plugs and FUT:

  • It’s an effective procedure for patients with lower hair density.
  • Recovery is more comfortable with less visible scarring.
  • The recovery period tends to be quicker.

The price of the treatment depends on multiple factors. However, with just a 2-hour flight to Budapest, you can save 70% of your hair transplant cost

Stem cell hair transplants

Stem cell hair transplantation is one of the newest methods available: a surgeon will remove a small sample of skin from your scalp and replicate its follicles in a sterile laboratory.

Research into the effects of this technique are ongoing, especially with regards to its safety. It’s likely that they will become more widely available and convenient in years to come.

Advantages of standard hair plugs

While hair plugs were groundbreaking when introduced, their value has diminished substantially since. Modern methods offer better results, a more natural aesthetic, and quicker recovery.

It’s likely that you’ll feel more satisfied with the way your hair looks after a modern hair restoration procedure than if you opted for a traditional hair plugs treatment.

What are the side effects?

Hair plugs were known for restoring hair with unnatural results, creating hair that resembled a doll’s. They also carried a greater risk of complications than modern techniques, such as:

The best hair restoration surgeons will discuss potential side effects during your consultation to help you make an informed decision.

How does hair replacement work

Who is the best candidate for a hair transplant?

Anyone affected by hair loss may benefit from a transplantation. Candidacy is based on:

Hair loss

Transplantation is effective for male or female pattern baldness (caused by genetics).

Health background

You should be free of conditions like HIV or diabetes, as they can affect your recovery and danger of infection.

Balding zones

Transplantation works best for balding at the front of the scalp, but can still be effective elsewhere.

Existing hair coverage

You should have enough healthy hair at the back and sides of the scalp for the surgeon to harvest the right number of follicles.

Hair colour and thickness

You may be a stronger candidate if you have dark, thick hair.


Your expectations should be realistic and well informed.


You shouldn’t be on medication that could disrupt hair growth (e.g. propranolol).

A comprehensive examination of your hair and scalp will determine if you’re a suitable candidate.

Check if you are a good candidate for a hair transplant!
Get a FREE hair analysis!

Can you change your hair plugs to a modern technique?

You may undergo one of the latest hair transplant procedures if you have enough follicles to harvest. Otherwise, surgeons may be unable to remove enough donor follicles without making your hair look thinner at the back and sides, or creating visible scarring.


Do hair plugs actually work? 

Generally, hair transplants achieve more success than hair-growth products purchased over the counter. However, it takes time: between 10 and 80% of transplanted hairs will grow back in full in around three or four months. This will become thinner over the years, like your existing hair.

How long do hair plugs last? 

It’s unlikely that you’ll see major changes in your hair growth within six months of undergoing a hair transplant, but the results should be visible after a full year. As healthy follicles are implanted into bald or thinning areas of the scalp, hair transplants typically last a lifetime.

Why are hair plugs bad?

Hair plugs have attained a poor reputation because they have created results that appeared unnatural: some patients’ scalps have highly visible follicles and resemble a doll’s head.

What is the difference between hair plugs and hair transplant?

Hair plugs and hair transplants may appear to be completely different treatments, but hair plugs are actually a type of transplant. The term “hair transplant” refers to procedures using implants to cover thinning or baldness. A hair plug is one type of implant, comprising a cluster of hairs.

HairPalace relies on scholarly sources, including peer-reviewed articles, as well as publications of medical associations and academic & research institutions. We follow strict sourcing guidelines and avoid tertiary references. Read our editorial policy for further information on how we keep our content up-to-date and accurate.
  • Garg AK, Garg S. Complications of Hair Transplant Procedures-Causes and Management. Indian J Plast Surg. 2021 Dec 31;54(4):477-482. doi: 10.1055/s-0041-1739255. PMID: 34984088; PMCID: PMC8719980.
  • Agrawal M, Lotti J, França K, Fioranelli M, Roccia MG, Lotti T. The evolution of artificial hair implantation. J Biol Regul Homeost Agents. 2017 APR-JUN;31(2 Suppl. 2):169-177. PMID: 28702978.
  • Epstein JS. Evolution of techniques in hair transplantation: a 12-year perspective. Facial Plast Surg. 2007 Feb;23(1):51-9; discussion 60. doi: 10.1055/s-2007-970164. PMID: 17330774.
  • Rousso DE, Presti PM. Follicular unit transplantation. Facial Plast Surg. 2008 Nov;24(4):381-8. doi: 10.1055/s-0028-1102902. Epub 2008 Nov 25. PMID: 19034815.