The first record of a successful hair transplant was in 1822, when a German medical student named Diffenbach performed an experimental surgery on himself and his mentor Dr. Dom Unger, they used hair from one area of a patient’s scalp and transported it to another area1.
The first modern surgical technique was described in 1939 by a Japanese dermatologist named Dr. Shoji Okuda. Dr. Okuda published what became known as “The Okuda Papers” in the Japanese Journal of Dermatology and Urology, describing his technique, full-thickness grafts of hair-bearing skin from hair-bearing areas to hairless areas to correct hair loss on the scalp, eyebrows and upper lip. These papers did not gain notoriety until 2003 when Dr Yoshihiro Imagawa was able to translate them for English speaking audiences post World War II2. In 1952 an American Dermatologist named Dr Norman Orentirech performed the first modern-day hair transplant in New York3. Dr. Orentreich was able to publish his work in 1959 in the Annals of the New York Academy of Science and it is this work that underlies all modern hair restoration endeavours. The paper presented the concept of “donor dominance” and “recipient dominance” for the first time. This was significant as the donor dominance concept explained the contradictory results of many previous hair transplantation studies.
Nonetheless, it wasn’t until mid-1990 that surgical hair restoration came out of the dark ages to yield actual ‘natural hair’ resembling results. This is due to the introduction of follicular unit micrografting or follicular unit transplantation (FUT). This has made follicular unit extraction hair transplantation a virtually undetectable, practical option for many hair loss sufferers.
TORONTO HAIR TRANSPLANT PIONEERS
Toronto, Ontario, in particular, has seen its fair share of pioneering hair transplant surgeons. One of the first is Dr Walter P. Unger. Dr Unger is a clinical professor of Dermatology and Director of the Dermatologic Surgery Fellowship Program at Mt. Sinai School of Medicine in New York, as well as a Director of the Fellowship Program for the International Society of Hair Restoration Surgery. He is an associate professor (Dermatology) at the University of Toronto. He was the adjunct professor (Dermatology) at Johns Hopkins School of Medicine in Baltimore, Maryland from 2003 to 2007. He has private practices in Toronto and New York City4.
Dr Unger advanced Dr Orentreich’s principle of “donor dominance” in 1994 by helping shape surgeons’ understanding of the limitations of the donor area from which hair follicles are harvested. He was the first surgeon to define the parameters of what he defined as the “Donor Zone”, the zone from which the most permanent hair follicles can be extracted for transplantation. We know that transplanted hair will only last in its new site for as long as it would have lasted in the original one. These findings from Dr Unger continue to serve as the groundwork for hair follicle harvesting on which both FUT and follicular unit extraction (FUE) are based.
In 1995, Dr Unger was presented a Golden Follicle award for clinical expertise from the International Society of Hair Restoration Surgery (ISHRS)5. In October 2003, Dr Unger also won the Pioneer in Education Award-Hair Restoration from the ISHRS5. In 2007 and 2001 he won the Teacher-of-the-Year, Department of Dermatology, Mt. Sinai Medical School, New York and is considered one of Castle Connolly’s “Top Doctors” in New York Metro Area starting from 2007 to the present.
Dr Mark Unger is another independent practitioner of hair restoration surgery. He was a co-editor for Hair Transplantation, 5th Ed., the reference textbook in the field of hair transplantation. He is also a fellow of the International Society of Hair Restoration Surgeons. Additionally, he authored chapters on Hair Transplantation in major cosmetic surgery and dermatology textbooks. He also practices hair transplants in Toronto, Canada.
Dr. David J. Seager, is one of the true pioneers of Toronto hair transplants, his reputation as a truly innovative hair transplant pioneer is well known within the hair restoration world. He was the first to perform high density “one pass” sessions in the mid to late 1990s. The high-density sessions means an excess of 3,000 grafts at a time. Dr. Seager and his staff also pioneered what would become known within the hair transplant community as “Ultra Refined Follicular Unit Hair Transplantation”. So the Dr. Seager signature hair transplant was 3,000 graft densely packed “One area – One session”, then the Follicular Unit Micrograft Hair Transplant procedure was turned into a team effort, so the grafts were immediately placed into the incision after the tiny needle incision was made6. This technique is referred to as “stick and place” technique. This technique is ideal as it enables the staff to use smaller and less invasive needles for the incisions. It is easier to place a small graft into a small incision if it is a fresh incision. In October of 2001, Dr. Seager was honoured with the Golden Follicle Award by the ISHRS in recognition for his many clinical contributions to the field of hair transplantation5. Additionally, other well-known hair transplant surgeons from around the world have chosen to travel to Toronto to have Dr. Seager perform their own personal hair transplant procedures. Dr. Seager passed away in December 2006.
The City of Toronto for a Hair Transplant
Toronto, Ontario is a good city to choose to undergo a hair transplant. There clearly is a strong history of pioneers in the hair transplant industry and hair transplant doctors are well experienced. If you are planning on coming into the city from out of town, hotels and amenities are close and affordable. Additionally, welcoming over 40 million visitors annually, Toronto is the leading tourism destination in Canada7. Toronto is a bold, dynamic city that offers excellent attractions, music and events backed by the best convention and sports facilities in Canada.
- Historical Overview: 181 Years of Hair Restoration Surgery [Internet]. [cited 2018 Jan 29]. Available from: https://www.ishrs.org/mediacenter/media-history.htm
- Jimenez F, Shiell RC. The Okuda Papers: an extraordinary – but unfortunately unrecognized – piece of work that could have changed the history of hair transplantation. Exp Dermatol. 2015;24:185–6.
- The father of Hair Restoration. Dr. Norman Orentreich, 1953.| New Orleans, LA [Internet]. Hair Transplant & Hair Restoration Ctr | New Orleans, LA. 2016 [cited 2018 Jan 30]. Available from: https://gulfcoasthairrestoration.com/the-father-of-hair-restoration-dr-norman-orentreich-1953/
- Toronto 5 Burton Rd, Maps OCP-9393 S map: G. Walter P. Unger, MD | Hair Loss Doctor Toronto | ISHRS [Internet]. [cited 2018 Jan 29]. Available from: https://www.ishrs.org/users/wung
- ISHRS Past Award Winners | International Society of Hair Restoration Surgery [Internet]. [cited 2018 Jan 30]. Available from: https://www.ishrs.org/members-only/ishrs-past-award-winners
- Dr. David Seager has passed away but his legacy remains. | Regrow Hair Q&A [Internet]. [cited 2018 Jan 30]. Available from: https://www.regrowhair.com/hair-restoration-physicians/seager/
- Tourism [Internet]. City of Toronto. 2017 [cited 2018 Jan 30]. Available from: https://www.toronto.ca/business-economy/industry-sector-support/tourism/
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