Hair Plugs vs. Hair Transplant: What You Need to Know

Wondering about the differences between hair plugs versus hair transplants? We’ve got you.

For starters, hair plugs are actually an outdated type of hair transplant that’s no longer performed (at least not by reputable clinics). However, many people still get plugs confused with modern hair restoration techniques.

We’ll cover the differences between hair plugs and more advanced hair transplant procedures, like follicular unit extraction (FUE) and follicular unit transplants (FUT). Let’s get started.

The origins of hair transplantation date all the way back to 1930s Japan. That’s when a dermatologist named Dr. S. Okuda described using skin grafts to move hair from the back of the head to sparse areas of the eyebrows, mustache, and scalp.

In the early 1950s, Dr. Norman Orentreich (sometimes referred to as “the father of hair transplantation”) performed the first hair transplantation surgery specifically for treating male pattern baldness using hair plugs.

Dr. Orentreich also established the idea of “donor dominance.” This is the ability of transplanted hair to retain characteristics of the donor site (the part of the head where hair is taken from), even after being moved to a different area of the scalp.

Dr. Orentreich was the first to articulate that hair that grew normally on the back and sides of the scalp will continue to grow when transplanted to a balding area.

The term “hair plug” is no longer used medically, as the procedure is obsolete. This type of hair restoration stopped being performed sometime in the early aughts, but it’s not uncommon to hear people confuse hair plugs and hair transplants.

So, what are hair plugs, exactly — or what were they?

Hair plugs are a type of hair transplant procedure that involves punching small circles of hair from the back and sides of the scalp and transferring them to areas of the scalp where there’s thinning or balding.

These circular sections were about four millimeters in diameter and contained about 10 to 20 hairs. They were referred to as “plugs” because they were essentially plugged back into the scalp.

Like a modern hair transplant, these plugs contained a person’s existing hair (as opposed to artificial hair), but they looked unnatural due to the irregular spacing and clusters of hair (called groupings).

Hair plugs often produced an unnatural hairline. They were sometimes described as having a “doll look” due to the areas of visible scalp between each graft, like a doll’s hair.

Hair transplant procedures have come a long way, and modern-day hair transplants look natural with minimal scarring.

How does a modern hair transplant work? The two most common types of hair transplants are called follicular unit transplantation (FUT) and follicular unit extraction (FUE). We’ll explain each below.

FUT Hair Transplant

FUT is the older of the two procedures, and it’s sometimes referred to as the “strip method.”

During an FUT transplant, a strip of hair and skin is removed from the side or back of your head. The strip is placed under a microscope, and individual hair follicles are removed and then transplanted into areas of your scalp where hair is thinning.

Research shows that hair follicles transplanted using FUT have a higher survival rate than those transplanted using the FUE method.

But a downside of FUT is that it creates a more prominent linear scar on the back of the head. Also, the recovery time is generally longer.

FUE Hair Transplant

FUE is a more recent advancement in hair restoration surgery. Unlike the FUT method, which involves removing an entire strip of the scalp, the FUE technique focuses on extracting individual hair follicles, also known as follicular units.

During an FUE procedure, the surgeon makes tiny holes (called micro-punches) to remove the hair follicles. After the follicles are extracted, they’re transplanted to areas of the scalp experiencing hair thinning.

Some FUE procedures are done using special instruments or even robots. One of the most common is a semi-automated FUE procedure called NeoGraft.

For a much deeper dive, check out our guide to FUT versus FUE hair transplants.

Looking for a quick read on the differences between hair plugs and hair transplants? Check out the list below.

• Time. Hair plug procedures took place over many weeks. A very old 1971 study describes the process as taking 16 weeks to complete, with plugs being added on a weekly basis. Modern hair transplant techniques typically take four to eight hours.

• Scarring. FUE leaves tiny scars that are barely visible, especially as the hair grows, while FUT leaves a thin linear scar that’s also easily hidden. Hair plugs produced more obvious scarring.

• How natural the hair looks. As mentioned, new hair transplant methods deliver much more natural-looking hair density and hairlines. Because of the irregular spacing and multiple hairs per graft, hair plugs tended to look conspicuous.

• Recovery. Hair plugs required larger circular hair grafts, which left behind bigger wounds. For this reason, the healing time for hair plugs was longer, and patients sometimes experienced complications like excess bleeding or scarring.

• Success rates. Modern hair transplants have a very high success rate for “properly screened and evaluated patients.”

• Availability. Hair plug procedures are no longer offered, so the only option is the more natural-looking (and more successful) modern hair transplantation procedures like FUE and FUT.

You can learn more about what to expect post-op in our guide to hair transplant recovery timelines.

Some men who got hair plugs a while back may not be satisfied with the results of their dated hair implants — especially once they see how much more natural modern-day hair transplants can look.

So, can you replace hair plugs with one of the newer technologies like FUE or FUT?  Yes — in many cases, you can.

When it comes to re-doing a hair transplant, the main consideration is whether there are enough donor follicles left to complete another transplant.

“Overharvesting” is the excessive removal of hair follicles during hair transplantation. Basically, it’s when a surgeon takes too many follicles from the donor site.

Overharvesting can result in thinning or scarring in the area where the hair is taken from. More to the point, it can leave patients without enough healthy follicles remaining when it comes time to do another hair transplant.

If that’s the case, a skilled transplant surgeon will know this before booking your surgery and advise against the procedure.

When hair growth treatments like minoxidil and finasteride haven’t worked, you might consider hair surgery. But which type?

Here’s the scoop on hair plugs versus hair transplants for thinning hair:

• Hair transplantation has evolved a lot since the early days of hair plugs, when it often produced unnatural results and required a lengthy recovery. Today’s methods, like FUE and FUT hair transplants, offer more natural-looking outcomes with minimal scarring and a shorter recovery time.

• Hair plugs — now an obsolete technique — involved transplanting large grafts that often led to visible scarring and an unnatural doll-like appearance. More advanced procedures move individual follicles and precisely insert them into areas with thinning, giving a much more natural appearance.

• For those who aren’t happy with older hair plug procedures, modern hair transplant techniques can provide improved results. However, success of a revision transplant depends on the availability of healthy donor hairs.

To learn more about hair transplants, check out our guide to hair transplant surgery for Black men.

Not sure if a hair transplant is right for you and want to explore other hair loss treatments? Start with our free online consultation. We’ll connect you with a healthcare provider who can recommend medications and other treatments to support healthy hair growth.

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.