How Does a Hair Transplant Work?

I assume hair tranplant surgery is indeed that, surgery. But what are the steps that you go through during hair transplantation?

Doctor Answers 15

Hair replacement candidates must have healthy hair...

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Hair replacement candidates must have healthy hair growth at the back and sides of the head to serve as donor areas. Donor areas are the places on the head from which grafts and flaps are taken. Other factors, such as hair color, texture and waviness or curliness may also affect the cosmetic result.

There are a number of techniques used in hair replacement surgery. Sometimes, two or more techniques are used to achieve the best results. Transplant techniques, such as micro-grafts, follicular unit transfer, and single unit transfers are generally performed on patients who desire a fuller, thicker head of hair.

In follicular unit hair transplantation, a donor strip of hair is harvested, excising a narrow strip of scalp from the donor area - an area at the back of the head that is resistant to hair loss. Each follicular unit from the donor strip contains one to four hair follicles. Under a microscope, the individual hairs are separated.

Follicular unit transfer can be combined with dense packing techniques in a megasession. Patients enjoy more dramatic results with less operations when these procedures are performed at a single sitting. As many as 2200 follicular units can be transferred in one megasession.

Follicular unit transplantation is an extremely efficient manner of hair restoration because several thousand hair grafts can be obtained from one small, thin donor strip. While follicular unit hair transplantation is very simple by principle, it takes an experienced surgeon, attention to detail, an artist's touch, and micro-surgical skills for the best implementation of this technique.

Dallas Facial Plastic Surgeon

Hair transplantation

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I have outlined how a hair transplant is done on my website, so look at the web reference below for that link

William Rassman, MD
Los Angeles Hair Restoration Surgeon
5.0 out of 5 stars 29 reviews

Steps in hair transplant surgery

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It is basically harvesting hair follicles from one part of the body and relocating to any part of the body that needs hair.

Jae Pak, MD
Los Angeles Hair Restoration Surgeon
5.0 out of 5 stars 106 reviews

When performed as FUE transplant - it is a minimally invasive surgery with rapid recovery

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Hair transplantation is really about relocating (transplanting) the bald resistant hair follicles from the back of the head to the balding areas on the top of the head.

This process works for a lifetime because the hair follicles taken from the back of the head are genetically resistant to baldness, regardless of where they are relocated to.

Prior to surgery (procedure is don under local anesthesia) , the hair in donor area that will be surgically removed is trimmed. 

No trimming or shaving of hair is needed in the top recipient area. Tiny incisions are made in the recipient areas in irregular patterns that mimic nature. The follicular unit grafts will then be placed carefully into these tiny incisions. The tiny graft incisions heal rapidly. The redness and scabbing in the recipient area normally clears up within about one week.
Most patients are surprised by how little discomfort, if any, they experience during and after ARTAS  or NeoGraft surgery.
By choosing a FUE procedure you are avoiding big linear scar in the back of your head since FUE technique is minimally invasive.

FUE Hair Transplant Step by Step

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That depends on the type of hair transplant you are getting. If you opt for follicular unit extraction (FUE), these are the steps involved, in a nutshell:

  1. Patient lies face-down on operating table
  2. Local anesthesia delivered to donor site; possibly intramuscular hypnotics ingested orally for the purpose of relaxation
  3. Extraction of donor hairs in individual follicular units; micropunching tool, needle devices and magnification used (grafts preserved in a holding solution while awaiting implantation)
  4. Patient turns to lie face-up on operating table
  5. Local anesthesia delivered to recipient site
  6. Microscopic slits made for implantation; customary blades used for incision
  7. No staples, stitches or bandages needed
  8. Patient receives detailed care instructions, mild pain killers, topical medication, and antibiotics


Sanusi Umar, MD
Redondo Beach Dermatologic Surgeon
4.6 out of 5 stars 33 reviews

Hair is Transplanted from Healthy Donor Region

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During a hair transplant, a strip of skin is taken from the donor region over the ears which extends to the central back of the scalp. Then, if a follicular unit technique is used, the physician surgically separates individual follicular unit grafts from this tissue with the use of a sophisticated binocular microscope. The grafts are then transplanted into tiny custom-sized incisions in bald or thinning areas of the scalp.

The single-haired grafts are used to recreate a frontal hairline, while the two and three, four -haired grafts are placed behind the singles, and so on. Because the hair is kept in its natural follicular units, it grows in the recipient areas in the most natural way possible. These individual follicular units provide a soft, natural look.  During the follicular unit extraction session there is no strip but the individual follicles are extracted one by one.

Edmond Griffin, MD
Atlanta Dermatologic Surgeon
4.0 out of 5 stars 6 reviews

Hair Transplant Procedure Explained

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Step 1:  Harvest donor hair from the back of the head .  Step 2:  Insert into new recipient site.  This may sound simple but it takes a highly skilled staff with years of experience to accomplish this well. 

Jack Fisher, MD
Nashville Plastic Surgeon

Hair transplant procedure

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All of these steps will be explained to you during your consultation most of which should be done with the surgeon doing most of the consultation  (although in many large hair transplant "offices", the consultation is done only by the staff and the patient doesn't meet the surgeon until the day of the procedure).

After the area of the scalp skin that is going to be worked on is anesthetized, these are in the back of the scalp, a small narrow strip is removed and they are cut into small 1 or 2 hair grafts. The surgical donor area is then closed. The patient is then turned on his back. The bald skin in the front of the scalp is anesthetized and tiny holes made by a toothpick are made and then the 1 or 2 hair grafts are placed as close as possible in the previously bald scalp. A light dressing is applied which will be taken off the next day. And then in about 6-9 months brand new hairs are seen growing out all over the previously bald scalp.

Peter Goldman, MD (retired)
Los Angeles Dermatologic Surgeon

Steps to Hair Transplant Procedure

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The most important step in the procedure is actually not the procedure... it's the consultation. See an experienced hair transplant surgeon to determine if your actually a good candidate for hair restoration surgery. This is dependent upon age, speed and extent of hair loss, donor availability, expectations, etc. If you're a good candidate, basically the surgeon will determine how many grafts will be necessary, where the grafts will be placed, what is the shape and location of the hairline, etc. All of this is going to be determined in the consultation. So, in my opinion the most important step in the hair transplant procedure is seeing a surgeon with training and experience in hair restoration surgery.

Andrew Kaufman, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 16 reviews

What is the procedure for hair transplantation?

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First, you and your surgeon need to discuss where you want the grafts placed and how many grafts are to be transplanted.  He/she will need to assess your donor sites to make sure there is enough to achieve your goals.

On the day of the procedure, your scalp will be marked out.  If you are nervous, you may be offered some medication to relax you.  The scalp is then anesthetized and strips of hair are harvested.  The wound is then closed.  The grafts are then prepared in follicular units of one, two, and three follicles.  While the grafts are being prepared you can eat, sleep, or watch TV.

The grafts are then placed with the single follicle units more toward the areas where existing hair is less dense and the multiple units where the hair is denser.  This allows the grafts to blend in so you can't tell that they are transplants.  After the grafts are placed the procedure is over.

Kenneth L. Stein, MD
Chicago Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.