Hair Transplants and Treatment

In a hair transplant, a surgeon transfers hair from a part of the scalp with plentiful hair to an area that is thinning or bald. These procedures are most commonly used to treat hereditary baldness.

A hair transplant is performed by a plastic or dermatologic surgeon who relocates hair to balding regions of the head. Typically, follicles are taken from the back or sides of the scalp and moved to the front or crown.

Hair transplant procedures are generally done in a clinical setting under local anesthesia, with the patient awake and alert throughout.

Androgenetic alopecia, also known as pattern baldness, accounts for the majority of hair loss in both men and women — about in each group. This condition is inherited. Other causes of hair loss include:

• poor nutrition
• high stress levels
• medical illnesses
• hormonal disturbances
• certain drugs

Are there different types of hair transplants?

Several hair transplant methods exist. The two principal techniques are follicular unit transplantation (FUT) and follicular unit extraction (FUE).

With FUT, a surgeon removes a strip of scalp from the rear of the head and dissects it into individual follicular units. In FUE, the surgeon harvests individual follicular units directly from the donor area. In both methods, the follicles are implanted into the thinning or bald regions. There are multiple variations of each approach.

Earlier, now less common methods included “hair plugs” and transplants using synthetic hair.

Who might benefit from a hair transplant?

A hair transplant can enhance appearance and boost self-esteem. Candidates typically include people:

• with androgenetic alopecia (pattern hair loss)
• experiencing hair thinning
• who have lost hair due to burns or scalp trauma

Hair restoration may not be suitable for:

• men and women with diffuse hair loss across the entire scalp
• individuals lacking adequate donor hair for harvesting
• people prone to keloid formation (overgrown scar tissue)
• those whose hair loss stems from medications like chemotherapy
• people with certain scarring alopecias

Research has also identified groups who are generally not good candidates for transplantation, including:

• very young children
• people with unrealistic expectations
• individuals with psychiatric conditions such as body dysmorphic disorder (BDD) or trichotillomania

»FIND CARE:Is a hair transplant right for you? Find a dermatologist in your area today to find out.

What happens during a hair transplant?

After the surgeon thoroughly cleans the scalp, a local anesthetic is injected to numb the treatment area.

In follicular unit transplantation (FUT):

1. The surgeon excises a strip of scalp from the back of the head using a scalpel. The incision is usually several inches long.
2. The wound is then closed with sutures.
3. The removed strip is dissected into tiny grafts under magnification. These grafts are positioned to create a natural hairline and growth pattern.

In follicular unit extraction (FUE):

1. The surgeon harvests hundreds to thousands of individual follicular units from the donor zones at the back or sides of the scalp.
2. Small recipient sites are made with a blade or needle in the balding areas, and the follicles are carefully placed into these openings.
3. Because FUE is more time-intensive, it can require multiple appointments over several days.
4. The treated areas are usually covered with gauze or dressings for a few days during and after the procedure.

A single transplant session can last four hours or longer. Sutures are often removed about ten days after surgery.

Many patients need two to four sessions to attain their desired coverage. Sessions are typically spaced months apart to allow adequate healing between procedures.

What happens after a hair transplant?

Postoperatively, your scalp may feel sore, and your surgeon may prescribe medications such as:

• analgesics for pain
• antibiotics to reduce infection risk
• anti-inflammatory drugs to control swelling

Most people can return to work within a few days of the operation.

It’s common for the transplanted hairs to shed in the weeks after surgery. This is a normal phase that makes way for new hair to grow. New growth typically becomes noticeable within 3 to 6 months.

Physicians often recommend medical therapies such as minoxidil (Rogaine) or finasteride (Propecia) to enhance regrowth and help prevent further hair loss.

What are the complications associated with a hair transplant?

Side effects from hair transplant surgery are commonly mild and resolve over a few weeks.

Possible complications include:

• bleeding
• infection
• scalp swelling
• bruising around the eyes
• crusting where hair was removed or implanted
• temporary numbness in treated areas
• itching
• folliculitis (inflammation or infection of hair follicles)
• shock loss — sudden but usually temporary loss of transplanted hair
• unnatural-looking clumps or tufts of hair

What is the long-term outlook?

Most people who undergo hair transplantation will maintain growth in the transplanted regions.

The apparent density of the newly transplanted hair can vary depending on:

• scalp laxity (how loose the scalp skin is)
• follicular density in the transplanted area
• hair thickness or quality
• hair curl pattern

Without ongoing treatments such as minoxidil, finasteride, or low-level laser therapy, you may continue to lose hair in non-treated parts of the scalp.

It’s important to discuss realistic results with your surgeon and set appropriate expectations.

»Learn more: Get additional information on hair transplants and their costs.

Frequently asked questions about hair transplants

Is a hair transplant painful?

A hair transplant is generally not painful during the operation because the targeted scalp area is numbed with local anesthesia. You may perceive pressure or movement but little pain.

However, during recovery you may experience soreness or discomfort at incision sites as healing occurs. Your medical team will review pain management strategies and ways to reduce the chance of complications.

Is it worth getting a hair transplant?

A hair transplant may be worthwhile for those who can afford the procedure and haven’t had success with treatments like minoxidil. Surgery carries risks, and in some cases the improvement in hair regrowth may be modest.

If you’re considering this option and believe the potential benefits outweigh the costs and risks, consult a dermatologist to determine if you’re a suitable candidate.

Takeaway

If you’re losing hair or noticing thinning, several treatment options exist. No treatment guarantees success, and costs can add up quickly because many hair-loss treatments aren’t covered by insurance.

If other hair regrowth methods have failed or a doctor has discussed surgical options with you, a hair transplant may be worth considering if you’re a good candidate and your medical team expects favorable results.