Growth GUIDE
A hair transplant is a significant commitment. Before opting for surgery, explore a range of less invasive treatments that might suit your needs.
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A hair transplant is a great intervention for hair loss, but surgical intervention should never be your first option. If you’ve just started noticing hair loss or have only just started to address it, here are some things to consider first
Identify the cause of your hair loss.
Though for most of us (especially men) androgenic alopecia is a natural part of the aging process, it can be a sign of another underlying issue including thyroid dysfunction, autoimmune diseases, skin or scalp conditions, or nutritional deficiencies. A trip to your GP is a good place to start for further investigation if required, especially if you have an atypical pattern of hair loss.
Don’t forget the basics!
Antidandruff shampoo
Stop smoking
Balanced Diet + exercise
Sun protection with a hat or scalp SPF
Pharmacological Interventions (The BEST thing you can do for your hair)
Increase Blood flow: Topical or oral treatments are available which improves blood flow to hair follicles, promoting growth and slowing hair loss.
DHT Blockers: DHT blockers taken orally are considered the “gold standard” in preventing further hair loss. Potential side effects are rare, but should be discussed with your doctor before commencing.
Non-Pharmacological interventions
LLLT (Low Level Light Therapy) - With evidence that shows results as good as minoxidil with consistent use, LLLT is a great, natural and low risk therapy that can be used in conjunction with pharmaceutical and surgical measures.
Natural alternatives
Many natural alternatives are available, however, none have strong evidence to work. These therapies can be good additions, but patients should have realistic expectations for the results they can expect. Some good examples include; rosemary oil, saw palmetto and Caffeine solutions.
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If you have tried the above and you're considering whether a hair transplant is the best option for you, there are a few things you may not have considered.
Who needs a hair transplant?
In short, no one needs a hair transplant! Although some hair loss may be a symptom of underlying health issues, for most of us, this is a natural part of the aging process. Nevertheless, the emotional toll of hair loss can be huge, impacting on people's self esteem and quality of life. For those struggling with the emotional effects of hair loss, addressing the issue can be an important step toward reclaiming their sense of self, and a hair transplant can offer a lasting and effective solution.
Things you may not have considered:
Long down times:
- Hair transplants are a full day procedure, with 1-2 weeks of downtime, usually requiring time off work and time away from hobbies and physical activity.Long wait time for results:
- The full results of a hair transplant aren’t seen until 12 months, with no growth expected prior to 4 months. This needs to be considered so certain life events like weddings and holidays can be carefully planned around.Long term commitment:
- A hair transplant needs care and attention in the first few months to be successful. Furthermore, a good hair care routine, ideally with medication is required for long term maintenance to avoid a second transplant.Goals not always achievable:
- All cosmetic procedures have their limitations. It is important to consider this and ensure your goals and desired results are realistic with the donor hairs you have available, your hair type, and your severity of hair loss.
Has your hair loss pattern stabilised?
Many patients who are quite young have not reached a stable pattern of hair loss yet, and it is therefore not advisable to undergo a hair transplant procedure until medical therapy has been trialed and the hair loss pattern has been established. Otherwise, you may find yourself in the situation where you’re needing a second transplant in new areas of hair loss shortly after you have seen full results for your first transplant.
Treatment Options
How it Works
There are actually many different ways to perform a hair transplant procedure which will all have an impact on the price of the procedure and of course, the likelihood of a successful result. When doing your research, its important to have an understanding of these differences to make sure you are comparing similar services. This can be confusing at the best of times, let alone when the details can be left intentionally vague by some clinics.
Extraction
Extraction is the first half of the procedure where all the grafts are removed from the safe donor site at the back of your head, ready for implantation in the recipient area. There are two main methods used, FUE and FUT which are outlined below.
FUT: (Follicular Unit Transplantation), is the original method used for extraction, and is sometimes called the “strip method”. During an FUT procedure, the Doctor will cut a strip of scalp from the patients donor site and suture the wound closed. The excised “strip” will then be dissected to separate the grafts out individually for implantation. FUT has become far less common than the newer FUE method as it is a more invasive method with a longer recovery time and more obvious scarring.
FUE: (Follicular Unit Extraction), is the more modern approach over the last few decades and involves the harvesting of individual follicular units from the donor site. This method involves using a motorised extraction punch usually diameter less than 1mm to extract each follicular unit, each follicular unit containing typically 1-4 hairs. These are still full thickness grafts containing the hair follicle with associated glands and soft tissue, so it leaves small, usually unnoticeable scarring which does not require suturing.
| FUT | FUE |
| More invasive – scalp incision + sutures | ✔ Less invasive – small 0.8-1mm incisions requiring no suturing |
| More scarring – always left with linear scarring | ✔ Much less scarring – small white dots usually unnoticeable |
| Longer donor recovery time + more post-procedure discomfort | ✔ Less donor recovery time, no suture removal |
| ✔ Faster procedure time – usually ~1 hour | More time consuming – usually 2-4 hours |
| ✔ Less skill required to avoid transecting grafts | More skill required to avoid transecting grafts |
| ✔ Typically larger number of grafts yielded | Typically fewer grafts yielded (although this depends on donor quality and physician skill) |
Implantation
Implantation is the second half of the procedure, where the extracted grafts are placed into the recipient area. This is usually done by two main methods outlined below:
Slits: (often referred to as Sapphire method, sapphire FUE or confusingly, just “FUE”) This is the more common method used as it usually involves less input from the Doctor and therefor reduced labour costs. This method involves the doctor cutting slits into the recipient area, then nurses or assistants will go back to place the grafts into these pre-made slits. Although this can save time, especially on the Doctor’s end, this technique usually requires more handling of the grafts, the grafts sit less tightly in the recipient area and does not allow for real time placement of grafts where it counts.
Direct Hair Implantation (DHI): This technique involves grafts being placed inside the lumen of a small gauge implanter needle (<1mm in diameter) where the Doctor then inserts the needle into the recipient area, releasing the graft at the same time the needle retracts. The graft is then inserted with full connection to the surrounding tissue, giving more surface area for new blood vessels to form and the graft to be successfully adopted. This technique ensures grafts are only handled at the top of the graft (away from the follicle) and are protected inside the needle when they are implanted, protecting them from damage or folding back on themselves. This also allows the doctor to make real-time final placement of the grafts and make any small adjustments as required.
| Slits | DHI |
| More handling of grafts | ✔ Less handling of grafts |
| Less contact between graft and recipient area | ✔ Greater contact between graft and recipient area |
| Less precise graft positioning | ✔ More precise, real time positioning of grafts |
| Greater chance of noticeable scarring | ✔ Reduced chance of noticeable scarring |
| ✔ Usually faster process | Usually more time consuming process |