Hair Transplant FAQs

Hair transplantation, also called follicular unit transplantation, is a surgical procedure that involves moving hair follicles from one part of the body (donor) to another area (recipient) where additional hair density is desired. Most cases involve moving scalp hair from the back or sides of the head to areas of hair loss – usually the front and top of the scalp in androgenetic (pattern) alopecia.

This procedure is performed under local anaesthesia. It involves removing hair follicles from the scalp by either removing a strip of skin and hair which is then dissected under a microscope (strip method) or by punching out individual hair follicle groupings one by one (follicular unit extraction or FUE). Hair transplantation often involves transplanting thousands of individual follicular groupings. It’s a very labour-intensive procedure, often taking the whole day.

If your hair loss is hereditary (known as androgenic alopecia or male/female pattern baldness), then you are suitable for this procedure – as long as you have enough donor hair to be transplanted to make a difference to your appearance.

Other types of hair loss that can be treated by hair transplantation include traction alopecia (caused by tight braids and other restrictive hairstyles), and hair loss due to burn damage or scarring.

It is also possible for hair from the scalp can be transplanted to eyebrows, eyelashes, moustaches and beards when injury or skin conditions have caused hair loss in these areas.

Patients with hair loss caused by conditions that are ongoing or recurrent such as;

• alopecia areata
• thyroid disease
• diabetes
• anaemia
• hair-pulling (trichotillomania)
• drug induced hair loss
• post pregnancy (postpartum) hair loss.

We recommend you wait until at least the age of 25 before considering a hair transplant. This allows the hormones responsible for adult hair growth to stabilise. Early surgery can result in unnatural looking hair growth patterns.

Patients with a very early stage of androgenetic (pattern) hair loss may be directed to other treatments such as Minoxidil, Propecia/Proscar or hormonal treatments rather than transplantation.

Androgenic Alopecia is caused by a hormone called DHT. As testosterone is broken down by the body’s metabolism, different hormones are created, including DHT. As the body gets older, genetic factors can cause the amount of DHT created to increase.

The excess DHT then binds with receptor proteins in the hair follicles in certain areas of the scalp. The follicles affected by DHT begin to shrink, and the resulting hair is brittle and falls out more easily. The growth cycle of the follicle becomes shorter, until eventually the hair is too weak to push through the skin.

The areas at the back of the scalp are unaffected by DHT, and don’t tend to lose hair. The number and location of the susceptible hairs is determined by inherited tendency derived from either one or both parents. These susceptible hairs may still continue to fall out, so repeat procedures may be required if the hair loss worsens.

The hairs that are removed from the back of the head have no DHT receptors. Even if they are moved, they remain programmed to continue growing, so the transplanted hair is unlikely to fall out.

This is a possibility if you have androgenic alopecia although the hair loss usually slows down and plateaus after a certain age.

Medical treatments can be used to slow down or stop ongoing hair loss, but these will only work if you continue to use them. Please ask for our Propecia/Proscar factsheet to find out more.

If the cause of your hair loss is due to another condition such as an injury, then it may not worsen over time, but it is possible that you may develop superimposed hereditary hair loss as well.

After surgery, you will have small scabs in the transplanted area for up to 2 weeks. You may develop swelling in these areas, and have mild pain, or redness. Infection is very rare.

In the donor area, you will have a narrow scar (usually about 1mm wide) for an FUT procedure or small punch scars for an FUE procedure. Both scarring patterns should be completely hidden by your remaining hair when cut to a ‘number 2’ length (6 mmm) or longer.

This will depend on your individual circumstances and the procedure chosen. We usually advise you to take 7 days off work postoperatively. Most people feel physically well the day after surgery with only some mild discomfort in the donor region. However, there are scabs and possibly mild swelling in the recipient area that may be visible if you do not have enough remaining hair to cover over the transplanted hairs. Once the scabs fall off there is then there are no visible indicators of your surgery until the new hairs start to grow through three or four months later. For the first week after surgery, you should avoid
any strenuous physical activity nor work in any dusty or dirty environments.

With an FUT procedure, the sutures in the donor area will be visible until removed ten to fourteen days after the operation. Exercise or strenuous physical activity should be avoided for 30 days after an FUT procedure.

British Association of Hair Restoration Surgery
www.bahrs.co.uk

International Society of Hair Restoration Surgery
www.ishrs.org

The Hair Dr website
www.hairdr.co.uk