The ideal outcome of a hair transplant procedure should be seamless and natural-looking, with an experienced hair surgeon using the right tools and technique. The outcome could be ineffective, though, if any of the aforementioned requirements are not met. Unluckily, this problem has affected a lot of men, both famous and not. However, the increased scrutiny brought on by public attention can encourage a desire for more covert methods and subtle outcomes. This may be challenging with older procedures like scalp reduction and flap surgeries.

In the 1980s, a common restorative procedure was scalp reduction, a technique no longer used by hair transplant surgeons today. It required the surgical removal of bald patches on the scalp. The two ends on either side were stretched and stitched together after the bald scalp skin was removed. This was done to lessen the surface area of bald spots brought on by androgenic alopecia, or male pattern hair loss.

The cutting, stretching and pulling involved in scalp reduction resulted in common side effects such as a loss of tightness in the scalp, creating a “stretch back” effect and visible signs of baldness, as well as hypoesthesia around the excision area and stretched skin around the sutures. Another typical side effect of the procedure is isolated patches of baldness.

The traditional method of FUE is to remove each individual hair follicle with a punch tool from the back of the head, but this method is ineffective because of the natural thickness of the native hair there, which can look harsh on the temple and hairline, as well as the scarcity of available hair in that region. The ideal solution would be to supplement the donor supply with hair from a non-head location that matches the intended recipient area. However, due to the angle of growth in non-head locations, such as the nape of the neck, beard, torso, leg, etc., the majority of basic FUE tools have difficulty safely extracting such hair. For such a procedure, a more sophisticated tool would be required, one that could remove all hair types from all hair locations.

Due to the severe curves of afro-textured hair beneath the skin, which straight, cylindrical punches frequently find difficult to safely extract, black celebrities may be at a disadvantage when undergoing hair transplant procedures. The difficulty of removing these grafts from the surrounding skin is frequently made worse by the tough skin texture and strong tissue attachments to follicular units. A strip of scalp with hair is removed from the back of the head during the FUSS hair transplant procedure. Then, hair follicles are removed from this strip of scalp and inserted into the balding areas. The linear scar created by the excision is visible with short hairstyles and has a propensity to stretch downward, which is a disadvantage of this method. Due to the linear-scar free method of FUE, FUSS is no longer as popular as it once was, but some African-American men may choose the former due to the negative history of black FUE procedures.

Potential remedies for patients with afro-textured hair are now available thanks to new developments in hair transplant technology. One such development is the recently performed world’s first ultrasonic hair transplant on a patient in the aforementioned category. A curved, sharp punch made for afro-textured hair was used in conjunction with ultrasonic frequencies that were specifically tuned for the patient’s skin tissue to make it easier to remove the curly hair grafts from the hard skin and sturdy attachments.

For a more effective, discrete procedure—perfect for public figures and people who can’t take time off from work after the procedure—ultrasound can be used in FUE in conjunction with other non-rotary tools, such as one designed for unshaven hair transplants.