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Thinking about surgery?

We've all seen them, those thick plugs of hair, stuck into balding scalps like seedlings in a tree farm.

Practitioners of hair surgery insist, however, that the only transplants that get noticed are the botched jobs.

"When I started doing this, other doctors said, "How could you get involved with those things? They're so ugly,' " recalled Dr. David Burton, a Clearwater plastic surgeon who traded cleft palates and tummy tucks for hair transplants after undergoing the process himself.

Two basic changes have improved the looks of hair transplants in recent years. First, surgeons are now transplanting as little as one hair at a time, to better simulate how hair really grows.

Second, they've improved how the donor hair is harvested from the back of the head. Instead of punching out plugs, which left unsightly scars, thin strips of hair are now removed and then divided. The incision is stitched up carefully, leaving a barely visible scar.

Furthermore, practitioners of hair surgery are taking action to improve their image as medical professionals. The first meeting of the International Society of Hair and Scalp Surgeons was held last month in Texas, where surgeons from as far as Australia gathered to share their knowledge.

"It was the first time the real doctors involved in this got together, not just the clinics that are only trying to make money," Burton said.

Still, he cautioned that prospective patients need to shop very carefully for a surgeon in a procedure that is more art than science. Only doctors can perform transplants, but there is no board certification in the field, and training varies widely. Horror stories abound of men who wound up with bizarre-looking hair and even severe scarring because of an unskilled surgeon.

Satisfied patients report that the new procedure not only looks better, it involves less post-operative pain. Bandages aren't even required in many cases.

"I've had five surgeries," said WTSP-TV newscaster Al Ruechel, who recently went to Burton for minigrafts to soften thick plugs along his hairline from a previous surgeon's work.

"The first one was in 1988. They knocked me out with gas and gave me massive painkillers (after the surgery). The last one, I think I took two Tylenol."

Transplants have helped Ruechel keep a neat, groomed appearance on camera, where bright lights can accentuate even mild hair loss.

"When you're doing a standup (camera shot) on Clearwater Beach and the wind blows, it's hard to hide a bald spot," Ruechel noted.

Otto Diekmann, a Boca Raton mortgage broker, says his job had nothing to do with his decision to get a hair transplant. He just wanted to look younger.

Diekmann said he'd been parting his hair lower and lower until somebody anonymously sent him a brochure advertising Dr. Constantine Chambers, founder of the Chambers Hair Institute in Clearwater and 12 other cities, including Athens, Greece.

Chambers crafted a tidy, natural-looking hairline for Diekmann where there once had been just wisps.

"Other than maybe boosting your self esteem a little bit, it's always nice if I mention my age (54) and someone says, "Gee, you don't look that old,' " Diekmann said.

George Chambers, Chambers' son and marketing director, said most men should expect to pay between $2,000 and $15,000 for transplants, depending on how many they need.

Like Burton, he said that prospective patients should visit several doctors, look at the results (in person, not in photos), and find out approximately how many sessions will be needed and what the total cost should be.

Women are also getting transplants, although the process is more difficult for them. Men's hair loss tends to follow a pattern, where a woman's hair loss usually occurs all over her head, making it harder to fill in the bald spots.