Hair Transplant

A hair transplant involves surgery to restore hair to bald areas. It involves taking hair from a suitable donor area on your scalp that has good hair growth and transplanting the hair to the bald patch area. For most people it will help bring back hair to a varying extent in previously bald areas.

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Why is it necessary?

A hair transplant involves surgery and can be an expensive procedure. It's considered a cosmetic procedure and is not covered under the NHS and is usually an option that people explore when other treatments have failed. If your hair loss is negatively affecting your self-confidence or your self-image, a hair transplant could help.

Suitable candidates for hair transplants include:

  • Men who've experienced hair loss due to male-pattern baldness
  • Some women who've experienced female-pattern hair loss
  • People who've lost hair as a result of scalp injuries or burns

Hair transplant surgery is not suitable if:

  • You're a woman with diffuse pattern hair loss
  • You've insufficient donor sites with suitably thick hair
  • You've keloid scars as a result of trauma, burns or surgery

Types of Hair transplant

There are two key methods of hair transplantation – Follicular Unit Extraction (FUE) and Follicular Unit Transplant (FUT).

Follicular Unit Extraction (FUE)

Follicular Unit Extraction (FUE) is a method that involves harvesting and extracting the hair follicle units individually. Small circular incisions of about 1mm are made around hair follicle units and the hairs are carefully extracted. The process can take up to a few hours and is carried out under local anaesthetic. Little pinhole receptor sites are then created on the scalp of the bald area that the hair follicles can be transplanted into.

Follicular Unit Transplant (FUT)

A Follicular Unit Transplant (FUT) is a method that involves the removal of a strip of hair from an area more resistant to balding, such as the back of the head. Using microscopic dissection this is then divided up into many different individual follicle units. Similar to the FUE process, these are then transplanted into receptor sites created on the scalp of the bald area.

Results of Hair Transplant

Hair transplants are often successful and offer the chance of a long-term hair growth solution. Once hair is transplanted, it should begin to grow in the new area. The growth process usually involves:

2-4 weeks: Newly transplanted hairs fall out
1-4 months Hair begins to regrow
4 months Results can usually start to be seen
Ongoing Hairs should grow at a rate of half an inch per month

It's estimated that of those who have surgery, 60% of them will see new hair growth after six to nine months.

Advantages of FUE versus FUT

Follicular Unit Extraction (FUE) has a number of benefits over FUT, the transplant method.

  • It doesn't leave linear scars in the donor area
  • There is a shorter healing time in the donor area
  • There are no limitations on movement of exercise after the procedure
  • There is less discomfort during recovery from the procedure
  • It's a useful alternative when FUT is not suitable due to risk of scarring or the scalp being too tight to harvest a tissue strip
  • It can be used when a patient wants to cover up a previous linear scar
  • You can use it to transplant finer hairs from the nape of the neck

Disadvantages of FUE versus FUT

Follicular Unit Extraction (FUE) also has some limitations and drawbacks when compared with FUT, the transplant method.

  • Follicular units need to be extracted from a far larger area. Some of these areas may also be prone to balding in time and if that occurs the scars may become visible.
  • The quality of the grafts may not be as good, as it can be easier to damage the hair follicles and more difficult to harvest the full units.
  • With each session, the scarring increases as the number of donor extractions increase.
  • The process for extraction is slower and the procedure may need to be carried out over two days.
  • The slower process also means that grafts tend to be out of the body for longer which can affect their growth.
  • The time and equipment required means it's normally a more expensive procedure to carry out.

Research conclusion

While hair transplants can achieve hair growth in previously bald areas in 60% of cases, they are limited in their effectiveness. Hair transplants cannot create new hair. They can only re-distribute and graft existing hair. The techniques are also time consuming and expensive, which means surgical options are usually a last resort for people. However, this is a highly active research area and, as cloning and gene therapies advance, it is hoped in the future that new hairs could be created and these surgical techniques could offer greater results in years to come.

Alternatives to hair transplant

While researchers search for better solutions, there are already a number of another promising treatments that are available now. Two of the key treatments approved by the FDA are Minoxidil and Propecia.

Propecia is a tablet taken daily that contains the active ingredient finasteride. It can be up to 90% effective in the treatment of male pattern hair loss and works by stopping the breakdown of testosterone into DHT (dihydrotestosterone). This treatment is extremely effective in cases where hair loss is as a result of sensitivity to DHT and tackles the root cause of the hair loss.

Minoxidil is used as a topical solution that is applied directly the scalp twice a day. It's a type of medication known as a vasodilator and is thought to slow the progression of hair loss and boost hair growth by dilating the blood vessels in the scalp. This medication can be used to treat male pattern baldness.

As well as both of these being standalone treatments for hair loss, both of these products may also be recommended in conjunction with hair transplants to help boost hair growth before and after surgery.