Hair Transplantation

A hair transplant is a procedure in which a plastic or dermatological surgeon moves hair to a bald area of the head. The surgeon usually moves hair from the back or side of the head to the front or top of the head.

Hair transplants typically occur in a medical office under local anesthesia.

Pattern baldness is responsible for the majority of hair loss. This comes down to genetics. The remaining cases are due to various factors, including:

  • diet
  • stress
  • illness
  • hormonal imbalance
  • medications

Are there different types of hair transplants?

There are two types of transplant procedures: slit grafts and micrografts.

Slit grafts contain 4 to 10 hairs per graft. Micrografts contain 1 to 2 hairs per graft, depending on the coverage needed.

Who might benefit from a hair transplant?

Receiving a hair transplant can improve your appearance and self-confidence. Good candidates for a hair transplant include:

  • men with male pattern baldness
  • women with thinning hair
  • anyone who has lost some hair from a burn or scalp injury

Hair replacement isn’t a good option for:

  • women with a widespread pattern of hair loss throughout the scalp
  • people who don’t have enough “donor” hair sites from which to remove hair for transplant
  • people who form keloid scars (thick, fibrous scars) after injury or surgery
  • people whose hair loss is due to medication such as chemotherapy

What happens during a hair transplant?

After thoroughly cleaning your scalp, a surgeon uses a small needle to numb an area of your head with local anesthesia.

Two main techniques are used to obtain follicles for transplantation: FUT and FUE.

In follicular unit transplantation (FUT):

  • The surgeon will use a scalpel to cut out a strip of scalp skin from the back of the head. The incision is typically several inches long.
  • This is then closed with stitches.
  • The surgeon next separates the removed portion of scalp into small sections using a magnifying lens and sharp surgical knife. When implanted, these sections will help achieve natural-looking hair growth.

In follicular unit extraction (FUE), the hair follicles are cut out directly from the back of the head through hundreds to thousands of tiny punch incisions.

  • The surgeon makes tiny holes with a blade or needle in the area of your scalp that’s receiving the hair transplant. They gently place hairs in these holes.
  • During one treatment session, a surgeon may transplant hundreds or even thousands of hairs.
  • After, the graft, gauze, or bandages will cover your scalp for a few days.

A hair transplant session can take 4 hours or more. Your stitches will be removed about 10 days after surgery.

You may require up to three or four sessions to achieve the full head of hair you desire. Sessions occur several months apart to allow each transplant to fully heal.

What happens after a hair transplant?

Your scalp may be sore, and you may need to take medications following hair transplant surgery, such as:

  • pain medication
  • antibiotics to reduce your risk of infection
  • anti-inflammatory medications to keep swelling down

Most people can return to work several days after surgery.

It’s typical for the transplanted hair to fall out 2 to 3 weeks after the procedure. This makes way for new hair growth. Most people will see some new hair growth 8 to 12 months after surgery.

Many doctors prescribe minoxidil (Rogaine) or the hair growth medication finasteride (Propecia) to improve hair regrowth. These medications also help slow or stop future hair loss.

What are the complications associated with a hair transplant?

Side effects from a hair transplant are usually minor and clear up within a few weeks.

They can include:

  • bleeding
  • infection
  • swelling of the scalp
  • bruising around the eyes
  • a crust that forms on the areas of the scalp where hair was removed or implanted
  • numbness or lack of sensation on the treated areas of the scalp
  • itching
  • inflammation or infection of the hair follicles, which is known as folliculitis
  • shock loss, or sudden but typically temporary loss of the transplanted hair
  • unnatural-looking tufts of hair

What is the long-term outlook?

Typically, people who’ve had a hair transplant will continue to grow hair in the transplanted areas of the scalp.

The new hair may appear more or less dense depending on:

  • scalp laxity, or how loose your scalp skin is
  • density of follicles in the transplanted zone
  • hair caliber or quality
  • hair curl

If you don’t take medication (such as minoxidil or finasteride) or undergo a low level of laser therapy, you may continue to experience hair loss in nontreated areas of your scalp.

Discussing the expected outcome with your surgeon and developing realistic expectations is important. Get additional information on hair transplants and their costs here.

Frequently asked questions about hair transplants

The good news is, no — a hair transplant is not painful. At the time of the procedure, the area of your scalp that the surgeon will be focusing on will be numbed with a local anesthetic, so while you may feel a little pressure or movement sensations during the procedure, it shouldn’t be painful.

But like with most postsurgery recovery, you may experience discomfort or pain at the incision points as your body starts to heal and recover. Your medical team will likely discuss the best ways to manage pain and other ways to minimize the risk of negative side effects or reactions.

A hair transplant is a good option for people who can afford the high cost of the procedure and haven’t found success from treatments like minoxidil or Rogaine. Hair transplant surgery is relatively low risk compared with other surgeries, but it isn’t without risks. There is also always the possibility that your hair regrowth may be minimal.

But if this is a procedure you are interested in and the potential rewards outweigh the costs and risks, consider talking with your doctor to see if this is a good option.

Takeaway

If you are experiencing hair loss or hair thinning, there are treatment options available. But no single treatment is guaranteed to work, and the costs can stack up quickly, especially since hair loss treatments are rarely covered by insurance.

But if you’ve talked with your doctor about treatments or found that other common hair regrowth treatments hadn’t worked for you, consider looking into a hair transplant. If you are a good candidate for the transplant and your medical team thinks you’re likely to see positive results, this may be a procedure worth considering.