The Tamura,Sasakawa and Fujita
Dr. Masao Sasakawa appears to have been the earliest of the 
Japanese hair pioneers. Born in Tochigi in 1887, he graduated from the Tokyo University School of Medicine in 1912.
By 1916 he was Professor of Dermatologyat Nagasaki University. From 1919 to 1922 he studied abroad in Switzerland, Paris, Austria, Germany, England, and the USA, so he must have beenreasonably competent in the German, French, and English languages. He was appointed Professor at Keio University School of Medicine in 1922 but died of a urological disease in 1932 at only 45 years of age.
■The Published Work of Dr.Sasakawa
Concerning hair grafts. Japanese J of Dermatol and Urology. Vol. 30, No.5, p. 76 (May 1929).
Dr. Masao Sasakawa summarized hair implant experiments in the past dating back to 1875 and reported on his own experiments on this subject.
Method: Using a specially designed needle he inserted doubled-up hairs deep into the subcutaneous tissues and allowed them to become fixed by the connective tissue for a period of up to 10 months.
Subjects:1 case of “malignant total alopecia” (? Alopecia totalis) and 2 cases of cicatricial alopecia were included.
Results: Dr. Sasakawa was surprised at the adhesive strength of the implanted hairs. Some required up to 80gm tension before removal compared to the average of 52.3gm for normal Japanese hairs.
Experiments with human female hair in rabbits showed less cellular infiltration than expected and poor fixation. He concluded by saying that if the method could be further improved, it would become a promising and interesting method of cosmetic dermatology.
Dr. Hajime Tamura was born in Ibaragi in 1897. He graduated in 1923 from Keio University School of Medicine and was Professor of Urology at Tokyo Women’s Medical College in 1937 at the time that he reported on transplantation of pubic hair in women.
Once becoming Professor at Keio University in 1944, he appeared to lose interest in such matters but he lived on well into the age of hair transplantation in the West, dying on January 28, 1977.
■The Published Work of Professor Tamura
1. Concerning hair transplantation of pubic hair.
Japanese J of Dermat and Urology. Vol. 41, No.4, p 597 (1937)
This was a brief report of a paper that was presented to the 5th Kanto-Tohoku Joint Regional Convention at Kanazawa University on September 6, 1936. Dr. Hajime Tamura performed 127 cases of hair implants to the pubic region of women and 1 male over an 18-month period.
The donor material was shaved pubic hair and did not include the hair follicles. The source of the donor hair was unstated but presumably they came from cadavers or from other patients.
After implantation, the hairs were tied to adjacent pubic hairs in some unspecified manner.
Results were presumably given to the meeting but not reported in this Abstract.
He alludes to the poor results in a later paper.
2. Concerning hair transplantation (2nd report).
Japanese Journal of Dermatol and Urology. Vol. 53, No. 2, p. 76 (1943)
In this 2nd report Dr. Tamura stated that his earlier effort in 1937 to transplant individual hair fibers was not successful. The hairs seemed satisfactory for a few days but many became inflamed and infected while others developed sebum plugs.
Dr. Tamura reported on further experiments performed since 1939 in which he transplanted tiny, fullthickness
grafts of scalp tissue into regions of acquired hair loss in women.
Of these cases, 130 were for genital atrichia, 4 for scalp cicatricial alopecia, and 1 case each of eyebrow and axilliary atrichia. This method was based on the methods of Drs. Maeda and Okuda.
Method: A” spindle shaped “strip of donor scalp was excised and the subcutaneous fat was removed. The strip was dissected into small strips containing one or more hairs, making sure that there was some surrounding tissue still attached. For ease of handling, Dr. Tamura liked to leave 3 – 4mm of hair on each graft. After dissection, the grafts were immersed in saline until inserted into ” large calibre needle holes” or 1- 2mm circular holes that had been created with a small trephine. The area was covered with olive oil gauze and a bandage applied.
Results: Hair growth was noted ” sooner or later” and Dr. Tamura emphasized the importance of keeping the grafts small ” otherwise it grows brush-like and of unnatural appearance.”
He also stated that he usually used single-hair implants and, although it was a very painstaking procedure, the result was often so good it was indistinguishable from normal hair growth.
Dr. Keiichi Fujita was born in Fukushima and was a 1947 graduate of Tokyo University School of Medicine.
He became a Dermatologist and served at the Dermatological Department of Tokyo University Hospital from 1947-1957.
During this period, he was also working at the Tama Zensei Yen (Institute of Hansen Disease) where he did HT for reconstruction of eyebrows and published papers in 1953 and 1954. From 1957 he worked at the Japanese Army Medical Hospital and Medical College. Like Prof.
Tamura, he appears to have written no more papers on the subject although he lived on well into the age of hair transplantation in the West, dying in 1985.
■The Published Work of Dr. Keiichi Fujita
1. Brow plasty.
Published in the journal Lepra 22, Vol 4, p. 218 (July 1953)
Dr. Fujita, working at the Tama Sensei Yen Hospital, experimented with hair shaft implants and living hair follicle grafts from the scalp inserting them into patients who had lost eyebrow hair due to leprosy (Hansen’s Disease).
Dr. Fujita claimed almost 100% success when using single-hair autografts. He commented that although the eyebrow hairs grew long and had to be trimmed frequently, the growth rate weakened within a year and became more like eyebrow hair.
He also found that if the donor scalp tissue was kept in the refrigerator for 3 – 4 days, it would still give good results though not as good as when fresh.
2. Homologous punctiform living hair graft.
Published in the journal Lepra 23, Vol 6, p. 364 (November 1954)
Dr. Fujita, now at the Tokyo University Dermatology Department, described his experiments with hair transplants in humans using homografts and unspecified heterografts.
He described how the crusts fall off at 10 days as usually seen with autografts, but at 60-70 days the grafts suddenly suppurates and is expelled, leaving a depressed scar after healing is complete.
This occurred even in cases where donor and recipient had the same blood group.
■The individuals behind Translating the japanese Pioneer
Richard C.Shiell, MBBS Melbourne, Australia
■Yoshihiro Imagawa, MD
Yoshihiro was born in 1922 at Kokura, a suburb of what is now Kitakyushu City. He graduated from the Kyushu University Medical College in 1945.
For the next four years he worked in the OB-GYN Department of the Kokura City Hospital and gained his Board Certificate in 1950. He set up in private practice and at the same time commenced post-graduate studies in cancer research. He had married in 1947 and had four children by this time.
In 1962, Dr. Imagawa sat for and passed the U.S. examination for Foreign Medical Graduates and leaving his wife and children behind in Japan, became a $400 a month Resident in OB-GYN at St. Johnﾕs Episcopal Hospital in Brooklyn, New York. He returned alone to the United States again in 1968-69, this time to Mt. Sinai Hospital New York to become an Anesthesiology Resident. He sat for his Boards in Anesthesiology and was awarded his F.A.C.A in 1973.
This multi-talented man did further study in Cytologist in 1984 and today at the age of 82 still practices Obstetrics and Gynecology in his private clinic in Kokura, where he has remained for the past 52 years.
Yoshihiro claims to have learned English by watching American movies with his son Kenichiro in the years after the War.
This does not explain his considerable competence in the language and its complex spelling and grammar so one must suspect that this is somewhat of an exaggeration. Inspired to learn English by watching American movies is probably closer to the truth. A lot of hard study and practice must have surely been required to reach a level of literacy sufficient to work in New York City hospitals.
■Kenichiro Imagawa, MD
Kenichiro, the son of Yoshihiro, was born in 1948 and graduated from Keio University School of Medicine in 1974.
Kenichiro clearly remembers his father’s long absences from the family but he explains that this was a different generation.
Many men had been away at the War for long periods and women were used to managing alone in those days.
Ken followed his father into Obstetrics and was Board Certified in OB-GYN in 1980.
Later, seeking to make his own way in the world, Ken joined the staff of the Yokohama Plastic and Aesthetic Surgery Clinic in 1982 and became its Director in 1985.
He was a Foundation Member of the Japan Society of Hair Restoration Surgery in 1995 and became its President in 1998-99. He has been a member of the ISHRS since 1994 and now runs a first-rate hair transplant Clinic in Yokohama with a staff of 10 and using follicular unit transplantation methods exclusively.
Ken is married to Megumi and they have two children.
■Editor Emeritus’ Note.
This was a very far sighted observation as implants of artificial hair became very popular in the late 1970s.
They were eventually banned in 1984 in the United States because of the occasional severe reaction and infections. Although still far from perfected, they have been improved considerably over the past 20 years.
It has been reported that over a million artificial hairs of various types are inserted each week in countries other than the United States and Canada.
Hair Transplantation Forum International March/April 2004
