What is The Difference Between Hair Plugs and Hair Transplants?

Posted on April 3, 2023

If you have researched hair restoration, you may have come across the terms “hair plugs” and “hair transplants”. However, what is the difference between these terms, and which technique is best suited for optimal results? Read on to learn more regarding this topic.

Hair Transplants

Hair transplantation involves moving hair from one area where an individual has a lot of hair (donor area) to another area where hair is needed (recipient area). In modern hair restoration, the term used for hair bundles when referring to hair transplantation is called a follicular unit. A follicular unit, as defined by Headington, is essentially a group of hairs bundled together consisting of 1, 2, 3, or 4 hairs in the unit. Certainly, follicular units can contain a few more hairs such as 5 or 6 hairs in a unit, but once over that number of hairs, one usually can identify two follicular units arranged next to each other. He also stated that the distance between two individual follicular units is about 1 mm.

The photograph below is a close-up of the scalp. As shown, there are 1-hair follicles, 2-hair follicular units, 3-hair follicular units, and multiple follicular units next to each other.

Gabel Center Close up of the scalp

Hair Plugs 

Hair plugs refer to a very large section of the scalp, usually 4 mm or larger in size, containing 4-20 follicular units in one graft. Hair restoration surgeons should not transplant plug grafts anymore because that will give an unnatural “doll head” appearance to the result. The doll’s head appearance forms because there are large spaces between the plugs mimicking a doll’s head. Unfortunately, some physicians still practice this outdated technique. 

Choose Hair Transplant for The Best Results

To summarize, modern hair restoration techniques involve transplanting individual follicular units from one area of the scalp to another. Done correctly, this will give the most natural appearance to the hair restoration result as this mimics the way hair exists on the scalp. Done incorrectly, it will result in a very poor transplant.  

Schedule a Consultation 

To learn more about the science and art of hair restoration, contact Dr. Gabel at (503) 693-1118 or send us a message online to schedule an appointment. As a highly skilled hair transplant surgeon, Dr. Gabel is here to assist you with your hair restoration goals.


Reference: Headington, J.T. Transverse microscopic anatomy of the human scalp. A basis for a morphometric approach to disorders of the hair follicle. Arch Dermatology. 1984(Apr); 120(4):449-456.

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