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What men will do for a few more strands of hair

Recent changes in transplant surgery have led to more natural-looking results and a boost of self confidence for some balding men.

Hair transplants are one of the top five cosmetic procedures for men in the U.S., with more than 19,000 performed last year, according to the American Society for Aesthetic Plastic Surgery. But is it worth it? As part of a three-part series on hair loss, “Today” spoke with two men who underwent the procedure.

Allen Appleblatt has made a big change in his life.  He works out, spends time with family and stays busy with work. And when it comes to his appearance, he's feeling good about his new head of hair.

“I kind of felt like I was an idiot looking at myself in the mirror,” said Appleblatt. “Whenever I took a shower, at the end of the shower I found a clump of hair at the bottom of the drain. And there was no way of stopping it.”

So Appleblatt had two hair transplants. His partner, Shirley Garofano, likes what she sees.

“I liked him both ways. But I like him better now. He looks great, he’s very positive, he’s happier,” she said.

Happier, but he still wants thicker hair. “Today” followed him while he underwent his third hair transplant, taking advantage of the latest techniques.

“Over the past 10 years we've developed a new procedure called follicular unit transplantation, where hair is transplanted exactly the way it grows,” said Dr. Robert Bernstein, an associate clinical professor of dermatology at New York's Columbia University.

This new technique replaces the plugs — groups of hairs inserted into round holes in the scalp — used in the early days of hair tranplant procedures. It is now known that hair grows in groups of one to four hairs.

“So follicular unit transplantation is a transplantation of hair in its naturally occurring groups,” said Bernstein. “We're really just transplanting the root.”

Appleblatt is given valium and local anesthesia, and then a donor strip is removed from the back of the head where hair is not genetically programmed to fall out.

“We have a team of people dissecting the grafts. They divide it into individual follicular units,” said Bernstein.

The units are then transplanted into the balding area. And 10 to 12 months later, the new hair will be in place.

“You don't really feel anything, just a little pressure,” said Appleblatt of the procedure.

Jeff Rosen, 40, is undergoing his fourth procedure with Dr. Walter Unger, in part, he says, to correct the appearance of past transplants done by another doctor.

“I know that this for me has created a natural look that I've been very happy with,” said Rosen. 

In previous sessions, he had a mixture of grafts to produce greater density and to better camouflage the plugs from his original transplants.

“I used something more than a follicular unit,” said Unger. “I used some grafts that were bigger than that, some that had two follicular units, some that had three, even some small round grafts.”

As with any surgery, there is a risk of complications, such as infection or post-operative bleeding. And not everyone is a good candidate, including people prone to bad scarring or those who have especially large bald areas. Still, doctors are quick to point out just how far they have come.

“Over the past 10 years, we're doing more and more grafts per session, with more and more likelihood that they all grow,” said Unger.

Great news for guys like Rosen and Appleblatt, who are no longer forced to watch their hair — and confidence — go down the drain.