What is a Hair Transplant? How it Works, Success Rate & What to Expect

Hair transplantation is a cosmetic surgical procedure that restores hair by moving healthy follicles from one part of the scalp to thinning or bald areas. It is commonly used to treat hair loss in both men and women.

Modern techniques, such as FUE, allow for natural-looking results, making hair transplants one of the fastest-growing treatments in aesthetic medicine. The procedure has gained popularity due to its effectiveness in restoring hair density and enhancing appearance with long-lasting results.

History of Hair Transplant Surgery

Hair transplant surgery dates back to the late 1800s, when Dr. Menahem Hodara of Istanbul, Turkey, conducted the first documented hair transplant experiment.

In 1897, Dr. Hodara successfully transplanted hair from one area of a patient’s scalp to another region affected by scarring alopecia. 

Significant technological advancements in hair transplant surgery have occurred in the 21st century. In 2008, the ARTAS robotic system, developed by Restoration Robotics, Inc., became the world’s first surgical hair transplant robot.

In the past decade alone, advancements in new technologies have made the FUE surgical technique easier, quicker, and more streamlined than ever, resulting in safe, healthy, and minimally time-consuming outcomes.

Hair Loss Conditions that require Hair Transplantation

An ideal candidate for hair transplantation is a patient who has the following attributes:

• Good general overall health
• A good donor area of hair
• Reasonable expectations.
• A healthy scalp

A few examples of hair loss conditions that can be addressed successfully with hair restoration surgery are:

• Most commonly, male and female pattern hair loss (also known as androgenetic alopecia)
• Traction alopecia
• Pubic, facial, and body hair placement for transgender patients
• Facial hair restoration for eyebrows, beards, and sideburns after facial trauma or burns

Active inflammatory skin and scalp conditions are usually contraindications to surgery; however, this should be discussed with your specialist medical professionals.

Contraindications

Certain types of hair loss and medical conditions make hair restoration surgery a difficult, if not entirely impossible, task. Examples of conditions contraindicated include:

Diffuse Unpatterned Alopecia

This type of hair loss refers to thinning of the hair all over the scalp, rather than in specific areas. As transplanted hairs need to be taken from areas less susceptible to this form of alopecia, it would not be easy to successfully densify scalps with this condition, as they will continue to lose even their transplanted hairs.

Cicatricial Alopecias

Cicatricial alopecia is an inflammatory condition that destroys hair follicles, causing scarring and permanent hair loss. Examples of this type of hair loss are lichen planopilaris (LPP) and discoid lupus erythematosus.

Hair transplantation is contraindicated in active cicatricial alopecias, as ongoing inflammation in the scalp can disrupt transplanted hairs and exacerbate overall damage. 

Patients with Unstable Hair Loss

Patients currently experiencing a rapid degree of hair loss should receive medical therapy for 6 to 12 months before undergoing surgery, allowing for adequate stabilisation of their hair loss.

Patients with Insufficient Hair Loss

Usually, at least 50% of native hair must be lost before it becomes noticeable. Patients with higher densities are more likely to benefit from the enhanced growth that medical therapies can provide before considering surgery.  

Young Patients

Young patients who develop male pattern hair loss often progress rapidly. Performing a hair transplant too early in life leaves room for error, as the scalp, hairline, face and bone structure will continue to develop.

How you look when you’re 16 is not how you’ll look when you’re 36, for example.
Depleting a young patient’s donor supply too early in life leaves them with fewer transplantation options in the future, and does not provide the best long-term outcome for their hair loss. Will deplete their donor supply and not provide the best long-term outcome.

It is best to medically manage hair loss for at least 1 year before considering surgery, as hair transplants are typically performed on individuals aged 25 and over.

Patients with Unrealistic Expectations

Patients must understand that hair will not be restored to or exceed pre-balding amounts. Some scalp will still be visible, and scarring may occur in the donor area where the hair is harvested, depending on the surgical technique. It is therefore crucial to discuss each patient’s goals for a transplant before proceeding. 

Patients with Psychological Disorders

Patients with body dysmorphic disorder (BDD) are at a high risk of being dissatisfied with the outcome. Other disorders that affect the scalp include Trichotillomania, an obsessive-compulsive disorder marked by the recurrent pulling out of one’s hair.

Medical Conditions that Complicate Hair Transplantation

• Smoking
• Diabetes
• Hypertension
• Advanced sun damage to the scalp
• Autoimmune disorders

Hair Restoration Techniques 

Follicular Unit Excision (FUE)

FUE is a meticulous technique which removes individual hair follicular units from the back and sides of the head (also known as the safe donor area) to an area of recession, like the hairline and temples. Each follicular unit, also known as a ‘graft’, has 1-4 hairs on average.

The relocated hair is resistant to the balding process, and when transplanted, it grows unhindered and potentially permanently.

This FUE method has become highly popular due to its minimal scarring, natural-looking results, and shorter recovery time. Most public figures opt for this method, as it allows them to return to the screen and resume public appearances soon after their hair restoration procedures.

Follicular Unit Transplantation (FUT)

FUT, also known as the strip method, involves removing a small strip of scalp from the back of the head, from which hair follicles are then extracted and transplanted to the desired areas.

This technique can yield many grafts in one session, making it beneficial for individuals with extensive hair loss, such as Elon Musk. However, FUT leaves a linear scar at the donor site, one reason high-profile clients often prefer FUE for less visible scarring.

These techniques are routinely performed at The Treatment Rooms London, where minimising the areas of shave can allow for a seamless recovery back to everyday life with minimal evidence that a hair transplant procedure was performed.

FUT vs. FUE hair transplantations

FUT and FUE are both effective forms of hair transplantation.  A good understanding of the differences between FUE and FUT helps individuals determine the correct procedure for their specific circumstances.

The simple table below can help compare and contrast the two methods:

	FUT (Follicular Unit Transplantation)	FUE (Follicular Unit Excision)
Donor Area Scarring	Linear scar	Dot-like scarring
Recovery Time	Longer	Shorter
Shave Type	Does not require a donor area shave.	It will require a donor area shave.
Cost	Less expensive	It will require some form of a donor area shave.

What about artificially transplanting hair?

In an artificial hair transplant,  lost hair is replaced with synthetic (human-made) fibres instead of a person’s hair. These transplants could be used for individuals who don’t have enough existing hair to be harvested to cover bare spots on their scalps.

However, the U.S. FDA banned artificial hair transplants in 1983, considering them unsafe or ineffective due to foreign body effects and reactions to foreign materials within the skin.

With further research and advancements in technology, artificial hair transplants may become an option for certain people in the future who don’t have enough hair from donors or have certain types of alopecia. 

The Hair Transplant Surgery Process

The hair transplant process begins with a consultation with a qualified surgeon. The following are essential to know when it comes to hair transplantation:

• Hair transplantation does not involve moving hair from one person to another. This means that patients serve as their donors and are entirely compatible.
• The hair follicles are extracted from a suitable donor area (usually the back and sides of the scalp) by using either the Follicular Unit Extraction (FUE) or the Follicular Unit Transplantation (FUT) method. 
• The extracted hair follicles are then kept in a suitable environment to maintain their viability while awaiting transplantation back into the scalp.
• Incisions are made in the thinning/balding areas of the recipient side to accommodate the hair follicles that will be transplanted.
• The follicles are then transplanted into these incisions.
• After the procedure, you’ll need to follow thorough aftercare instructions to ensure the hair follicles heal and settle into your scalp – this usually takes about two weeks. From there, the growth of the newly transplanted hairs typically begins, with full results appearing between 12 and 18 months.

Hair Transplant Costs

The cost of a hair transplant varies depending on location, the number of grafts required, and the specific surgical requirements. The average price ranges from £3,000 to £12,000, depending on the extent of the work required. Financing options are available to help make a procedure more affordable. 

Recovery and Aftercare

Post-operative care is necessary after any surgery. The recovery period of hair transplant surgery is approximately 14 days, with detailed recovery plans in place, and follow-up appointments for your surgeon to monitor the hair and provide instructions on how to care for the transplanted hair to enhance healing. 

Medications such as antibiotics and anti-inflammatories will be prescribed by your surgeon during and after surgery to ensure a safe and more comfortable recovery.

Choosing the Right Surgeon

The choice to have a hair transplant is a personal one. Many individuals can conceal hair loss well until a certain tipping point, after which they may want to consider more permanent options, such as a hair transplant.

Hair transplant surgery is not only for the rich and famous but for those struggling with hair loss. Research indicates that individuals experiencing hair loss are more likely to feel physically and socially less attractive, which can lead to low self-esteem in social situations.

While hair transplant surgical procedures can be relatively straightforward, achieving a natural-looking result requires an experienced surgeon with an artistic eye and a passion for patient well-being.

The overall design of a hairline should be conservative and age-appropriate, making it appear natural. Further steps should be taken to ensure it looks natural at the microscopic level. 

Single hair grafts must be placed at the front of the hairline, creating a soft and fluffy appearance that aligns with a natural hairline. Unfortunately, when surgery is done poorly, larger grafts are often placed in the frontal hairline, leaving patients with a plug-like appearance similar to a doll’s artificial sewn-on hairline.

Another element that indicates a high-quality hair transplant is the close attention to detail in hair direction. It is not uncommon to see procedures where grafts are placed vertically or in the opposite direction of natural hair growth, resulting in a harsh and unnatural appearance.

Control of graft angulation ensures hairs are implanted at a natural angle in the scalp. An example of such equipment is the use of implanter pens, a graft orientation technique our award winning surgeons, Dr Fernando and Dr Vara, and team specialise in.

At The Treatment Rooms London, we have perfected the art and science of hair transplant surgery, providing patients with world-class care before, during, and after their procedure. Our surgeons consider your individual needs, including your hair texture, curl pattern, and natural hairline progression, to create a seamless transition from donor hair to transplanted areas.

When considering a hair transplant, selecting a reputable, surgeon-led clinic is crucial for a quality, professional, and medically qualified result.

Award-winning clinics like The Treatment Rooms London provide and prioritise personalised assessments, employ highly skilled medical professionals, and utilise cutting-edge technology to ensure precise, natural-looking results.

Alternatives to Hair Transplant Surgery

Medications are the gold-standard therapy for those to trial before considering surgery, as it is cheaper and effective to try.

Examples of medications include: 

Minoxidil:(Rogaine®): Approved for use in both men and women, this FDA-approved medication has been proven effective in treating androgenetic alopecia. It comes as both an oral tablet and a topical solution.

Finasteride (Propecia®): Approved for use in men, this FDA-approved medication has been proven effective in treating androgenetic alopecia. It comes as both an oral tablet and a topical solution.

Hair Transplant Side Effects

The list of side effects from any surgery can be exhaustive. However, the main side effects of undergoing a hair transplant procedure are scarring due to harvested hairs from the donor area, numbness after local anaesthesia administration, swelling, bruising, post-operative discomfort of the scalp and redness of the skin.

These standard hair transplant side effects are easily manageable, and serious complications are rarely seen. 

When to Call a Doctor After Your Hair Transplant

If you have had a hair transplant and develop any of these symptoms at any point, please immediately go to A&E and contact your surgeon as soon as possible:

• Heavy bleeding
• Sudden onset of severe rash, skin bumps, or cysts (signs of infection)
• Wound incision opening
• Skin that has turned a dusky colour and is crusty
• Worsening swelling in your face, which may be accompanied by hives and difficulty breathing (anaphylaxis)

Conclusion

Recent advances in technology have made hair replacement surgery a viable option for many people experiencing hair loss.

Award-winning clinics like The Treatment Rooms London provide and prioritise personalised assessments, employ highly skilled medical professionals, and utilise cutting-edge technology to ensure your hair loss is treated with dignity and that you are well informed of all the treatment options.
Get in touch today to find out more.