What Is a Hair Transplant?

A hair transplant is a surgical procedure used for people who are experiencing hair loss, most often male- or female-pattern baldness. During the procedure, hair is moved from an area of your scalp where hair grows more plentifully to areas of your scalp where you have hair loss. A surgeon performs the transplant alongside a team of hair technicians, nurses, and other personnel.

Purpose

People usually seek hair transplants because they are distressed by their hair loss or want a more youthful or natural appearance. The hope is that the procedure can improve their self-confidence and appearance.

Hair transplants are primarily performed on people who are experiencing male- or female-pattern baldness (androgenetic alopecia). The condition's prevalence increases with age. With male-pattern baldness, hair loss usually starts at the hairline and gradually recedes backward in an "M" shape. With female-pattern baldness, the hair thins throughout the scalp.

Male- and female-pattern baldness aren't the only conditions that might prompt someone to seek a hair transplant. You might also be a candidate for a hair transplant if you've experienced hair loss from other causes, such as injuries or lupus.

Types of Hair Transplants

With a hair transplant, hair is removed from the part of your scalp where the hair grows more plentifully (for instance, in male-patterned baldness, usually the back of the head) to the areas where hair loss is occurring. This can be done in one of two ways: a follicular unit transplantation (FUT) or a follicular unit extraction (FUE).

Follicular Unit Transplantation (FUT)

For the FUT technique, a small strip of scalp skin containing hair follicles is removed from the area of your scalp that has more hair. The strip of hair follicles is then separated into smaller pieces and transplanted into the part of your scalp where hair loss is occurring.

Follicular Unit Extraction (FUE)

FUE is similar to FUT in that hair follicles are removed from the hairier area of your scalp and transplanted to the less hairy area of your scalp. But with FUE, each follicle is removed individually and then inserted into small holes made in the area of hair loss. The FUE method minimizes scarring because it doesn’t involve removing a strip of skin.

FUE is the more common technique. This is partly because the postoperative pain and healing time are less than with FUT. Another benefit of FUE is that the surgeon can use hair from other parts of your body for the transplant.

How Does It Work?

Hair transplants are usually done as an out-patient visit at a location like a plastic surgeon's office, meaning you don’t need to stay at a hospital to get a hair transplant. You will be awake during the procedure, but your scalp will be numb so the procedure won’t be painful. Recovery can take place at home, and your care team will give you instructions for scalp aftercare and pain management.

Before the Procedure

Before your surgery, you will likely have a consultation with your hair transplant surgeon to discuss your goals for surgery. This also gives your medical team an opportunity to assess your scalp and come up with a plan for surgery.

On the day of the surgery, your scalp will be thoroughly cleaned, and you will be given a local anesthetic to numb your scalp. Your care team will mark off the areas of your scalp where hair will be removed, as well as the areas where the transplantation will occur.

During the Procedure 

Hair transplant procedures are done carefully and meticulously. Hundreds or thousands of hair follicles can be transplanted during a procedure, which means that hair transplants can take several hours from start to finish. Here’s what to expect while the procedure is occurring:

1. The surgical team will position you so that you are lying face down.
2. They will prepare the area from where the hair will be extracted (donor site) by shaving it down to 2 millimeters.
3. During a FUT procedure, a small strip of scalp tissue and hair follicles will be removed with a scalpel. The area where the removal takes place will be stitched closed afterward. For a FUE procedure, individual hair follicles will be removed using a small device.
4. You will be sat up for the rest of the procedure.
5. The transplant area (recipient site) will be thoroughly cleaned.
6. Small cuts will be made in the recipient site, and the hair from the donor site will be carefully transplanted into these incisions.
7. The scalp will be cleansed and covered with gauze.
   

Your hair's color and texture might affect how much hair needs to be transplanted. Coarse, gray, or light-colored hair can provide more coverage than fine, dark hair.

After the Procedure

You should be able to return home soon after the procedure is done. Your care team may have you wear a bandage that applies pressure to the area for a day or two.

You may be advised to rest for a few days or a week as your scalp heals. You may also be asked to sleep with your head elevated to minimize swelling. The area can be iced to decrease swelling, as well. Any pain can be managed with medication, which your care team may prescribe to you. You may also be given antibiotics to reduce the chance of infection as well as anti-inflammatory medications to decrease swelling.

Other care instructions may include dressing for the surgical wounds, followed by topical treatment to prevent scarring. Your care team will let you know when you can resume activities like showering or using shampoo.

Risks and Precautions

Hair transplants are generally a low-risk procedure with manageable side effects. This is because there is a plentiful blood supply to your scalp, which aids in healing. Possible complications and side effects to hair transplant procedures include:

• Swelling
• Bleeding
• Pain
• Numbness (This is usually temporary, but it can be permanent.)
• Hair shedding at donor or recipient site (This is temporary, and hair will grow back in three to four months.)
• Ingrown hairs
• Non-cancerous cysts beneath the skin
• Infection (This is rare, especially with preventative antibiotics.)

There are certain populations who might not be good candidates for hair transplants. For instance, hair transplant might not be for you if you use medication that slows or impacts hair growth. Hair transplant might also not be the best option for the following groups:

• People who've experienced symptoms like fever, rashes, and itching with their hair loss, since this might signal an inflammatory condition
• People who've had hair trauma because they've brushed, blow-dried, or scratched too much
• People with certain medical conditions, including vitiligo, thyroid disease, diabetes, HIV, syphilis, vitamin deficiencies, and recent pregnancy
• People with psychiatric conditions like body dysmorphic disorder or a hair-pulling disorder since the conditions may make people be dissatisfied with or have unrealistic expectations of hair transplant surgery
  

How to Prepare for a Hair Transplant

You’ll have an appointment with your care team before the surgery takes place, and you’ll be told how you should prepare for the surgery. Depending on your medical history and needs, your team may ask you to refrain from eating certain foods, drinks, supplements, or taking certain medication before the procedure. They will also discuss what clothing to wear and who you can take with you to the procedure.

If you smoke, you will be asked to refrain from smoking before your surgery, as studies have shown that smoking can decrease blood flow to the scalp and increase your risk of tissue death after surgery. Although sometimes hair shaving or trimming is done during the procedure, some surgeons may ask you to shave or trim the hair on the donor site before you come to the office for the procedure.

Hair transplant surgery is not used to treat medical conditions. Rather, it's a cosmetic surgery to increase confidence and improve a person’s emotional well-being. As such, hair transplants are not covered by insurance. If you'd find it helpful, you can ask your provider if a payment plan is available.

Results

Most people who have hair transplants notice substantial hair growth in the areas where hair was transplanted within a few months. Sometimes more than one procedure needs to take place for more satisfying results. If you need more than one procedure, you'll likely have to wait a few months between sessions to allow your scalp to heal. Once the hair transplantation is fully done, it can take up to two years to see completely final results.

In many cases, hair replacement is permanent, and no follow-up care is needed. Although, research shows that it's possible to experience some change.

A 2020 study looked at how long hair transplants lasted for people who received a FUT transplant. Of the 112 participants, 81% reported positive results one year after the procedure. However, after four years, most participants reported some reduction in hair density in the area where the transplant occurred.

Your care team will help you understand the success rate of the specific procedure you are having, what factors may affect that success, and whether any follow-up procedures will be necessary for continued satisfaction.

A Quick Review

A hair transplant is a surgery where hair is taken from one part of your scalp and moved to an area on your scalp where hair loss is occurring. The procedure is usually used for people who are experiencing male- or female-pattern baldness.

Your scalp will be numbed for the procedure so you won’t feel pain. The procedure is low-risk and may involve some swelling and soreness afterward which will subside within a few days. Results are typically successful, and you'll start to see noticeable hair growth in the months following the surgery.

People with certain conditions or who take certain medications might not be good candidates for a hair transplant; a surgeon can let you know whether you are eligible for the procedure and what you might expect your results to be.