Hair transplant: how it works, recovery, risks and what to ask

A hair transplant moves hair-bearing skin from a donor area to a bald or thinning area of the scalp.¹ It is surgery, and the plastic surgeons' society (ASPS) says the outcome is never completely predictable.¹

Here is how the two main methods differ, who the ASPS says is a candidate, what recovery involves and the risks. It is a society of plastic surgeons describing its own field, so weigh it accordingly. Whether to have a transplant is for you and a surgeon.

The two main methods

In follicular unit extraction, individual hair follicles are removed from the back of the scalp and inserted into the recipient site. In follicular unit transplant, a strip of skin with follicles is removed from the back of the scalp, and the follicles are separated from it and placed.¹ The ASPS calls extraction the newer and more common method, and typically less invasive, with quicker recovery and less scarring. It says the strip method is still performed and has its own benefits.¹

Flap surgery, tissue expansion and scalp reduction are other ways to replace hair. The ASPS says grafting suits patients who want a more modest change in fullness, and that flaps, tissue expansion and scalp reduction are usually more suitable for a more dramatic change.¹

Who is a candidate

The ASPS says you may be a candidate if you have healthy hair growth at the back and sides of the head to serve as donor areas. Hair color, texture and waviness or curliness can also affect the result.¹ All hair replacement techniques use your existing hair, so the goal is the most efficient use of it, and the results won't necessarily match your ideal.¹

The ASPS also says that baldness is often blamed on poor circulation, vitamin deficiencies, dandruff and hat-wearing, and that all of these theories have been disproved. It adds that, as a rule, the earlier hair loss begins, the more severe it becomes.¹

Recovery and results

Any aching or throbbing can be managed with pain medication. Bandages, if used, are usually removed a day later, you may wash your hair gently within two days, and stitches come out in a week to 10 days.¹ The ASPS says to avoid vigorous exercise and contact sports for at least three weeks, and expect several visits in the first month. You may feel well enough to go back to work and light activity after several days.¹

Many patients are dismayed to find the transplanted hair falls out within six weeks. The ASPS says that is normal and almost always temporary, and that growth resumes after another five to six weeks, at about half an inch a month.¹

The ASPS says it is best to anticipate that you will need a touch-up procedure, and that your surgeon can usually predict how extensive it will be.¹

Risks

As with any surgery, infection may occur. Some grafts may not take, and sometimes the skin plug dies and surgery must be repeated. Small bumps can form at transplant sites and can usually be camouflaged with surrounding hair.¹ Scalp reduction can cause excessive bleeding or wide scars. If hair loss progresses after surgery, an unnatural, patchy look may result, and more surgery may be needed.¹

Which licensed professionals may perform a hair transplant depends on your state. The ASPS recommends a board-certified plastic surgeon. See our guide to who may inject for how to check a license.

Here is what to bring to a consultation.

Cost

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Common questions