Hair Transplant: What You Need to Know

Medically reviewed by Jeffrey Epstein, MD, FACSHair Restoration Surgeon, Board Certified in Facial Plastic Surgery
Written byJolene EdgarUpdated on December 6, 2022
RealSelf ensures that an experienced doctor who is trained and certified to safely perform this procedure has reviewed this information for medical accuracy.You can trust RealSelf content to be unbiased and medically accurate. Learn more about our content standards.
Medically reviewed by Jeffrey Epstein, MD, FACSHair Restoration Surgeon, Board Certified in Facial Plastic Surgery
Written byJolene EdgarUpdated on December 6, 2022
RealSelf ensures that an experienced doctor who is trained and certified to safely perform this procedure has reviewed this information for medical accuracy.You can trust RealSelf content to be unbiased and medically accurate. Learn more about our content standards.

Fast facts


Hair transplant surgery is a cosmetic procedure that involves taking donor hairs from one or more areas of your body—most commonly the back or sides of your scalp, or even your beard, back, or chest—and moving them to an area where you've had hair loss.

The healthy hair follicles are transplanted as “grafts” that each contain one, two, or three hairs.

Hair grafting was once done almost exclusively on the scalp, and that’s still the most common procedure. However, hair restoration surgeons are now doing beard transplants, eyebrow transplants, and even eyelash transplants, according to Dr. Jeffrey Epstein, a facial plastic and hair restoration surgeon in Miami. 

According to the American Academy of Dermatology, more than 80 million men and women experience hair loss. It’s normal to lose 50–100 hairs a day, but bald spots, a thinning part, and a receding hairline may indicate a bigger issue that warrants hair transplants.

For most people, the causes of hair loss are genetic. Androgenic alopecia, also called female or male pattern baldness, commonly begins in men as a receding hairline or thinning in the crown, while women usually experience recession near the temples and a widening part.

Some people also develop an autoimmune disorder called alopecia areata, which can lead to patchy hair loss anywhere on the body.

If your hair loss hasn't progressed too far, and any underlying medical conditions can be successfully treated, a hair transplant can usually restore most of what you’ve lost—and deliver a boost to your self-confidence.

Interested in a hair transplant?

Find a Doctor Near You

Pros

  • After an expertly performed hair replacement procedure, the new hair continues to grow for the rest of your life. 
  • Surgical hair restoration is usually performed under local anesthesia with sedation, so you should be awake but relaxed and sleepy, with little discomfort during the procedure.
  • Hair transplant results can look extremely natural, when they’re done well.  
  • Most patients don’t need pain medication afterward, especially with the FUE (follicular unit excision) technique, says Dr. Epstein.  
  • A majority of reviewers on RealSelf say their hair transplantation was Worth It, citing a boost in their self-esteem.
  • Eyebrows, beards, and other thinning areas can also be restored with hair transplants.

Cons

  • A hair transplant is an expensive procedure that isn’t covered by insurance.
  • A hair transplant doesn’t stop the progression of future hair loss. Patients may need to have subsequent procedures, if preventative hair restoration therapy isn’t taken or doesn’t work. 
  • When this type of surgery goes wrong, hair transplant results can look unnatural or just plain bad, due to poor design and technique. Many of the RealSelf members who rated their surgery Not Worth It say their hair implants look pluggy and sparse. 
  • A botched hair transplant can damage surrounding hair follicles and increase shedding.  
  • Not all transplanted hair will survive, so it may not be possible to achieve a full head of hair. 
  • While your hair transplant scar can usually be hidden under the surrounding hair, it's possible to be left with visible scars, particularly if you like to keep your hair cut very short.
  • A hair transplantation can take up to eight hours. “It’s not a speedy process,” says Dr. Epstein. “The goal is to get the best regrowth of hair by properly handling each graft.” 
  • Because the procedure is so long, some patients have reported that their anesthesia started to wear off and they had to request additional numbing after feeling some discomfort.

  • Average Cost:
  • $7,300
  • Range:
  • $2,387 - $19,000

How much a hair transplant costs depends on factors like who’s performing the procedure, where they're located, the number of hair grafts needed, the device used, and how long your procedure takes.

You can finance your treatment with CareCredit.

See our complete guide to hair transplant surgery costs

Interested in a hair transplant?

Find a Doctor Near You

The hair transplant photos in our gallery have been shared by the provider who performed the procedure, with the patient's consent.

The best candidates will be in their late 20s or older. When you’re in your early 20s, it’s hard to know how much more hair you’ll lose in the future. Plus “younger patients tend to have unrealistic expectations,” notes Dr. Epstein. Most older patients already show signs of male- or female-pattern hair loss, making it easier for hair transplant surgeons to predict future hair loss and create a hairline that looks natural.

To achieve the best hair transplant results, you’ll need enough healthy donor hair for the surgeon to harvest. If your scalp is thinning all over or you already have significant hair loss, you may not have a healthy enough donor site for a successful hair transplant procedure.

A survey of hair restoration specialists found that hair transplant surgery is performed on men nearly 86% of the time, but women can also be good candidates, with a high hair transplant success rate, even if they have long hair. 

RealSelf Tip: If a receding hairline is your primary concern, you might be a good candidate for a hairline lowering procedure called forehead reduction surgery.

Before a hair transplant procedure, patients are typically sedated (so they’re awake but relaxed), and the areas of the scalp that will be treated are numbed with a local anesthetic. RealSelf member R. Ahmed describes the process as “a little painful but bearable.”

There are two primary hair restoration techniques.

Follicular unit transplantation (FUT), aka the strip method 

  • The hair transplant surgeon makes an incision with a scalpel and removes a strip of skin with healthy hair from the back of your scalp. 
  • The incision is closed, and you’re left with a fine-line hair transplant scar that’s usually concealed by hair. 
  • This technique should produce a lot of viable grafts, which are extracted and transplanted to the recipient area. 

Follicular unit extraction (FUE), aka follicular unit excision

  • The surgeon removes individual hair follicles not only from areas of the scalp, but also from the beard, back, and chest, for transplantation into the scalp. 
  • “An FUE hair transplant is the much more common technique, [and since] we move hair grafts one at a time, there’s no linear scar,” says Dr. Epstein. “It’s an excellent option for patients who have the need for a large number of grafts, or who’ve had a prior transplant with scarring of the scalp donor area,” he says. 

In both cases, after the donor grafts are obtained, the surgeon creates tiny holes in thinning or bald areas with a blade or needle. Then they implant the grafts, which are tiny bundles of one to three hairs. 

“The aesthetics are absolutely determined by how the surgeon makes the recipient sites—the angulation, the pattern—and the distribution and placement of the grafts,” says Dr. Epstein. 

If you’re having an FUE hair transplant procedure, keep in mind that the surgeon usually will shave the donor area before extracting hairs. However, there’s also the option of undergoing what is called a “no-shave” FUE, a more time-consuming and meticulous technique that allows the surgeon to harvest all of the grafts without needing to trim the donor area. 

Note that an FUE procedure isn’t truly scar-free: You’re left with tiny dots where the hairs were extracted. But once your shaved hair grows back, those spots should be undetectable, even if you keep your hair short.

About 80% of all hair restoration procedures are now done with the FUE technique, according to Dr. Epstein. More and more often, you’ll find these treatments being performed by technicians rather than physicians, especially at hair transplantation clinics that use proprietary devices.

Some use the robotic hair transplantation device Artas to extract the grafts, and even to make the recipient sites prior to implantation. 

Others use NeoGraft, a device that can harvest the FUEgrafts. NeoGraft is often marketed to doctors as a way to delegate the procedure to technicians who are trained by the device manufacturer and then hired for the day. 

You’ll get the best hair transplant results with a licensed physician who has extensive training in hair-restoration surgery. “You want to make sure your doctor is doing the work,” says Dr. Epstein. There are a few reasons for this: 

  • A hair transplant is a surgical procedure, so not doing it properly can put the patient at risk. 
  • A technician lacks aesthetic training, so they may not pay close attention to the direction and pattern of the implanted grafts.
  • They also usually lack formal medical training, so they may misdiagnose a hair disorder that’s caused by an underlying disease.

At your consultations with potential hair-transplant surgeons, ask to see a lot of pictures. “Make sure they’re photos of the doctor’s patients and not from the manufacturer of the device,” says Dr. Epstein. You’re looking for results that appear natural and believable, with a well-shaped hairline.

“Hair transplant recovery is usually a piece of cake, especially in the donor area where the grafts were taken out, which should be fully healed in three days,” says Dr. Epstein. 

You may experience mild scalp tenderness and swelling, along with some scabbing and crusting for six to seven days where the hairs were implanted. “If follicular unit extraction is performed, the donor area on the back of the head will be essentially healed and not noticeable within 7–10 days,” says Dr. Matthew Richardson, a Frisco, Texas, facial plastic surgeon.

For the first five days, you’ll want to take a gentle approach when washing your hair. Use a mild shampoo and don’t scrub aggressively (you don’t want to dislodge a graft). After that, it’s safe to resume your usual hair washing habits. 

You can start exercising again five to seven days after the transplant.

Two to three weeks post-transplant, the hair implants will fall out. Don’t be alarmed: They’ll grow back. “The new hair starts to grow three to four months later and continues to grow for a lifetime,” says Dr. Epstein. 

At about 6–10 months post-op, you’ll start to see real results as the new hair grows in. 

After 10–12 months, you’ll see 90% of the results of your new hair growth.

See hair transplant before and after photos

The transplanted hair should be permanent. 

However, you can have new thinning in other areas. To help maintain your fuller head of hair, your provider may recommend complementary hair loss treatments, such as medications like minoxidil (Rogaine) or finasteride (Propecia). 

“We have recently found significant success in the prescribing of topical finasteride and minoxidil compounded solutions, which seem to work well without the undesirable risk of sexual side effects” adds Dr. Epstein.

With an experienced surgeon who has a solid hair transplant success rate, this procedure carries minimal risks. 

Minor hair transplant side effects like bleeding, itchiness, swelling, and crusting where hair was harvested or implanted usually clear up in a few weeks. 

Some patients can develop an infection or inflammation called folliculitis. Talk with your surgeon about how to gently clean the areas of the scalp that were treated. 

"Shock loss" of the original existing hairs right after the transplant is not common, but it can happen. It’s usually temporary, though a botched hair transplant can damage surrounding hair follicles, leading to tufts and patchiness that can only be remedied by another procedure. 

Some visible scarring is also possible, especially if you like to wear your hair short.

There are several nonsurgical hair loss solutions, though none offers the no-maintenance permanency of surgical hair restoration.

If you want to avoid a surgery (and hefty hair transplant costs), explore the best treatment options to regrow thinning hair.

Interested in a hair transplant?

Find a Doctor Near You

Updated December 6, 2022

0

0

Featured stories from RealSelf News