EXPERT GUIDE

Hair Transplant Guide (2021)

Medically reviewed by Dr. Sternberg Written by David Stelzer on 17 Feb 2021

Do you want to learn more about hair transplantation (methods, costs etc.)? Are you overwhelmed by the flood of information on the Internet? Then this is the right website for you. At medihair we have created the complete A-Z guide to hair transplantation.

No matter whether you are still thinking about surgery or have already decided to get a hair transplantation, this guide will help you make the best decision for your hair loss.

Definition and history

With hair transplantation, a patient’s hair is removed from one part of the body and re-inserted in the bald area.

This means that no new hair is grown by the transplantation, but the existing hair is distributed more evenly over the body to cover bald or thinning areas.

The origin of hair implants is 10,048 km away from the UK: in Japan. At the beginning of the 20th century, the two Japanese doctors Tamura and Okuda performed the first hair transplantation.

What was the result? Well, some hairs could be successfully transplanted, but the hair transplant was recognizable even from a distance, it looked very unnatural.

In the 60s, hair transplantation found its way to the western world. Dr. Orentreich transplanted the hair of his patients for the first time in the USA. Dr. Orentreich still looked quite unnatural decades after the hair transplant (so-called “hair plugs” were transplanted).

In the beginning of the 90s, the doctor, Masumi Inaba, from Japan, succeeded with a revolutionary technique (“FUE” – more about this later) in achieving a result which looked very aesthetic and natural. Masumi Inaba thus paved the way for modern, minimally invasive hair transplantation.

Since then, the methods of hair restoration have been continuously improving. Nowadays, hair transplantation can achieve a very natural looking result with no significant side effects.

Recently, hair transplantation has increasingly incorporated technology as a part of the procedure. Hair transplantation robots, such as the ARTAS technology, enable automated removal from the donor area. This method is much faster than manual transplantation and only the most vital hair is selected reducing the waste of hair grafts.

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Hair loss types

Before you start thinking about possible remedies for hair loss, you should first analyze your own hair loss in detail. It is important to first get a proper diagnosis before seeking out therapy.

At this point we can only give general advice on this and refer you to your specialist for individual diagnosis. There are three main types of hair loss:

Androgenetic hair loss
Androgenetic hair loss is by far the most type of common hair loss and affects 80 percent of all men. This type is also known as genetic or hereditary hair loss and usually occurs between the ages of 20 and 30. With androgenetic hair loss, the hair roots are extremely sensitive to the hormone dihydrotestosterone (DHT) and fall out.

In the typical course of the disease, the hairline recedes and will often begin at the temples. Later, the androgenetic hair loss can develop into a circular toning at the back of the head to a complete bald head with hair remaining only at the back and sides of the head.

Hair transplantation is an effective and lasting remedy for androgenetic hair loss.

Hair loss symptoms

Alopecia Areata
Alopecia Areata, also known as circular hair loss, is a form of patchy hair loss. This type of alopecia causes round hair loss spots to form on the affected person’s head.

The causes can be an autoimmune disease or stress. This form of hair loss is often temporary and in many cases, it can be solved by fighting the symptoms.

In case of Alopecia Areata, it is absolutely necessary to consult a specialist. The transplantation of the patient’s own hair is only suitable to a limited extent and depends on the individual cases.

Diffuse hair loss
With diffuse hair loss, hair falls out over the entire head area.

The causes can be stress, hormone fluctuations or malnutrition.

In many cases, it is sufficient to remedy the diagnosed causes e.g., by a change in diet. Hair transplantation is also rather unsuitable for diffuse hair loss and should only be performed in consultation with a specialist.

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Hamilton-Norwood Scale

Hair loss can range from a slight receding hairline to total baldness. The bigger the bald spot, the more hairs need to be transplanted. The degree of hair loss is determined with the Hamilton-Norwood scale. The scheme divides hair loss into seven different stages and is based on the typical course of androgenetic alopecia. For women, the typical hair loss is represented with the Ludwig or Olsen scheme.

Typical male pattern hair loss: The norwood scale.

Before considering hair transplantation, the patient’s own hair loss progress should be analyzed using the Norwood Scale. This will help you to determine how many grafts need to be transplanted and how much the hair transplant is likely to cost. Most of the patients have a type 4 prior to a hair transplant (accoding to the medihair hair transplant study).

Hair loss degree prior to hair transplant

What is a graft?

A graft refers to the strip, or piece of skin which contains a hair follicle to be transplanted. These grafts are typically harvested from the donor area at the back of the head. However, they can be taken from any part of the body (body hair transplant). Grafts are individually harvested in the FUE method, while grafts in the FUT method must be dissected after the strip of skin is removed from the head. In general, most clinics or surgeons will price their hair transplantation services per graft.

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Costs of hair transplantation

According to popular opinion, a hair replacement must be expensive! Is this right or is this a myth? Our large hair transplantation cost study helps here: Hair transplantation with the FUE method costs an average of 3.22 USD per graft in the UK and 1.07 USD per graft in Turkey. Accordingly, UK hair surgeons would charge 6,440.00 USD for 2,000 grafts and Turkish doctors 2,140.00 USD.

Hair transplant cost per country

This is of course a considerable amount that not everyone can afford to pay directly. However, you should know that hair restoration is a permanent procedure and the transplanted hair will not fall out again. Hair transplantation is therefore worthwhile for most patients.

In most cases there is no medical necessity for hair transplantation. Therefore, the costs for the cosmetic operation are not covered by health insurance.

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Hair transplantation methods

There are many different transplant methods to pursue when looking at getting a hair transplantation. The following treatment methods are most frequently used:

  • In the FUE technique (short for Follicular Unit Extraction), individual hairs are removed from the donor area using a hollow needle, processed and then re-inserted in the desired location. Recently, in combination with the FUE technique, the extraction with a robot (e.g. with the ARTAS technique) is also offered. This procedure has the advantage that only the most vital hairs are removed and the operation time can be shortened. The DHI technique uses a special tool to remove the grafts and then directly implant it into the scalp without having to create incisions ahead of time.
  • The FUT procedure (short for Follicular Unit Transplantation) differs from the FUE method especially in the removal technique. Here, a whole strip of hair is taken from the donor area and then fragmented. Therefore, this procedure is often known as the strip method. The implantation is similar to the FUE method.

Hai Transplant FUT or FUE

Important!

The best method for your hair transplantation depends on your hair loss degree, your age and the surgeon. Every hair surgeon has his or her preferred method. Many hair surgeons only know the FUE method and few know both the FUE and FUT methods. Whether the FUE, FUT or ARTAS method is used there are excellent results in practice: Checkout the results

What is the right time to get a hair transplant?

Should I wait to get a hair transplantation until my hair loss is complete? Many patients ask this question and the answer depends on the individual case. Before a hair implant hair loss should have stabilized, otherwise further bald spots may appear, which will make the transplanted hair look unnatural.

Professional literature distinguishes between three different forms of hair loss:

  • In the “Early Wildfire”, the hair begins to fall out beginning at the age of 20. The hair loss then progresses rapidly and reaches the fifth, sixth or even seventh stage of the Norwood Scale before the age of 30. In the case of “Early Wildfire”, hair transplantation can often be considered as early as the age of 30, as long as there is enough donor hair available.
  •  If the hair does not fall out until the age of 30, it is called “Early Smoldering”. Often this hair loss proceeds more slowly and stagnates at a middle stage of the Norwood Scheme. With this form of hair loss, it should be stabilized before a hair transplantation is performed.
  • The so-called “Late Onset” describes hair loss that does not begin until the age of 40. This hair loss usually proceeds very slowly and only very rarely ends in complete baldness. For this reason, hair transplantation can be useful in the “Late Onset” at an early Norwood stage.

Average age of patients at first hair transplant

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Who is a candidate for a hair transplant?

Patients over the age of 40, with an ample donor area suffering from androgenetic alopecia are optimal candidates for hair transplants. In some cases, a hair transplant is suitable for individuals in their 20s. However, it is important to talk to a specialist and get a full anamnesis before getting a transplant at this age. You don’t want to have hair transplanted to a bald area that will eventually fall out as well because it is not resistant to DHT. This can happen when doctors perform a transplant on a patient whose hair loss has not fully developed.

Certain hair characteristics such as curly or wavy hair or thick hair, will have more natural results than those with thin, straight hair. Dark hair is generally easier to transplant than light hair. Especially for patients who have lighter skin, the contrast helps surgeons and robots to identify the individual hair follicles.

Opportunities and risks

There are certain risks associated with hair transplants. Before you have your hair transplanted, you should be aware of these risks and weigh them against the benefits. The following list of risks and opportunities can help you to do this:

Pro Cons
Hair transplantation offers a sustainable, long-term solution to hair loss that requires little to no mainte-nance. A hair transplantation is considered to be a surgical procedure, and as such there are associated risks like infection, these are relatively low for hair transplants though.
There are very few, small side effects from the pro-cedure which usually alleviate within weeks of the transplant. The drug finasteride can impair the sex drive and cause depression. There are minor side effects such as swelling, tension, slight bleeding, and feelings of numbness. These will all subside in the first week after the procedure for most patients.
Although the initial cost of a hair transplant is quite large the money an individual spends on other hair loss remedies over many years is nearly equal. An individual will spend an average of 10,000 USD on minoxidil over a 30-year treatment period. Hair transplants cost an average of 1.07 USD per graft in Turkey and 3.22 USD per graft in the UK. With an average of 2,500 grafts being transplanted this can be quite costly.
A hair transplant can dramatically improve an indi-vidual’s self-esteem. There is a risk of the transplant having unnatural results, however this is very low when a surgeon has lots of experience with these procedures.

Hair transplantation has a lot of potential. Although there are risks that everyone should be aware of before the operation, they are often less than the risks of comparable hair loss remedies. It is also important to understand that a hair transplant is often complementary to hair loss medication such as finasteride and minoxidil and not an alternative. Furthermore, hair transplantation is more promising than, for example, mesotherapy or PRP treatment. In addition to the general risks associated with these therapies, there are also method- and location-dependent risks. In order to increase the density, more and more patients receive in addition to the hair transplant a scalp micropigmentation, especially for the crown region.

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Which hair surgeon?

Do you want to get advice from a hair surgeon? Or have you already decided to have a hair restoration and are now looking for the right hair surgeon? Then you are in exactly the right place with Medihair. On our platform we compare over 100 hair surgeons and clinics. And the best thing is: We do it all independently and free of charge for you.

We compare costs, quality, location and much more. We have already done all the tedious research work for you.

hair transplant where

Our hair loss experts also updates our information and content daily with its meaningful evaluations, experience reports and before-and-after pictures to ensure that you will find the perfect hair surgeon for your hair transplant.

Get an overview of the methods and prices of hair surgeons in the following locations:

Is your preferred city or country not mentioned? No problem, just sign up and we will provide you with qualified hair transplant doctors near you.

Our Tip

Inform yourself comprehensively about the procedure and compare several offers so that you can make an informed decision. There are big differences in quality and price between the individual providers. Our experts will be happy to help you: Inform yourself now

Consultation and pre-treatment

The consultation by a hair surgeon before a hair transplantation is very important, because only the hair surgeon can determine the appropriate treatment method for your hair loss. In addition, the hair surgeon can inform you about the results you can expect from a hair transplant. During the preliminary examination, the hair loss is determined, the future development of hair loss is predicted and the possible donor areas are analyzed. The consultation not only serves to inform you about possible treatment options, but also to enable you to examine the hair surgeon and his clinic in detail. You should therefore prepare yourself for the consultation and ask the hair surgeon questions. This will give you an impression of his competence and the quality of the facility.

The consultation is often not free of charge, since hair transplants are usually not medically necessary and are therefore not covered by health insurance. However, if you choose the hair surgeon, the costs incurred for the consultation are deducted from the surgery costs.

However, the consultation costs should not prevent you from having a consultation. Often it is even worth taking several consultations with different hair surgeons, as there can be considerable differences between hair surgeons, in price and quality. After all, hair transplantation is not an insignificant procedure and should be considered carefully.

Hair transplant by gender

Procedure

A hair transplant procedure takes between 3 and 7 hours. First, the grafts are removed from the donor area, prepared and re-inserted at the desired location. The treatment is performed under local anesthesia and the donor area is usually shaved bald in both the FUE method and the FUT method. The donor area is in most cases the back of the head. If this region is not suitable the beard can also be the donor.

In the FUT method or strip method, a strip of skin with a dense amount of hair, which can be up to 1.5 cm wide, is taken from the donor area. Using a special technique, the resulting wound is sutured up so that the hairs can grow on the scar. The scar is no longer visible from a hair length of 1.5 cm. After the removal, the skin strip is dissected under a microscope into the individual grafts or hair follicles. Then the receiving holes are made in the anesthetized recipient area, into which the prepared hair roots are then implanted.

The FUE method differs from the FUT method only in the sampling. In this method, individual grafts are removed from the anesthetized donor area using a hollow needle with a diameter of 0.8 – 1.1 mm. The removal is either performed manually by a physician or with a robot, such as the ARTAS robot. The tiny donor sites remain open and heal later. For this reason, many small crusts form in the donor area after the operation, which are removed within two weeks.

Most common hair transplant method

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Aftercare

With the FUT method, the stitches are removed from the donor site after approx. 2 – 3 weeks. The temporary lack of oxygen to the graft during the operation causes the transplanted hair to fall out after the hair transplantation. Especially with the FUT method, the described “shock loss” can occur after the operation and hairs in the area around the donor site can fall out. The hair can be washed two days after the operation with a mild shampoo e.g., with a baby shampoo. After about 12 weeks, the first hairs sprout from the displaced hair roots. For the first few centimeters, the new hair grows curlier than the rest of the hair. But after about 5 centimeters, the hair continues to grow in the original shape, structure and color of the donor site.

After the hair transplantation, certain activities and hair products should be avoided for a certain period. For example, you should not dye your hair or treat it with other chemical products for up to two months after the operation. Heavy work and sports should be avoided in the first week after the hair replacement. In the first month, you should also avoid going to a solarium or sauna.

When can I expect the final result?

In most cases, the result is already visible after 6 to 9 months after the operation. The final result can be expected after a year. Do not be shocked if the transplanted hair falls out in the first weeks after the surgery. This is called the “shock loss” of the transplanted hair, the new hair growth usually begins to grow within the 5th to 6th month.

Growth after hair transplantation

Before and After hair transplant

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Is one hair transplant for full coverage?

The number of grafts an individual needs is determined by the extent of the hair loss. The more severe the balding, the greater the number of grafts. Many hair surgeons will transplant up to 2,500 grafts in one sitting, it is unwise to do any more than that. The process is time-consuming and the surgeon will become tired and unable to provide the same quality of work as when they began the procedure. For extensive hair loss the procedure may take several days.

Average number of grafts per hair transplant

Generally, a single hair transplant will provide full coverage of the bald area. In the future patients may seek touch-up procedures, but if the transplant is successful only one large transplant should be necessary.

Summary

The path from the hair transplant to the new hair does not have to be rocky. With the help of this guide, you can tackle the subject of hair transplantation easier, faster and better. But of course, this guide does not replace a visit to the hair surgeon or a consultation. With the help of the preliminary examination a hair surgeon can judge the suitability of a hair transplantation. We strongly advise against a hair transplantation without a preliminary examination.

Hair transplantation is one of the few sustainable solutions against hair loss with relatively few side effects. This has become a popular hair loss treatment option for celebrities such as Wayne Rooney or Elon Musk. In 2019 there were roughly 182,025 hair transplant procedures performed in the US/Canada and 106,949 procedures performed in the UK. This is an increase of 75% in the US/Canada from 2008 and an increase of 231% since 2008 for Europe.

Emotional impact of a hair transplant on a patient

Of course, the price is high and the decision-making process is not easy. When making a decision, the performance and quality of the respective hair surgeon should be particularly important. Our hair transplant comparison with over 100 hair surgeons using many evaluations and reports from patients is very informative.

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Frequently Asked Questions

How much does the hair transplantation cost?

How successful is a hair transplantation?

How long does a hair transplantation last?

Is hair transplantation painful?

How long does it take after the hair transplantation to achieve the final result?

Do you have to shave your head for a hair transplant?

Is it possible to wear a hat after a hair transplantation?

Source

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