Losing a few strands here and there is a normal part of your hair growth cycle. But for millions of people, hair loss can be more severe — from sudden bald patches or loose hair follicles to receding hairlines and visible scalps.
Significant hair changes can be distressing, but in many cases, the problem can be treated with a hair transplant. It’s a widely performed medical procedure in which a surgeon surgically adds real hair to a person’s scalp. Worldwide, more than 700,000 people had hair transplant surgery in 2021.
Hair transplants can be a big investment: Health insurance doesn’t usually pay for them, and many recipients need touch-ups before noticing results. Yet experts say the success rate is high, and advancing technology is making the process more efficient. Below, two surgeons explain what goes into a hair transplant.
What happens during a hair transplant?
In a hair transplant surgery, a medical professional moves hair follicles from one area of a person’s scalp to an area with less hair, says Dr. Luis H. Macias, a Los Angeles-area plastic surgeon who regularly performs hair transplants. For example, someone might be balding on top of their head but have thicker hair in the back. “We ‘deforest’ the denser area, but not completely,” says Macias. “Usually, we leave 80 percent of the hair behind, so it’s not noticeable.”
Hair transplants are an outpatient procedure, meaning you get to leave the clinic or hospital the same day. You’re awake for the procedure too; patients typically undergo local anesthesia to numb the scalp, since hair transplants involve lots of incisions that can be painful.
There are two types of hair transplants. The oldest method is called follicular unit transplantation, which involves harvesting a “ribbon” of tissue from the back and sides of the scalp. Medical providers split that into different hair follicles, which are placed in the transplant area, says Dr. Paul T. Rose, a Bay Area hair transplant surgeon and former president of the International Society of Hair Transplant Surgery. FUT is the fastest and least expensive method, but it can leave a line-shaped scar on the back of the head.
The second method is called follicular unit extraction. A surgeon will use a circular knife, similar to a hole punch, to harvest hair follicles. “You’ll have up to 3,000 little punctures on the back of the head,” says Macias. After dissecting the follicles, the surgeon creates incisions on the scalp and inserts the hair.
While FUE doesn’t result in a noticeable scar, it’s usually pricier and takes longer. Either process could take about eight hours, as it involves a lot of precision. “We make the incisions in the direction of the naturally growing hair, so it looks more natural,” Macias says.
Surgeons usually ask patients to come back for a checkup a day or two after surgery. “We shampoo them and go over postoperative instructions,” Rose says. Expect to go home with special hair spray that helps your newly placed follicles heal and grow.
As with any surgery, hair transplants aren’t without risk. Patients may feel uncomfortable or swollen after the procedure. Some people experience bleeding after the surgery, and it’s also possible to get an infection or nerve damage in the scalp.
How much is a hair transplant?
Insurance doesn’t cover hair transplants because they’re considered cosmetic procedures. They can cost from $3,000 to more than $15,000.
Who can get a hair transplant?
Hair transplants aren’t for everyone. You have to have an area of healthy hair growth on the head. Macias says most people who get hair transplants have a condition called male pattern baldness, a genetic condition that causes hair loss on the top and front of the scalp. Less commonly, women can experience the same pattern.
Hair loss due to inflammation on the scalp, from conditions like lichen planopilaris or frontal fibrosing alopecia, usually doesn’t turn around from transplants. “In these disorders, the hairs are being eaten up, so if you try to do a transplant, the hairs will be lost,” Rose says.
Stress can cause hair to fall out across the entire scalp, which means people experiencing stress-induced hair loss often don’t qualify for a transplant. Luckily, Rose says that this usually resolves on its own with time.
If someone is a good candidate for hair transplant surgery, surgeons usually encourage taking over-the-counter or prescription hair growth medication before surgery to stimulate better hair growth in the donor area.
How do I get a hair transplant?
If you’re interested in a transplant, Rose recommends searching for hair transplant clinics in your area. There’s no official board certification for hair transplant surgeons. Certain dermatologists, plastic surgeons and even primary care doctors can do them.
You may have to go back a few times for your desired results. Transplanted hair grows like any other hair, but because hair follicles grow in different cycles, most people don’t notice a huge difference until after a few sessions of hair transplantation. “It’s not like liposuction or breast augmentation, where you see immediate results,” Rose says.