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How Do Hair Transplants Work? Risks, Costs, and Alternatives

How Do Hair Transplants Work

Millions of men and women suffer from hair loss in its various forms. While prescription and over-the-counter medications have come a long way to promote hair growth, many people turn to hair transplants as a means of regrowing hair. Read on to learn more about how hair transplants work.

What is a Hair Transplant?

While hair transplants have existed in the United States since the 1950s, methods have continuously changed. The main concept still involves taking hair that you have and transferring it to an area where hair is thinning or gone. This hair is usually taken from the back of the head, but it can also come from different parts of your body.

Why Hair Transplants Work

DHT, or dihydrotestosterone, is an androgen hormone and the main culprit of male and female pattern baldness. Certain areas of the scalp are more sensitive to DHT than others, which is why balding most often appears in a pattern that affects the crown, temples, and hairline. However, hair follicles at the back and sides of the head are generally resistant to this DHT sensitivity. They maintain this resistance even after transplant.

How Hair Transplants are Performed

All hair transplant procedures start by sterilizing the area of hair removal. The doctor can use a local anesthetic to numb the area or sedate you for the length of the procedure. From there, the doctor can use one of two methods: follicular unit strip surgery (FUSS) or follicular unit extraction (FUE).1

Follicular Unit Strip Surgery

hair transplant

FUSS, alternately known as follicular unit transplantation (FUT), starts with the removal of a strip of scalp from the back of your head. This piece usually measures 6 to 10 inches in length. The area is then stitched up and hidden by surrounding hair.

The removed piece of scalp is divided into 500 to 2,000 smaller grafts, each comprising an individual hair or several hairs. The number of grafts you receive depends on the characteristics of your hair, including hair thickness, color, and the size of the area where you need the transplant.2

The doctor uses a needle or blade to make punctures in your scalp. The individual grafts are then placed in each hole. The entire scalp is then bandaged and covered.

Follicular Unit Extraction

The FUE procedure starts with the doctor shaving the back of your head. Unlike FUSS, which involves the removal of a larger portion of scalp, with FUE, individual follicles are taken from your scalp. These are then grafted into the area of thinning or balding hair and bandaged.

How Much Hair is Transplanted?

With a typical hair transplantation procedure, you can expect about 800 to 1,000 follicular units to be transplanted. For larger sessions with larger areas of hair loss, the doctor may transplant 3,000 to 6,000 follicular units.

Are Hair Transplants Permanent?

Most hair transplants are successful and offer good results. One report suggests that upwards of 80 percent of transplanted hair will maintain growth.5 Despite the generally successful results of hair transplants, some hair loss is possible, and much like regular hair, transplanted hair will naturally thin as you age.

Your doctor may prescribe minoxidil following the transplant procedure to promote hair growth. Minoxidil is a drug that is FDA-approved for the treatment of hair loss. It is also recommended to use a DHT blocker, like finasteride, to achieve the best results. In one study, 79 men with androgenic alopecia were given either a placebo or a 1 mg dose of finasteride 4 weeks prior to a hair transplant and for 48 weeks following the transplant. Results showed that the finasteride group had significantly greater increases in frontal and superior scalp hair and general hair density after hair transplant.6

Hair Transplant Risks

While the hair transplant procedure is generally safe, it is still a surgical procedure and can come with certain risks. Bleeding and infection are the main risks, and you will likely feel some pain and soreness in your scalp in the first few days following the procedure. Even after healing, you may experience some scarring on your scalp.

Once the new follicles take root and begin to grow, you may experience some inflammation or an infection in the hair follicles known as folliculitis. Your doctor may prescribe antibiotics and anti-inflammatory medication to relieve these symptoms.1

You may also suffer shock loss, which refers to the sudden loss of existing hair in the area of your scalp that received the follicle transplants. However, this is not permanent in most cases.2

Some potential side effects of a hair transplant include:

  • Drainage around the incision sites
  • Itching or swelling in the scalp
  • Loss of sensation in surgical sites
  • Patches of hair that appear thin or uneven compared to surrounding hair
  • Continued hair loss1

How Much is a Hair Transplant?

The cost of a hair transplant will generally range from about $4,000 to $15,000. Hair transplants generally are not covered by health insurance as they are considered a cosmetic procedure. This cost is determined by a variety of factors, including:

  • Amount of hair being transplanted
  • Availability of surgeons
  • Hair transplant method

Aftercare also factors into the final cost.1

Hair Transplant Alternatives

Although hair transplants can be successful, they are not for everyone. They are mainly for those who are experiencing natural thinning or balding or who have lost hair due to injury. They may not be as effective for those who have:

  • More widespread hair thinning and baldness
  • Thick scalp scars from previous injury
  • Hair loss caused by medication or chemotherapy treatments1

Thankfully, there are a wide variety of hair transplant alternatives to help you reduce hair loss and promote hair growth.


Minoxidil is an FDA-approved treatment for male and female pattern baldness (androgenetic alopecia). When applied topically, minoxidil has been shown to stimulate hair growth, though researchers still are not completely sure how. Speculation suggests that minoxidil may widen blood vessels and potassium channels in the scalp, which may allow for more oxygen, blood, and nutrients to reach the hair follicles, resulting in hair growth.3

Natural DHT Blockers

DHT blockers aim to inhibit or control production of DHT, often by regulating an enzyme known as 5-alpha reductase, which converts existing testosterone into DHT.4

Finasteride is an FDA-approved DHT blocking medication, but there are a variety of natural DHT blockers, including HairOmega DHT, that may help to support healthy hair growth without the risk of side effects. Some of the most common natural DHT blocker ingredients include:


  • Saw palmetto
  • Stinging nettle
  • Lycopene
  • Pygeum
  • Pumpkin seed oil
  • Fenugreek
  • Green tea extract
  • Tea tree oil
  • Lavender oil
  • Caffeine
  • Ketoconazole

While hair transplants may be an effective option for your hair loss, it’s not the best option for everyone. Talk to your doctor and consider other options before you decide to go with a hair transplant.

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