How Hair Transplants Work

How hair transplants work

Introduction to Hair Transplants

Hair transplantation is a minor surgical technique for hair restoration which reliably and consistently restores hair, even to a bald scalp. The male hair transplanting technique relies on the fortunate fact that even men who lose a lot of hair will not lose the hair above the ears and the back of their heads. There are many older men with this characteristic ‘horseshoe’ shape of remaining hair to prove this fact. This is called the hair transplant donor area or the area left with a Norwood Stage 7 in the classification of hair loss.

For this reason, we work on the assumption that your hair loss will ultimately progress to Norwood stage 7 and only take hair from this region. This ensures that you will always have growing transplanted hair and that the donor area is always covered. In addition, this area is more densely packed with hair follicles than the rest of the head, even before hair loss starts. Women can also be helped by a female hair transplant. Although the type or pattern of female hair loss is different to a man, the hair transplant surgery technique is just the same and just as effective. The hair transplant donor area is also the same.

A hair transplant in detail

Hair grows not as single hairs, like teeth in a comb, but in little bunches called ‘follicular units’. These form the basis of our ‘grafts’. Follicular units typically average two hairs, but they can be just one hair or even four hairs. Because Nature grows the hair this way, it makes sense to put the hair back in this way to achieve the most natural look (rather than splitting up all the follicular units into single hairs). This is called follicular unit hair transplanting or FUHT (Follicular Unit Hair Transplant). Firstly though, we need to remove the hair from the donor area before we can re implant it. This involves transplanting the whole follicle i.e. the hair bulb and surrounding structures from one part of the scalp to another. The process is similar to gardening on a microscopic level – if you are transplanting a daffodil bulb from one area to another, you can’t just transplant the leaves or flowers (hair) but you need the whole bulb, roots and shoots (the hair follicle). The average number of follicular unit grafts that we transplant in a single session is typically around 2000 (equivalent on average to 4000 hairs). The actual number required by each patient varies depending on size of area, the donor density, the recipient density, hair type, age, potential of future hair loss etc. In some suitable candidates we can perform 3000 grafts or more in a single session which is known as a mega session follicular unit hair transplant.

The donor area

Men’s hair is thicker, bushier and faster growing on the back and sides of the scalp, which is why men traditionally have a ‘short back and sides’ haircut. This means that we can transplant hair from this region and move it to where it is needed without the donor area looking thin too. There is obviously a limit to how much hair can be removed, but experience has shown that up to six sessions is a comfortable average. Female donor hair isn’t usually as thick or dense as a man’s so that limits the number of hair transplant sessions to usually three. Because the hair that we remove from the donor area is genetically programmed not to fall out because of male pattern baldness (MPB) or female pattern baldness (FPB), the hair will continue growing on the bald scalp, just as it would have done if it had remained in the donor area. That is why hair transplantation can give you your own hair growing again, and that is why it won’t fall out again. This basic theory has been shown to be true for the past 80 years, since Dr Okuda (and others) in the 1930’s first discovered hair transplantation was possible. There are currently two methods of taking hair from the scalp: the strip hair transplant method of hair transplantation and the FUE hair transplant method. Please note: the method of re-implanting the hair remains the same, irrespective of the method used to extract it. As a side note, body hair transplants are also possible i.e. transplanting from a hairy chest to the scalp. However, this a very variable technique using the FUE method and results at best, are only additional to a good hair transplant performed using scalp hair first. It is also important to understand that hair transplanting does not create new hair but redistributes the whole follicle from the donor area. It therefore cannot regenerate itself but much research is taking place into the technique of hair cloning or hair multiplication.

The hair transplant recipient area

This is the area which we want to put the hair transplants back into. Usually this is the scalp – frontal, temples, hairline, crown etc but can be the body. We commonly perform eyebrow hair transplants and hair restoration for traction alopecia and also less frequently for the other causes of hair loss, as pubic hair replacement.

Body hair transplant

You can in fact perform a hair transplant from anywhere on the body to another location, on the same person. So move leg hair to the scalp for instance. Interestingly, the transplanted hair grows more similar to the natural location hair i.e. a leg hair will become thicker, longer growing, straighter etc. However, it doesn’t become a fully formed scalp hair, only more similar and less like a leg hair.

Hair transplantation – is a type of hair loss surgery, there are other hair loss surgeries available – click here to find out more.