If you are experiencing hair loss and have sought advice from friends or professionals, chances are that one of them has suggested a hair transplant.
Considering that it doesn’t come cheap, it is advisable to understand the process, how it works and the implications which come along with it.
Read on as we dig deeper into the subject and answer some common questions about the procedure.
Table of Contents
Basic Concept Behind Hair Transplantation
Hair transplantation is a minimally invasive surgical procedure in which hair follicles are removed from one part of the head, also known as the donor site, and ‘planted’ on a bald or thinning part, also known as the recipient site.
Hair transplants are most commonly used to treat male pattern baldness in which men lose hair on the top and sides of the head.
This explains why surgeons typically select the back of the head as donor sites. It contains hair follicles that are genetically resistant to balding.
Who is qualified to perform a hair transplant?
Just because it involves your hair, it doesn’t mean your local barber can perform your hair transplant. Being a surgical procedure, only certain medical professionals are legally permitted to perform hair transplants.
Two medical specialists are the best choices.
The first is dermatologists because they have knowledge and expertise in trichology. The second is plastic surgeons because hair transplantation is cosmetic surgery.
According to Dr. Jeffrey Epstein, the ideal surgeon would also have additional, specific training in hair transplants and hair restoration in general.
Types of Hair Transplants
There are two main methods used in hair transplantation procedures, that is FUT (Follicular Unit Transplantation) and FUE (Follicular Unit Extraction). Let’s break them down further.
FUT ( Follicular Unit Transplantation)
FUT is the traditional and most common method used in hair transplantation. In this case, the surgeon removes a strip of tissue from the back or side of the head which is the donor site, and uses special equipment to wash it and separate it into grafts.
What is a graft?
Hair grafts are different from individual strands of hair. Hair naturally grows in groups of between 1 and 4 strands depending on the individual. It is these groupings or tiny bits of tissue that are referred to as hair grafts.
The surgeon uses a blade or needle to make tiny incisions on your scalp and proceeds to transplant the separated grafts in each incision. The surgical site is then covered with gauze to allow it to heal.
FUE (Follicular Unit Extraction)
FUE is a somewhat more modern technique. With hair on the donor site shaved, the surgeon cuts out individual grafts by making circular incisions around each graft. These are then transplanted onto the recipient site one at a time.
Patients with large balding areas require more grafts than those with small problem spots.
In summary, the key difference between the two techniques is that FUT has the surgeon extract many hair grafts at a time by cutting a strip of tissue from the donor site. Separated grafts are picked from a specialized tray and transplanted.
FUE requires the surgeon to extract singular hair grafts from the donor site one at a time. The key similarity is that both techniques require incisions to be made on the recipient site in order to ‘plant’ the hair.
Pros and Cons of FUT and FUE
Pros of FUT
- The donor area does not have to be shaved short
- It takes a shorter time to complete since many grafts are extracted at a time
Cons of FUT
- It leaves a visible scar on the donor site. Fortunately advancing techniques are improving the surgical repair process therefore reducing visibility of the scar left.
- It takes between 10 and 14 days to heal which is longer than for FUT.
Pros of FUE
- There is no scar left after recovery
- Heals fairly quickly ( in about a week)
Cons of FUE
- The procedure is very time consuming
- Extraction process requires intricate skill and precision
- More expensive than FUT
Which Hair Transplantation Technique is Best?
Deciding which of the two mentioned techniques is best for you should be based on advice from the surgeon to conduct the procedure. That said, a clear understanding of the pros and cons of each does help us understand a few elements which the specialist takes into consideration. With these, it is clear who are the best candidates for each type of transplant.
Ideal candidates for FUT:
- Men with long hair. If you typically like to wear your hair long, FUT would be a good option because it can easily hide the scar left after the procedure.
- Men with extensive baldness. If most of your head is bald, FUT would be best because it allows the surgeon to cover larger areas in a single session.
An average of 4,000 grafts can be transplanted in a single procedure, therefore making the entire process faster and more cost-effective.
Ideal Candidates for FUE
- Men with minimal balding. If you are experiencing hair loss on a small part of your scalp, FUE would be a better option because it requires a small number of grafts. Considering the time-consuming nature of the process, it won’t take too long to cover a small bald spot and be done with the procedure within reasonable time.
- Youth. Young men, such as those in their late twenties are ideal candidates for FUE because they are likely to change their minds about their hairstyle at some point in the future. If they have a concealed scar to think about, it limits their options significantly.
- Men with short hair. If you like to wear your hair short or have a job which requires you to maintain a short buzz cut, FUE would be best for you. Unlike FUT, there is no scar left so you never have to worry about a visible, unsightly line along the back of your head.
- Men who have had a similar procedure before.In the event that you had a FUT procedure a couple of years ago and now want to have another hair transplant, you don’t want to add more scars.
How Much Does a Hair Transplant Cost?
When it comes to costs for a hair transplant, the first point to note is that you will most likely need to pay for it out of pocket. Medical insurers consider this a cosmetic procedure so it is not covered under medical schemes.
The general range stands at between $4,000 and $15,000. Yes, this is a wide range but there are several key dynamics that determine just how much your hair transplant will cost.
Here are a few.
In the U.S for instance, the procedure costs anywhere between the mentioned $4,000 and $15,000. In other parts of the world, it is possible to find more affordable clinics and surgeons who offer equally high-quality services.
Turkey is a notable destination with a flourishing hair transplant industry where you can get a full procedure for an estimated $2,000. About 60,000 people visit Istanbul every year in search of a full head of hair. They are spoiled for choice as there are more than 350 clinics in the capital offering hair transplant services.
Locals say it is common to see foreigners with bandaged heads sightseeing and visiting museums before returning to their home countries.
The extent of hair loss:
Surgeons usually quote a price per graft. In the U.S it ranges between $2 and $10 per graft while cheaper overseas facilities could quote as low as under $1 per graft.
It then follows that if your entire head is bald, a hair transplant will cost you more than a man with a small bald or thinning area.
It is interesting to note however, that hair transplants with a large number of grafts to be done could turn out to be less expensive when considered per graft.
For instance, a practice could charge $2,000 for a hair transplant of 200 grafts, which works out to be $10 per graft. The same facility could charge $12,000 for $3,000 grafts which works out to be $4 per graft.
A professional surgeon with many years of experience and a long list of happy clients in his portfolio is more expensive than surgeons who have been on the job for only a couple of months.
Type of transplant:
With an understanding of the two main types of hair transplant procedures, it is clear that FUE is a much more time-consuming process requiring greater skill and expertise. This is why FUE is generally more expensive than FUT.
Pricing may differ at different facilities but whatever the cost, FUE is typically more expensive than FUT.
If you choose to travel away for the procedure, then costs such as airfares and accommodation should be factored into the overall cost.
Is a Hair Transplant Permanent?
Considering the hefty cost for a professional hair transplantation procedure, it is no surprise that many men want to be assured that the pain on the scalp, as well as in their pockets will provide a life-long solution.
Is hair transplantation a permanent fix?
The short answer is yes. It is a permanent solution to hair loss. Permanent in the sense that the movement of the hair follicles is permanent and cannot be reversed. Hair will grow on the recipient site as it would grow naturally on the donor site.
Why are hair transplants permanent?
The permanence of transplanted hair is a result of the part of the scalp selected as the donor site. Surgeons select donor sites from the back or sides of the head. Why so?
Hormonal and other processes which cause hair loss don’t affect these areas. That is why it is common to see elderly men who have gone bald on the front and crown of the head but still have hair on the back and sides of the head.
Hair transplanted from these parts retains its resistance and continues to grow on the recipient site for years.
When it comes to hair density, hair transplants may not be considered permanent. Although it is unlikely that a man could go bald on an area with transplanted hair, it does continue to thin with age, just as the hair on the back and sides of the head thins as men get older.
This means that transplanted hair that originally grew thick in the years after the surgery could get thinner over the years.
Permanence, therefore, lies in the fact that follicles of the transplanted hair will produce at least some hair for the rest of your life. However, it is likely to get thinner over time. Your hairline also won’t recede much, if at all.
When is the Best Time to Have a Hair Transplant?
The question as to when it is best to have a hair transplant can be confusing. Is it to say that there is a right and wrong age for a hair transplant?
Well, yes. The basic rule is that you should not have a hair transplant until you actually start losing hair. Some men have naturally thin hair even from an early age and may consider transplantation simply to increase density as early as 20 years or so.
In the same breath, some men may start showing signs of male pattern baldness as early as 18.
According to the Hair Doctor, a hair transplant at this age would be a mistake.
He explains that between the ages of 18 and 29, the hairline is still forming. What may appear like a receding hairline may be what is referred to as a mature hairline which is quite different from balding.
By age 25 or so, apparent hair loss should have stabilized, therefore making this the youngest age at which a hair restoration expert should advise a hair transplant.
Many years later…
Another issue linked to hair transplants early in life is that the hair may start to look unnatural after several years. When you get older and start to lose hair, balding and receding happen on the areas around the previously transplanted hair. Since transplanted hair is resistant to the effects of hormones that cause balding, it does not recede or bald while surrounding hair does, therefore creating a visibly uneven head of hair.
Hair Transplantation – Success Rate
A hair transplant is a surgical process. Like any other surgery, there is always a chance that it doesn’t produce the anticipated results.
For starters, it must be said that no surgeon, no matter how experienced, can guarantee 100% success after a hair transplant. According to clinical studies, best results range between 80% and 90% regrowth of transplanted hair. With this as the best-case scenario, there are chances that your surgery is a lot less successful than this. Just how well your hair transplant surgery turns out depends on several factors.
Here are some of them.
Type of hair transplant
As mentioned, patients choose either FUT or FUE which are the two main types of hair transplant procedures.
FUE success rates are generally higher thanks to its minimally invasive nature. FUE success rates have always been slightly higher than FUT. However, with recent developments such as the use of sapphire or diamond blades during the surgery, FUE now boasts of even higher success rates than before.
Type of hair
Specific characteristics of your hair may affect the success rate of a hair transplant. For instance, transplants on thick Afro hair call for extra caution and time so as to achieve the same success rate compared to thinner hair.
Surgeon and facility
It goes without saying that a poorly trained or inexperienced surgeon is more likely to botch a procedure than a skilled and experienced one.
Other than expert technique and experience you get from a professional surgeon, there are also factors such as hygiene of the facility and use of appropriate tools which could come into question when you put yourself in the hands of the wrong facility.
The Long Wait after a Hair Transplant
This is one of the main demerits of hair transplants. It takes what seems like ages to finally enjoy the results of the procedure.
According to Hair Sure, a hair transplant center based in India, it could take up to 18 months to see the full results.
Here is what to expect in the course of this wait.
In the first month or so, the transplanted hair is likely to fall out. This could be alarming if you were not aware that it is actually quite normal.
- 1- 4 months: In this time you see 35% of the final result as some transplanted hair begins to grow albeit sporadic and uneven.
- 5 – 6 months: At this point you should see 55% of the final result. New hair is now thicker and grows longer.
- 7 – 10 months: By this time 70% of the final result should be evident. Hair thickness and texture continues to improve as length increases.
- 12 – 18 months. This final phase should give you 100% of the final result. It should now be long and dense enough to style or cut as desired
Preparing for a Hair Transplant Surgery
Once you make the decision to have the surgery, it is necessary to prepare yourself appropriately in order to minimize stress and increase the chances of overall success.
Mental preparation and moral support
Start by preparing yourself mentally for the procedure. It typically takes several hours so you can go home after that.
Most importantly, prepare yourself for a long wait before any significant results can be seen.
On the day of the surgery, take someone trustworthy along with you to the facility. They will not only provide moral support but also help you get home safe after the procedure since you will still be under anesthesia and not in a position to drive.
Free up your schedule to allow yourself some healing time. You can move around as normal but it is advisable to take a few days off work and take a break from lots of movement and busy schedules.
Alcohol and cigarettes
A week before the surgery, stop consuming alcoholic products. If you are on any medication, consult your surgeon on whether it is safe to continue taking them as you approach the set date.
If you are a smoker, stay away from cigarettes for at least a day before the surgery. Smoking affects blood flow and could interfere with supply to the scalp, thus reducing the chances of acceptance of the transplanted hair. The same goes for caffeine.
Alcohol and cigarettes should also be avoided for about a week after the procedure.
You will of course want the surgeon to work on a clean, fresh scalp so you should wash your hair but be careful not to use anything more than regular shampoo. Any other chemical-filled products may leave your scalp ill-prepared for the procedure.
Lastly, remember to dress appropriately. The procedure will leave your scalp sore and possibly painful so stay away from t-shirts and any tops which have to be pulled over the head to remove them.
Recovery and Post-surgery Precautions
During your final consultation prior to the procedure, your surgeon will recommend a couple of post-surgery precautions that should be followed strictly. These should not be taken lightly as they play a crucial role in determining the overall success of the procedure.
These are some useful precautions to take.
For the first week or so, you may need to sleep with your head in an elevated 45-degree position. This helps to manage swelling by reducing blood flow to the scalp.
Doctors recommend sleeping on a recliner which also helps to ensure your sore scalp doesn’t rub against beddings.
Some people don’t experience much swelling. If you are one of these lucky few, then a recliner may not be necessary.
Swelling typically happens on the third or fourth day after the surgery. To manage it, place an ice pack above the eyebrows for a few minutes several times a day.
It is alright to wash your scalp three or four days after the procedure. The precautions are to ensure you do not scrub or use hot water. Use a gentle shampoo and conditioner to relieve any itching. Avoid letting shower water fall directly onto your scalp. Instead, use a cup to rinse it out.
Try to stay indoors for the first few days. This way chances of infection-causing bacteria coming your way are reduced. It also keeps you away from direct sunlight which will not do your healing scalp any good.
After the procedure, you are likely to get basic medication like a painkiller, an antibiotic to prevent infection, and anti-inflammatory medication to deal with swelling.
On top of these, most surgeons prescribe Minoxidil (Rogaine) or Finasteride (Propecia) which help to improve hair regrowth as well as slow future hair loss.
Alternatives to Hair Transplants
It is true that hair transplants are the first thing many people recommend as a solution to hair loss. However, that is not to say that it is the only option for you if you are experiencing thinning, balding, or a receding hairline.
You may want to seek alternatives because of the high cost of a hair transplant procedure or because you are under the age of 25.
What other options are available?
The two most common medications used to deal with hair loss are Minoxidil (Rogaine) and Finasteride.
Minoxidil: This is an over-the-counter (nonprescription) treatment that comes in liquid, foam, or shampoo form. Even experts don’t fully understand exactly how Minoxidil works but are sure that it causes widening of hair follicles which allow for the growth of thicker strands of hair
Finasteride: Unlike Minoxidil, you will need a prescription for Finasteride. It is specifically used to treat male pattern baldness and carries warnings against use by children or women who may be pregnant.
It works by reducing the levels of DHT in the scalp, a hormone that appears to cause thinning of hair follicles. Lowered DHT, therefore, increases hair regrowth and slows down hair loss.
Scalp Micropigmentation (SMP)
SMP, also known as hair tattoo, is a non-surgical procedure in which specially trained technicians use micro-needles to deposit pigment in the scalp to create the illusion of hair.
On a bald head, SMP creates the appearance of a freshly-shaved buzz cut. On thin but long hair it creates the look of thicker, fuller hair.
How exactly does laser therapy work? The light produced by the device is absorbed by the scalp and boosts microcirculation, therefore, improving blood and nutrient supply to hair follicles. It also stimulates cellular activity in follicles. The result is increased hair growth and reduced hair loss.
Hair transplants are no doubt a popular solution to hair loss challenges for men all over the world. If you are dealing with balding, thinning, or a receding hairline, and are considering a hair transplant, now you are sufficiently informed to make a decision.
It is a fairly expensive procedure that is not covered by medical insurance schemes so you have to meet the entire cost out of pocket. It also calls for immense patience because it takes several months before you see any results and up to a year and a half for the full effects.
Can you have multiple hair transplant surgeries?
Yes, there is no harm in having more than one hair transplant a few years apart. However, you shouldn’t have to. If you have it done well enough, it should ensure you don’t need another one any time soon.
That said, some men undergo a second procedure many years later to deal with more recent balding.
Is a hair transplant painful?
Both types of hair transplant, that is FUT and FUE are relatively painless at the time of the procedure because it is done with the patient under local anesthesia.
It is in the days after the surgery that pain sets in particularly if the harvesting method was FUT. Surgeons typically prescribe medication to help manage the pain. It will be about a month before the treated area feels normal again. Even after the pain wears off, it remains sensitive as the scalp heals.
Can I have someone else’s hair transplanted on my scalp?
If you don’t have enough donor hair it seems like perfect sense to just have someone donate some to you. But no, it doesn’t work. Donor hair is harvested along with the individual’s scalp tissue. Transplanting another person’s scalp tissue on your scalp would automatically elicit an immune reaction which would cause your body to reject the foreign tissue. This is why transplanting hair from one person to another would certainly fail.
Will hair on the donor site grow back after a hair transplant?
Yes, it can grow back. It depends on whether the extraction was by FUT or FUE. It also depends on how well you nurse the area after the procedure.
Can hair from other parts of the body be harvested for a hair transplant?
Yes. As long as it is from the same individual, surgeons can extract hair from other parts of the body such as the chest, beard, armpits, or pubic area. Experts say the best hair to harvest for a hair transplant (apart from the scalp) is from a man’s beard or chest.
Will transplanted hair turn grey?
This is a common concern for men who fear that they may end up with hair in two different colors when some of it starts to turn grey. There is no reason to worry because greying depends on the individual and the specific donor hair.
If the donor hair starts to turn grey then the transplanted one will do the same.
Can I wear a hat after a hair transplant?
Doctors strongly advise against wearing any kind of head accessories in the first ten days after the procedure. If you absolutely have to wear one, make sure it is a loose hood or hat and be careful not to touch the implanted grafts when putting it on or taking it off.
Can I color transplanted hair?
Yes. You can color transplanted hair but no less than 5 weeks after the surgery. The point is to let the scalp heal completely before exposing it to any chemicals. Consult your hair restoration expert before coloring it.
Even with a green light to do it, stick to products you have used before in order to minimize the chances of an allergic reaction.