How Does a Hair Transplant Work?

• What is a hair transplant?
• How does a hair transplant work?
• Different procedures available
• Does a hair transplant hurt?
• Who is eligible for a hair transplant?
• Male pattern baldness
• Causes of male pattern baldness
• Hair loss stages
• How many grafts will I need?
• Hair transplant prices
• Before and after a hair transplant
• The patient’s journey
• The aftercare and recovery process
• Side effects & considerations
• Hair transplant scars
• Hair transplant growth timeline
• How long does a hair transplant last?
• What happens if it goes wrong?
• Second hair transplant?
• Hair transplant reviews
• How to find a good clinic

What is a hair transplant?

A hair transplant is a process of moving healthy hair follicles from one part of the scalp, usually the back or sides of the head, to a balding area on the scalp.

The procedure is used to treat genetic and hormonal hair loss, as well as hair loss which is the result of an injury or rarer condition. Many men find that undergoing a hair transplant can restore a more youthful appearance boosting their self-esteem and well-being.

A trained and qualified surgeon should be performing a hair transplant. You will usually be given a local anaesthetic before the start of the procedure to ensure you do not feel pain when surgery is being carried out. The two most common methods of hair transplant are follicular unit excision (FUE) and follicular unit transplantation (FUT). We discuss the difference between FUE and FUT two in greater detail later on in this guide.

Take a look at the clip below to see the process of FUE hair transplant surgery in action:

How does a hair transplant work?

An FUE hair transplant involves the excision of healthy hair follicles from donor areas found at the back and sides of the head with small punch incisions before they are implanted in small holes in the recipient area.

An FUT hair transplant involves the removal of a strip of scalp from the back of the head, followed by stitching this area, the separation of the extracted strip into small pieces of hair, and their implantation into the recipient area.

The hair transplant procedure can take four hours or more. If you have non-dissolvable stitches, they will be removed about ten days after the procedure. Most patients are able to rest and recover at home without any issue. You’ll be given clear and easy instructions on your aftercare for the days following the procedure.

Different procedures available

The two main hair transplant techniques are FUE and FUT. Let’s look at them in closer detail:

FUE Hair Transplant Surgery

Using the FUE hair transplant surgery technique, hair grafts are removed from the back of the head as individual follicles. This is done with hundreds or in some cases thousands, of tiny ‘punches’.

The hair follicles can then be placed gently in the small holes which have been created at the recipient site. Once all the individual hair grafts have been transplanted, the back of the scalp where hairs have been taken from will be bandaged, and remain so for 24 hours.

FUT Hair Transplant Surgery

The FUT technique involves the removal of a strip of scalp from the back of the head. This strip is typically several inches long. This site can then be stitched up with the strip of scalp split into several smaller sections of hair grafts with a surgical tool. These hair grafts are then implanted into the recipient area.

Does a hair transplant hurt?

Is a hair transplant painful? This is a common question from somebody considering an FUE hair transplant procedure.

Some people might have the belief that the procedure is very painful. However, many of those who have a hair transplant doesn’t feel anything during the procedure itself. After a local anaesthetic has been administered via an injection into the target area of the scalp, a patient should not feel any discomfort.

We can also provide pain-relieving medications to help reduce discomfort further. Many measures are used to increase the comfort level of patients during the procedure. You may like to watch TV or listen to music, to help keep your mind off the procedure. All of this is offered at The Treatment Rooms London, our custom-built hair transplant clinic is temperature-controlled, and we offer aromatherapy to help relax your body and mind.

During recovery, you will not usually feel significant pain. You should aim to take sufficient time to rest (usually 4-5 days) and follow your aftercare and recovery instructions. A patient's recovery should be relatively pain-free with any discomfort easily managed with Paracetamol or Ibuprofen.

Antibiotics will help to guard against infection, and if you do have post-operative swelling, medication for this is provided.

Our hair transplant surgeon Dr. Roshan Vara talks about whether hair transplants are painful below:

Who is eligible for a hair transplant?

Let’s move on to the question of suitability for a hair transplant. In general, suitable candidates for a hair transplant will be in good health and have hair follicles that are in good condition and able to remain healthy after the transplant has been performed.

The treatment is suitable for men with male pattern baldness and has stabilised their hair loss either with medications or naturally with age. A hair transplant can also be an option for both men and women whose hair loss is due to burns, trauma, or rarer conditions.

When looking at what is the right age to get a hair transplant, it is advised that men wait until they are 30 or older as hair loss generally begins to slow and become more predictable.

Male pattern baldness

Male pattern baldness, also known as androgenic alopecia, affects over half of all men aged over 50. It is one of the most common reasons why people choose to have a hair transplant.

Male pattern baldness is an inherited trait that can give men a thinning crown and receding hairline. The most common patterns of male pattern baldness are;

• Hair thinning at the top of the head and the temple area, which can eventually form a ‘horseshoe’ of remaining hair
• Hair receding from the hairline’s front, gradually pushing the hairline back

The Treatment Rooms London surgeon Dr. Dilan Fernando offers a definition of male hair loss below:

Causes of male pattern baldness

The cause of male pattern baldness is dihydrotestosterone (DHT), a byproduct of testosterone. DHT can affect sensitive hair follicles by shrinking them over time. In the process of the affected hair follicles getting smaller, the life span of the hair is reduced. This continues until the affected follicles cease to produce hair.

Research suggests that male pattern baldness is often inherited, with over 80 percent of those who experienced significant hair loss having a father who lost their hair, too.

Hair loss stages (Norwood Scale)

You should always have your hair loss examined by a certified hair transplant specialist. They will be able to analyse your hair loss and recommend the best course of treatment, be it surgical or non-surgical.

Male hair loss is classified by the Norwood Scale, which provides pictorial representations of the different balding stages. You should note that some doctors and surgeons may use a different classification scale.

The Norwood Scale defines its seven stages as follows:

• Stage 1: No significant hair loss or recession of the hairline
• Stage 2: There is a slight recession of the hairline around the temples. This is also known as an adult or mature hairline
• Stage 3: The first signs of clinically significant balding appear. The hairline becomes deeply recessed at both temples, resembling an M, U, or V shape. The recessed spots are completely bare or sparsely covered in hair
• Stage 3 vertex: The hairline stays at stage 2, but there is significant hair loss on the top of the scalp (the vertex)
• Stage 4: The hairline recession is more severe than in stage 2, and there is sparse hair or no hair on the vertex. The two areas of hair loss are separated by a band of hair that connects to the hair remaining on the sides of the scalp.
• Stage 5: The two areas of hair loss are larger than in stage 4. They are still separated, but the band of hair between them is narrower and sparser
• Stage 6: The balding areas at the temples join with the balding area at the vertex. The band of hair across the top of the head is gone or sparse
• Stage 7: The most severe stage of hair loss, only a band of hair going around the sides of the head remains. This hair is usually not dense and may be fine

Using the Norwood Scale as a reference point, the extent of baldness can be diagnosed, the correct treatment option can be provided, and the effectiveness of the treatment can be measured. The scale is also used to help plan how many grafts a patient may require in order for them to achieve coverage of hair following surgery.

How many grafts will I need?

The number of grafts that are required will vary according to the extent of balding. Grafts are strips of skin containing healthy hair follicles that are harvested and moved to a bald area of the scalp in a hair transplant procedure.

When the FUE technique is used, hair grafts are taken as individual follicles from the donor area of the scalp. That means that there will be hundreds, or even thousands, of tiny punch incisions needed to remove the grafts of individual follicles.

These small individual grafts are then individually placed into tiny holes which have been made in the recipient area. To get an idea of how many grafts may be needed for your FUE hair transplant, use our hair transplant graft calculator.

With the FUT technique, a vast number of hair grafts are removed as a single strip from the donor area, usually located at the back of the head. Once the strip has been removed, it is separated into individual grafts with a surgical tool. These hair grafts can then be implanted at the recipient site.

Hair transplant prices

The cost of a hair transplant in the UK will vary according to several factors, including the extent of your hair loss, your age, your hair colour, your hair type, and your gender.

FUE hair transplants are usually calculated by the number of grafts that are needed. At The
Treatment Rooms London, we charge £4 per graft, and our starting price for surgery is £3,000.

As everybody’s hair is different, the most accurate price estimate can be obtained only by consultation with a hair transplant surgeon. However, you can give yourself a better idea of what the procedure will cost by using our hair transplant graft calculator.

Before and after a hair transplant

So what are the results that you can expect from an FUE hair transplant? We’ve collated a series of photos from prior to, and following hair transplant procedures – see them here on our FUE Hair Transplant: Before and After page.

You’ll see a variety of before and after shots, demonstrating the results of various procedures including; creation of a new hairline, a hairline and temple FUE hair transplant, an FUE crown hair transplant, results 9 and 10 months after surgery.

We’ve also included photos from our procedures involving patients requiring a different number of hair grafts, allowing you to see the work required.

The patient’s journey

So what is it like to have a hair transplant? In this section, we will outline the hair transplant patient journey at The Treatment Rooms London

On the morning of your procedure, you’ll be welcomed by the lead surgeon and his team, and talked through the procedure and consent forms. After you have given your consent, you and your surgeon will again draw your planned hairline or crown in detail to ensure you are happy with what was discussed in your initial consultations with your Surgeon. Following this, you’ll move to a personalised surgical room where the preparation of the extraction and implantation zones will start.

Whether you’d like to watch TV, listen to music, or relax with some aromatherapy; everything will be done to make you as comfortable as possible throughout the procedure.

You will be given injections of a local anaesthetic to numb the back of your head, and pain-relieving medication tablets if necessary. Once you are comfortable, the careful extraction of follicles for implantation will begin.

The hair follicles are kept in cooled petri dishes and separated into bundles to ensure correct planning for the creation of the hair density and style you desire. Before implantation begins, you’ll have time to eat lunch with a meal tailored to your dietary requirements.

After lunch, you can relax with the television or music on whilst your scalp is anaesthetised, before the implantation begins. When you have been satisfactorily numbed, hair follicles will be placed to blend in with your natural hair density and direction. After the implantation, we’ll take aftercare steps such as bandaging the extraction zone and fitting you with a cap to protect your scalp in the days following procedures.

The aftercare packages that we provide contain medications and materials that you need to protect your newly implanted hairs, and we’ll supply you with detailed aftercare instructions to take home.

Hear from one of our FUE hair transplant patients: John’s procedure used 2,078 grafts to treat hair loss at the front of his scalp and other thinning areas. Watch his FUE hair transplant patient journey in the video below.

The aftercare and recovery process

This section is all about the hair transplant aftercare & recovery process, the final part of your hair transplant journey, that begins when you leave the clinic, and ends with a full head of healthy hair.

It is key that hair grafts are looked after correctly following a hair transplant so that they can become secure and the follicles can grow normally. You will need to avoid exercise for the first few weeks following the procedure to reduce scarring.

A bandage is typically worn for 24 hours, and you are usually advised to avoid washing your hair until around day 5 when you can gently lather up using shampoo (have a read of our hair washing tips post-surgery article for more information).

Following a FUT hair transplant, if non-dissolvable stitches have been used, they can usually be removed after two weeks.

Here are some quick aftercare tips:

DO

• Wash your hair after day 5 to help healing
• Use pain relieving medication when you need it
• Wear a hat outdoors

DON’T

• Rub your hair with a fabric towel after washing (just let it air dry)
• Scratch your scalp
• Do any intense physical activity in the 14 days after the procedure

Side effects & considerations

Can you expect side effects from a hair transplant? And what should you consider before undergoing the procedure?

There are several common side effects of a hair transplant, but you may not experience all of them. Swelling after a hair transplant procedure can be common, and typically occurs in the forehead.

It usually lasts no more than a few days. Some ooze at the extraction (donor) area can happen in the hours following an FUE hair transplant but will stop once you develop scabs. A cotton bud can be used gently to soak up any blood.

Itching after a hair transplant is another common side effect often experienced by our patients. This is a natural response to healing and is a sign that the recovery process is well underway. Itching can be felt at both the extraction and implantation area. Although you might feel like scratching your scalp, it is important that you resist!

You can get some advice on itching after a hair transplant from one of our lead surgeons Dr. Fernando in the video below:

You should certainly consider these potential side effects before you have a hair transplant. Your hair transplant surgeon will be able to talk you through them in more detail during your initial consultation. But what else do you need to think about in the consideration stage?

Here are five considerations from The Treatment Rooms London:

• Understand your hair loss and why it is happening
• Consider all the options for hair loss treatment, both surgical and non-surgical
• Appreciate how a hair transplant works
• Choose a certified clinic and surgeon who can discuss any concerns you might have
• Recognise the need for future treatments, if any

Hair transplant scars

One potential side effect which we haven’t covered in the section above is scarring. So, do hair transplants leave scars?

Both the FUE and the FUT hair transplant techniques leave scarring to a varying degree. However, in both cases, these scars may not be visible to the naked eye. Let’s look at each technique in greater detail.

An FUE hair transplant is much less likely to leave noticeable scars than a FUT hair transplant, and that’s due to how the procedure is carried out.

Because hair grafts are taken as individual hair follicles, rather than as a large strip, you can expect small scars which are less than a millimeter in diameter at the donor area. When your hair grows beyond level 1, these tiny scars will become unnoticeable. This approach is suitable for those who wish to style their hair in shorter and longer hairstyles moving forward.

FUT hair transplants take hair grafts as a strip of scalp from the donor area before the strip is separated into smaller sections for implantation. This technique can cause a noticeable linear scar at the back of the scalp, because of the larger area of tissue that is removed in the extraction.

After a few months, once the tissue has strengthened as part of the healing process, the scar will begin to fade naturally, and the growth of new hair will also help to conceal scarring. Some people might choose to have a medical tattoo in order to conceal the scarring further. Longer hairstyles are required to conceal the scar following FUT surgery moving forward.

Hair transplant growth timeline

A very common question we get asked after a hair transplant is “how long will it take for my new hair to grow?”

The first thing to recognise is that your hair will not grow immediately – you’ll need some patience and to follow your surgeon’s aftercare advice carefully. Let’s track the various stages which follow a hair transplant procedure:

0-5 days

The first few days after a hair transplant aren’t about hair growth, they are about hair survival and the scalp accepting the implanted follicles.

You’ll need to protect your new hair grafts against factors such as dehydration and lack of oxygen, and avoid touching them in the days following the procedure. The best hair transplant clinics will give you detailed instructions on aftercare, including when and how you should wash your hair. Ensuring your hair grafts become secure after a transplant is vital for future growth.

2 weeks - 3 months

Don’t be alarmed if your transplanted hair begins shedding following your surgery. Hair shedding is a normal part of the three stages of the hair growth cycle namely, growth, transition, and resting.

Following a hair transplant procedure, hair will often move into the resting phase. The resting phase is when the roots shed their hair.

This process is entirely normal and can start happening after a few weeks. So don’t be alarmed.

3-12 months

Your new hair will begin to grow, steadily increasing your hair volume and getting closer to achieving the look and style you desire.

12-18 months

A year after the procedure, your hair transplant should come to fruition, with the final results being clearly visible.

Hair transplant follow-ups

The responsible hair transplant clinics follow up with their patients regularly. At The Treatment Rooms London, all our patients are offered follow-up consultations if required. We also encourage you to keep in contact during your recovery period, asking any questions you may have and sending us photos for evaluation. Each patient will have a one-year follow-up to review results.

How long does a hair transplant last?

The results of a hair transplant, which can usually be seen after a year, can last many people for life. Certainly, you can expect results to last for 15-20 years or more. The potential permanence of a hair transplant is one of the reasons it is so important to be happy with the results.

If you are taking medications to prevent further hair loss, the results of your hair transplant are set to suit you for a longer time. If you do not take medications to prevent further hair loss, there is the chance that your hair transplant results will no longer suit you after further hair loss has occurred. For these cases in which hair has receded behind the implanted hairs, a second or third hair transplant are options.

Is there such a thing as a bad hair transplant?

Hair transplants can go wrong if not performed properly. You should beware of black-market clinics and international clinics that may not be accredited to the same standards as those in the UK. When considering hair transplant clinics in the UK, you should be sure that a clinic is registered with the Care Quality Commission (CQC), with surgeons that are licensed with the General Medical Council (GMC).

If you have been affected by a substandard hair transplant, we understand that it can be frustrating. At The Treatment Rooms London, we have years of experience helping clients rectify poorly executed hair transplant surgeries that they might have had abroad.

For more information as to how we will be able to help, get in touch for a consultation with one of our surgeons.

Second hair transplant?

Aside from a procedure gone wrong, there are other reasons why you might need a second hair transplant.

After a few years, hair loss behind the hair transplant area can mean that further grafts could be needed behind the new hairline. For this reason, it is prudent for a reputable surgeon to leave a share of usable donor hair at the extraction site, just in case a second hair transplant is needed, thereby ‘future proofing’ your hair transplant.

Hair transplant reviews

Many people who have hair transplants are delighted with the results, citing an improved appearance and more youthful look, as well as the confidence boost which comes with a full head of hair.

Hair transplants are valued as a low-maintenance alternative to topical hair treatments, and over the years, they can also prove to be more cost-effective than alternative treatments.

Patients at The Treatment Rooms London have remarked on the clinic being “well maintained” with a “refreshing atmosphere”. We are consistently praised for the way we make patients “feel comfortable”, and are often commended for our “professionalism”.

Would you like to hear more from our patients? You can read more hair transplant reviews here.

How to find a good clinic

The UK offers a wide range of hair transplant clinics, but how should you go about finding the best hair transplant clinic for you? We recommend that you tick the following five boxes in your hair transplant clinic search:

• Ensure that the clinic is licensed (GMC) and registered (CQC)
• Use trusted surgeons with demonstrable experience in managing hair loss and hair transplantation
• Choose a clinic in the UK, rather than an international clinic which may not operate to the same standards
• Check for customer reviews online
• Do surgeons have an online digital presence?

At The Treatment Rooms London, you can enjoy peace of mind from a total FUE hair transplant package that includes personalised aftercare. Learn more about our FUE hair transplant treatment or get in touch today to book in your consultation with one of our industry-leading surgeons.