The complete guide to hair transplants & Hair transplant frequently asked questions

air transplant surgery is on the rise – but what does the procedure actually involve, what are the risks, and are there alternatives? Here, we explain everything you need to know...

Hair transplant surgery

Techniques have become so advanced in recent years that FUE and FUT hair transplants can reverse female - or male -pattern baldness to the point where no one will know that you were ever losing your hair.
Breaking down the embarrassment-factor, a number of public figures have also spoken about having had hair transplant procedures. Footballer Wayne Rooney, actor James Nesbitt and reality TV star Calum Best have all gone on the record about it; while others, such as chef Gordon Ramsay, actor Rob Brydon and tennis player Rafa Nadal are all rumoured to have had transplants.
That said, it's not a decision to rush into: the cost is not insignificant and the effect will be dependent on who carries out the operation. So you need to know the different types of procedure and what questions to ask a hair transplant surgeon before making your decision.
But first, we need to understand what causes hair loss.

What causes male-pattern hair loss

Around one in three men experiences male-pattern baldness to varying degrees by the age of 30. Hair grows from follicles below the surface of the skin and a single hair will normally last between three and five years before it’s shed, and a new hair grows from that follicle. This cycle continues throughout life.

Male pattern baldness occurs when a modified form of testosterone, Dihydrotestosterone (DHT), begins to attack the hair follicles. This results in the follicles miniaturising and producing thinner and shorter hairs. As your thicker hairs fall out and are replaced by these weaker ones, you start to thin out on top.

Whether you go through this process depends on your genes. If they are coded to resist DHT, you’ll keep your hair. If they are coded to be susceptible, you’re in trouble. The follicles on the back and sides are usually coded to fend off Dihydrotestosterone, which is why it’s common for men to keep their hair there. The genes for hair loss can come from either parent.
Male-pattern hair loss is progressive, so if you start losing your hair happens at an early age, the overall effect is likely to be a very bald pate.

What causes female hair loss?

Hair loss among women is more common than you might think. It can be caused by a number of factors, including, like male-pattern hair loss, hormonal change. Specifically, these are male hormones (androgens) so the hair loss can happen any time from adolescence onwards, but is most likely to occur post-menopause when female hormones decrease and male hormones increase. As in male-pattern baldness, testosterone is converted to DHT and this results in the follicles producing smaller hairs.

Types of hair transplant surgery

There are two main types of hair transplant procedure, Follicular Unit Extraction(FUE) and Follicular Unit Transplantation (FUT), which work in a similar way. Because the hair follicles on the side and back of the head are more resistant to DHT, and therefore usually keep producing strong and healthy hairs when the follicles on top of the head are shrinking; those healthy follicles are taken from the back and sides and transplanted into the balding areas of the scalp.

FUE hair transplant

FUE transplants are the gold standard procedure. Single follicles are removed from the donor area of the scalp with a specialised cutting tool. These individual follicles are then inserted into tiny cuts made into the recipient site where they bed down. The skilled surgeon ensures that the recipient cuts are angle to reproduce the natural direction of your normal hair. The follicles then grow strong and healthy hairs in the previously bald patch.

FUT hair transplant

With FUT surgery, instead of taking individual follicles from the donor site on the scalp, your hair transplant surgeon cuts away a strip of them. This strip is then divided up into single follicles or small groups which are inserted as with the FUE procedure into the recipient area. Hence it's sometimes referred to as "strip harvesting".

Hair transplant frequently asked questions

Does a hair transplant hurt?

You will have a local anaesthetic so the operation will be painless. You might have some discomfort during the healing process. Because FUT strip harvesting is more invasive, there’s likely to be a bit more than with the FUE procedure. Afterwards, any pain should be treatable with standard painkillers.

Will a hair transplant leave a scar?

FUE surgery shouldn’t leave a scar, so if you want to keep your hair short then it’s probably the better option. FUT surgery is likely to leave a scar on the donor site, although it can probably be hidden under medium-length hair .

How long does a hair transplant procedure take?

It depends on the scale of the operation ie how many individual follicles you are having transplanted, but normally about eight hours. FUE transplant recovery is fairly quick because there are no stitches. An FUT transplant will normally take around a month for a full recovery, during which time there is likely to be a little more discomfort than with FUE surgery. Your scalp might be quite red for a few weeks, so if you don’t want anyone to know, book a holiday.

How much does a hair transplant cost?

Follicular Unit Extraction surgery will cost anywhere from £5,000 to £12,000 depending on the scale of the operation. Follicular Unit Transplantation costs less because the surgeon can harvest a donor hair strip of follicles at once, cutting down the work. Expect to pay £5,000 to £8,000 for FUT.

How long before I see the results of my hair restoration?

The first results will be visible after about four months. The full effect of a hair transplant operation should be apparent at the one-year mark. It’s possible that the transplanted follicles will themselves eventually begin to shrink and produce smaller hairs, in which case another transplant procedure is an option.

How many procedures will it take?

Quite possibly one, but perhaps a few transplant procedures will be necessary for good coverage on the recipient sites.

How successful is a hair transplant?

With the normal caveat that everyone is different, most people who undergo FUE and FUT hair transplants are happy with the outcome. The success will largely depend on how many good follicles you have left, how big a recipient area you want to cover, and the skill of the hair transplant surgeon - which underlines how important it is to do your research on hair transplant clinics and getting their predictions for the outcome.

Is a hair transplant permanent?

Because the transplanted hairs will behave just as they would have done if they had stayed in the donor area, a transplant isn't guaranteed to last forever. But it will probably last a very long time.

Who is a suitable candidate for a hair transplant?

To state the obvious, you need to have some hair left to transplant. The more you have available, the better the resulting coverage. But you might be surprised how few healthy follicles you need for a reasonable effect. Anyone with Diffused Unpatterned Alopecia, which leads to hair falling out, is unlikely to be suitable.

How do I choose a hair transplant surgeon/clinic?

Personal recommendation is very useful. Also make sure you see before and after shots of their work. Speak to one of their past patients if you can. And ask how many hair transplant operations they have performed. Start with the  International Alliance of Hair Restoration Surgeons. Take your time to research and choose.

I've heard of Turkish hair transplant clinics. What about going overseas?

There are numerous overseas clinics offer hair loss surgery, especially in India, Thailand and Turkey. They’re cheap, but you’re far less likely to know much about your surgeon’s background and if the procedure turns out badly, you’re going to have a bigger job getting them to put it right.

What are hair plugs?

Those awful 1980s hair plugs that made men look like they had doll-like ropes of hair? They don't exist any more. You can, if you have some, have them removed and replaced with FUE and FUT surgery.

Can women have a hair transplant?

Yes, although fewer will be suitable candidates than among men because the pattern of hair loss tends to be more widespread, meaning fewer good donor sites.

What are the risks of hair transplant surgery? Are there side-effects?

FUT and FUE transplants are generally very safe, but as with any surgical procedure, complications are possible. There may be swelling, bruising or bleeding; the existing hairs in the recipient area can die due to the shock of the procedure (they will normally return, but not always); small cysts can form, though these usually soon disappear or can be treated quite easily.

Can a hair transplant fail?

Yes, it’s possible for your body to reject the new follicles so the transplant fails. It's rare, though.
 Souce: Telegraph

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