We guide you through all the factors in how to get a hair transplant to ensure success, including when to do it, how to know if you are suitable, and how long it takes.
Thinning hair, a receding hairline or a bald head are no longer a fate that men simply have to put up with. In the fight against hair loss, transplantation from your own hair has proven itself. Hair transplants are now firmly established in surgical dermatology. This involves removing one’s own hair roots from a head zone with a thicker hair density, usually on the back of the head, and transplanting them into bald areas.
The most important area of application for hair transplantation is hormonally induced hair loss, known by experts as androgenetic alopecia. The hormone dihydrotestosterone (DHT) plays the decisive role here: the hair roots are overly sensitive to DHT and fall out prematurely. This hypersensitivity is built into the genes. Therefore, hair loss is only a matter of time, so to speak. In men, in extreme cases, only a fringe of hair remains on the back of the head. The hair growing there does not fall out even under the influence of DHT (“DHT-resistant hair roots”). Women do not go bald. Here the hair tends to thin out overall, preferably in the area of the middle parting.
Patients lose hair less often as a result of injuries, burns or operations. Certain skin diseases can also be responsible for permanent hair loss from time to time. These include alopecia areata, the so-called “circular hair loss”, and folliculitis decalvans, an inflammation of the hair follicles. After they have healed, bald spots may remain.
The hair on the head only appears visually lighter when more than half of the hair is missing. In this respect, it is sufficient for hair transplants to achieve a density of 50 percent of the original hair density. Hair transplantation is also possible for patients who have lost beard or eyebrow hair.
When is the procedure considered?
Hair transplantation is suitable for patients with irreversible hair loss. In the case of hair loss caused by hormones, doctors usually first attempt a drug therapy. For women, hormone-containing preparations and the active ingredient minoxidil are in the foreground. In men, medication can usually only prevent hair loss from progressing. Finasteride and minoxidil have proven themselves. However, many patients do not want to take medication on a long-term basis.
A hair transplant is an option when other therapies fail. In the case of hormone-related hair loss in men, however, many doctors advise against interfering with too early. They recommend a minimum age of 30 to 35 years. The hair loss should already have largely come to a standstill.
How does a hair transplant work?
When removing strips, a narrow strip of hair is removed from where there is still enough hair to remove the hair roots. With individual hair removal, the hair and its roots are extracted from the skin. In hair transplantation, removed hair roots are inserted where the hair should later become thicker again. New hair should soon grow here: A surgeon sets the receiver channels for the upcoming hair transplant on a patient’s forehead. A hair transplant is precision work. Only a specialized practitioner should do it.
Whether such a hair transplant is an option depends, among other things, on the cause of the hair loss. In addition to hereditary hair loss and hormone fluctuations, certain diseases, malnutrition or medication can also be triggers. If there is a disease behind the hair loss, the hair will grow back at some point. That is why those affected should definitely have the cause clarified by a doctor.
Hereditary hair loss: The so-called androgenetic alopecia is the most common form of hair loss in men. The reason for this is an over-sensitivity of the hair follicles to the hormone dihydrotestosterone (DHT). DHT is a conversion product of testosterone, a male sex hormone. As a result, the hair growth phase is shortened and the hair follicles atrophy. The follicles on the sides and back of the head are not affected. Therefore, these are particularly suitable for hair transplants.
For whom is a hair transplant suitable?
Another prerequisite for a hair transplant is that there are still enough functioning hair follicles with hair roots. The doctor usually finds hair roots in the side and back of the head, which can then usually be transplanted wherever thicker hair is desired. It is important that the patient is given intensive advice and information before the operation. Hair transplantation is not always recommended. If, for example, baldness is already well advanced, there may simply be too little donor hair for adequate coverage.
Hair transplant methods
If the patient is suitable for a hair transplant and has decided on one, the procedure is carried out on an outpatient basis. The patient is put into a twilight sleep. Under local anesthesia, the doctor usually removes healthy hair-producing roots from the back of the patient’s head and transplanted them into hairless regions. It is not possible to remove it from other people. The cloning or propagation of hair roots is not yet fully developed either. Local anesthesia of the scalp is usually sufficient for hair transplantation. The addition of adrenaline helps reduce possible bleeding.
There are usually two methods used for hair removal: Depending on how the hair roots are removed, a distinction is made between two techniques: With the Follicular Unit Transplantation ( FUT technique ), doctors remove the hair roots with a strip of skin, with the Follicular Unit Extraction ( FUE technique)) as individual hair root groups, so-called follicular units. One to five hairs grow from such a hair root group. In men, the DHT-insensitive ring of hair on the back of the head is suitable for hair removal, which is called a “safe donor area”. Even after the hair has been transplanted, it remains insensitive to the hormone DHT. These circumscribed donor areas on the head do not exist in women. In principle, the doctors can remove the hair from the entire back of the head.
With the FUT technique, the strip of skin to be removed is about 1 to 2 cm wide. Its length depends on how much hair to transplant. Doctors cut the hair short in the appropriate area. After they have removed the strip of skin with the hair roots it contains, they sew up the wound. The adjacent hair stays longer and now covers the scar. Surgical assistants often extract large amounts of hair root groups from the strip of skin, which can then be transplanted. You will work with magnifying glasses and microscopes.
With the FUE technique, the staff – depending on the number of hairs to be transplanted – shaves the back of the head over a large area. Then a tiny hollow drill loosens the hair root groups. Then the specialist can pull them out with special instruments. The procedure can take several hours, but does not require any incisions. The tiny scar points are barely visible afterwards. This is especially important for patients who want to keep their hair very short later on. The FUE technique is often sufficient when the doctors only need a small number of donor hairs with fewer than 500 to 1000 hair root groups. In the case of very curly and frizzy hair, it is often technically too complicated.
How long does a hair transplant take?
It depends on several factors and the treatment method. Basically, the more hair roots are removed and implanted, the longer the hair transplant will take. A treatment time of four and eight hours applies as an average.
This is how the roots are implanted
With both methods, the hair roots are then examined under a microscope for injuries and prepared. The hair root groups obtained were stored in a cooled nutrient solution until the next step. They are then implanted into the bald scalp. To do this, the hair surgeon uses a micro-drill or a tiny knife to make small openings in which to place the hair roots. The number and arrangement of the openings later determines the volume of hair.
After that, nothing happens. The hair roots rest, after two to six weeks the first fine hairs fall out again. About three to four months later, the roots get going and produce strong hair that is then permanently retained.
What does a hair transplant cost?
The price of the hair transplant depends a lot on the degree of hair loss. Depending on the number of hairs transplanted, the procedure costs between 2000 and 8000 euros. As a rule, the health insurance companies do not grant any subsidies. The decisive factor is how many grafts need to be transplanted. In hair transplantation, graft refers to the transplant, i.e. the hair root. Up to six hairs can sprout from one root, but on average there are two to three hairs. The higher the number of grafts, the fuller the result of a transplant will be.
Foreign institutes often advertise treatments at much lower prices on the Internet – but caution is advised here. Patients are on the safe side when they seek advice from a specialist.
Preparation for hair transplant
The patient should be informed about and agree to the operation at least 24 hours before the operation. First, doctors and patients discuss the opportunities and limitations of hair transplantation. The doctor also asks the patient about important requirements for suitability for surgery, for example whether the patient has a tendency to excessive scarring. In addition, the doctor examines the patient, especially the area that will be operated on, and documents the condition before the operation.
During the procedure, the doctors can only skillfully redistribute the roots of the hair. The initial situation therefore often sets limits: For example, it is not possible to cover a large bald area with a small fringe of hair on the back of the head with youthful hair density. As a rule of thumb, if the area of the donor hair is less than 20 percent of the recipient region, a comprehensive hair transplant is not possible.
Doctors use measures of hair density and hair mass to describe the condition before the hair transplant. The structure and color of the hair are also important. For example, light hair appears less dense than dark. Photos before and after the hair transplant help prove the success of the procedure.