Like most cosmetic procedures, hair transplants are a very personal, private experience. That is, unless you're the self-proclaimed "Human Ken Doll," aka Justin Jedlica. The famous plastic surgery fan recently welcomed cameras into his procedure room at Beverly Hills Hair Restoration, as he had 900 pieces of skin extracted from the back of his head in order to transplant the follicles to other areas. However, because most hair transplants (often known by the antiquated phrase "hair plugs") are performed without an audience, (or even without the person saying they had one afterward) they can seem mysterious to someone who may be considering the procedure, making it easily stigmatized.
In reality, hair transplants can look far more realistic than their reputation has long implied. The procedure is more advanced than ever, and there's more information available to potential patients. Here are seven things anyone intrigued by hair transplants needs to know, whether you're looking to move forward with it as a hair-loss solution or you're simply curious about the procedure.
Hair transplants are typically associated with men seeking a remedy for male-pattern hair loss, but the number of women looking to the procedure has been on the rise. "In our practice, about 27 percent of our surgical patients are female," says Carlos K. Wesley,, a hair restoration surgeon in New York City. "A large percentage of women wish to lower their hairline or even give the illusion of lowering their hairline by increasing the hair density surrounding their face. Adding healthy hair follicles throughout the part line can also provide a profound cosmetic improvement in women with hair thinning atop their head."
Although hair transplants can make a huge difference for many people experiencing hair loss, the procedure isn't for everyone. Francesca Fusco, a dermatologist in New York City, explains there are important criteria to consider: "Does the person have enough donor hair to supply the areas that are thin or balding? What kind of hair loss does the person have?" she says, explaining that androgenetic hair loss (aka male pattern baldness), caused by high level of the male hormone androgen, is usually the optimal type for this procedure. "The donor hair should also not be in the process of miniaturization, which means on its way to falling out."
The goal of increased hair density is the same, but there are two different methods for achieving a successful hair transplant, both of which require local anesthesia. "After it's numbed, healthy hair follicles are harvested from the donor area — the back of the head — either by extracting a thin ellipse of the hair-bearing scalp and closing the area with sutures or by extracting individual hair follicles one by one with a tiny motorized punch," Wesley explains. "The first approach, known as follicular unit transplantation (FUT), does not require trimming of the donor hair, and it leaves a thin linear scar tucked away within the permanent hair so it is not visible after the procedure. Individual follicles are then isolated from this ellipse under a microscope."
The other method doesn't require suturing, but hair in the donor area typically needs to be trimmed. "The second approach, called follicular unit extraction (FUE), usually requires trimming regions of the donor area so as to most effectively see how the hairs exit the scalp surface, but it leaves the majority of the hair intact so that the harvested areas are not seen once the hair grows back," says Wesley, who notes that only one out of every three to five donor follicles are harvested with FUE.
4. The cost is steep, but worth it if you want quality.
Of course, this type of procedure will cost you a bit of a grip. But sometimes, you've got to pay a little extra in order to get amazing results. Both types of transplants can range in price from $5,000 to $20,000 depending on the practitioner performing the procedure and the number of hair follicles that need to be harvested.
Patients can expect to spend a good chunk of their day in their surgeon's medical facility, and they will very likely need a friend or family member to transport them home when it's over if their doctor uses mild sedation, like Wesley does for his patients. "The surgical procedure is an all-day affair, ranging from five to eight hours in length. It is performed under local anesthesia, and patients are in a comfortable twilight," he says. "They spend the majority of the day watching movies while resting in a reclining chair.
The results, however, are not immediate. One of the biggest myths about hair transplants, Fusco says, is that "you can immediately have full, long hair." It can take several months for the transplanted follicles to grow new hair.
6. Hair transplants can look completely natural — as long as you go to the right surgeon.
Hair transplant candidates may be concerned about the conspicuousness of their results, but with a talented and qualified surgeon, "Your scalp will not look like a doll's head. When performed by a credible physician, the results should not be too obvious," Fusco says. Technically, any physician can perform a hair transplant, so when looking for that credible physician, it's wise to seek out someone with extensive surgical hair transplant experience. In fact, hair transplant surgery and hair restoration procedures have no approved medical specialty board sanctioned by the American Board of Medical Specialties (ABMS), according to the American Hair Loss Association.
"The subtle nuances and artistry with which the surgery is carried out are what set the most natural-appearing results apart from those that draw unwanted attention to themselves," says Wesley. "The best hair transplants involve mimicking nature. Poorly performed hair transplants, just as with a number of aesthetic practices, are those that don’t take into account the current features of that patient’s appearance. It doesn’t make sense to approach every single patient the same way. Every man and woman has a different hair density, hair caliber, hair color, hair curl, hairline, etc. Even the angles and directions of a patient’s part line and cowlick differ. All of those have to be recreated in order to have the most natural appearance."
Although hair transplantation is a relatively low-risk procedure, Wesley says the side-effect most concerning to patients is something called "shock loss," a temporary thinning of the pre-existing hair caused by the micro-trauma of having tiny incisions made between the existing hairs. "While the hairs do grow back in, about 10 to 20 percent may go through a new cycle, falling out temporarily, before growing back in," Wesley explains. "This can last for a few weeks following the procedure, and the positive impact of the transplanted hairs can be appreciated about six months after the procedure and thereafter."
Other side-effects include temporary swelling of the forehead and temples, typically for less than a week, and decreased sensitivity on top of the head for a few weeks or months after the procedure.
The top of the head isn't the only area that can benefit from a hair transplant. Eyebrows have become increasingly popular as a spot to transfer follicles — and you may be surprised where the donor hair can come from. "We have performed a number of leg hair to eyebrow transplants to take advantage of the growth cycle of that particular hair type," Wesley says. However, even though a few rare cases of scalp-focused hair transplants have used beard and chest hair as donor areas, the vast majority of hair transplants use another part of the scalp.
Ultimately, the decision to get a hair transplant is a personal one to be made between a patient and qualified surgeon, and that decision should be both well-informed and made without any shame or embarrassment.
Read more stories on cosmetic procedures:
- Breast Reduction Surgery: What to Know About This Procedure
- This Unexpected Plastic Surgery Procedure Is Trending Among Millennials
- Penis-Whitening Cosmetic Procedures Are Gaining Popularity
Check out 5 steps to high hair:
