Hair Transplants Explained (From a Person Who Went Through It)
I’ve had a hair transplant—and so has my partner. Here’s everything you need to know before the procedure, and what to expect afterwards.
July 23, 2024
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If you’re thinking about getting a hair transplant, then it’s important to understand if you’re an ideal candidate for the procedure in the first place—because it might even be too premature, even if you have experienced significant loss. (It also might be too late; we’ll get into that, too.) But speaking firsthand, let me say: Modern hair transplants are life changing. And educating readers about them is one of my biggest joys as a grooming journalist. My experience has been so overwhelmingly positive, and I love helping others get to that same point.
But I must also remind you: Going bald and embracing it is extremely admirable, and a source of as much confidence for so many men. I envy anyone who embraces it like that. I never got there myself. I chose the hairier route—with a lifetime of hair retention efforts ahead of me—but at least for me, I am satisfied with the result.
So, if you’re mulling on the idea of a hair transplant, then let me help set some expectations.
Who Should Get a Hair Transplant?
Hair transplants are not a last resort, nor are they an early resort. Get a hair transplant only after you have been using finasteride and/or minoxidil for a year or more. That way, you are working with the fullest possible canvas and the healthiest possible hair. I advise against hair transplants for anyone not using at least one of these medicines, and/or LLLT.
Getting a hair transplant without any retention efforts in place will mean you transplant as few hairs from the backs and sides of your head as possible, and those follicles will be as prolific as possible, too. Every follicle on your head can sprout 1-5 hairs, and you want as many follicles sprouting as many hairs, as thick as possible. So use those medicines. And measure their results between months 7 and 12.
These telemedicine sites can all set you up for a digital consult (with a board-certified dermatologist) so that you can get the right medicines you need, with proper monitoring processes baked into the timeline. And they can deliver to your door.
XYON | Hims | Roman | Keeps | Happy Head
Also, you will need to keep using those hair loss treatments after the hair transplant, because you don’t want to continue experiencing hair loss after such a procedure. All the hairs transplanted from the backs and sides onto the top of your hard are, in essence, there forever. Only the hairs that originate on the crown of the head are predisposed to thinning, recession, and loss. (It’s befuddling, I know.) So, let’s say you relocate all these follicles up top and then stop using minoxidil/finasteride. (Or let’s say you were never using it in the first place.) What happens when the rest of your original top hairs fall out, leaving behind the smattering of transplanted ones—and namely a thick wall of hairs at the front of your crown? You’ll have a little furry donut hat (Franciscan monk chic!) for the rest of your life. You definitely want to avoid that.
Also, if you have severe hair loss—a 5, 6, or 7 on the Norwood scale—and have tried other hair loss efforts for 1+ year, then it might be too late to get the hair transplant results you want. Still visit your dermatologist to assess the matter, because they will provide an honest, unbiased opinion (since they aren’t going to be trying to sell you on the hair transplant). The last thing you want is to do a transplant, max out the hairs from the sides and back, and still end up looking sparse. Then you’re stuck with it for life.
Hair Transplants for Curly and Coiled Hair
One other thing to note: If you have curly or coiled hair, there’s a good chance your curl pattern extends below the scalp line. Lots of doctors hesitate to do transplants on ultra curly hair, because they have only been trained on hairs that more or less go neatly into the scalp (hair-transplant tools are designed for those straight roots, too). So, while this message is especially targeted at Black men, it doubles for anybody with really curly hair: Make sure your chosen clinic is well trained and even specialized in working with this curl pattern. It’s absolutely achievable, but you don’t want to work with an inexperienced hand, because the hairs can be damaged beyond salvation, or implanted quite poorly and unevenly.
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How Much Hair Can You Have Transplanted?
The number of “grafts” pulled from the back and sides will probably range between 1,200-4,000 in a single session; it all depends on the technology they’re using and the number of hands working on you. Most people won’t exceed 3,000 grafts in a session and will require two separate sessions, spread months apart. And after that, the back and sides might start looking too sparse as well, so doctors will begin taking hairs from your neckbeard, chest, pubes, or anything simply to “fill in” the hair up top. Hopefully you don’t get to this point; again, going bald isn’t so bad, so I’ve heard.
But this graft number isn’t the number of actual hairs that are being transplanted. Each of your hair follicles will have between 1-5 hairs sprouting from them, so the number of transplanted grafts is multiplied by this average number of hairs sprouting. (And they can estimate this number before the procedure with modern scan technology.)
An average of 3-5 hairs per follicle is great (very few will have 5, but 3-4 is realistic). With this level of density, the overall expression will be much thicker than if your average is just 1-2 per follicle. So, in addition to your strand density, imagine the density you get from having prolific follicles. (Again, if you’re using hair loss medicines for over a year, chances are you’ll be working with much healthier and more prolific grafts—ditto if you’re leading a healthy and active lifestyle.) It often boils down to genetics, though, so don’t be too discouraged if you sprout thin hairs with just 1-2 hairs per follicle. (My partner was in the ~2 zone, while I was in the ~4 zone, and we both did the same efforts to keep our hair plump. It’s all genetics.)
How Much Do Hair Transplants Cost?
The cost of a hair transplant depends on the types of technology used, the reputation and experience of the supervising doctor and their team, as well as the geographic location. And it’s that last part that often raises the cost to exorbitant heights.
Our transplants in Turkey were in the $2,500-3,500 ranges including hotels and ground transfers, whereas similar ones in NYC or Miami or LA might cost five or 10 times that amount. I understand wanting to stay close to home for your hair transplant—and I’ll outline the recovery process below—but for that cost difference? Gosh, I don’t think I could rationalize $20K unless I was rolling in cash. I also don’t think I would skimp on that cost and go to an inexperienced clinic, either. You want experienced people working on something so permanent.
To me, the perfect middle ground is to fly abroad for a world-class doctor in the most concentrated markets, like Turkey. That high competition drives the cost down. Why not do some sightseeing in Istanbul beforehand? Hey, at least there will be hundreds of other guys in the airport with fresh transplants, so you won’t feel like a weirdo walking around with thousands of micro wounds on your head. In fact, it strangely feels normal walking around there.
My partner and I both went to Dr. Serkan Aygin’s clinic in Istanbul, a few years apart. I cannot say enough good things about the clinic, either. 10/10, 5 stars, highly recommended, etc. (And I asked them for a referral link, which you can access in the URL above or the button below. I’ll get a nice bonus if you book there through my link, so… thank you, if so!)
Dr. Serkan Aygin – Istanbul – Referral Link
Also, might I add, that my barber says I have the best hair transplant he’s ever seen, and most people who meet me for the first time are shocked to learn I ever got one. Don’t click away yet, but you can read about my transplant on MensJournal.com, and compare both of ours on GQ.com.
Again, if you have really curly or coily patterned hair, it is imperative you visit a clinic that has proven visual results and lots of clientele who have the same pattern. For this, Dr. William Yates in Chicago is absolutely someone to inquire with (and for all types of hair transplants, at that).
Do Hair Transplants Hurt?
For me, this initial general anesthesia was the only part that I remember hurting; it sedates you enough to endure the local injections they then administer to the scalp. They’ll turn this sedation anesthesia up and down as needed throughout the procedure, depending on how lucid they need you to be. (You can opt out of this sedation if you are opposed to anesthesia; just be warned that you are going to feel plenty of pricks and pokes for many hours on end.)
A few times during the procedure, I would feel a prick and ask them to re-up the local anesthesia; I wouldn’t say the procedure hurt though. I have read some articles or heard stories that describe the process as excruciating and I can only wonder… did they not get anesthesia? Because I would rate it as a ‘2’ on a 10-scale. And afterwards, they give you the anti-inflammatories and painkillers necessary to endure the next few days of swelling and recouping. The whole process is uncomfortable and weird and annoying, but never actually painful—at least to me and my partner, there wasn’t much pain to tolerate.
Hair Transplant Preparation
The day before the procedure, the clinic will take scans of your hair to approximate the general density and amount of grafts to transplant. This will also help them approximate the new hairline and crown density.
They will start by shaving the back and sides of your head—though shaving the top is optional. They can transplant around grown hairs, but I recommend just buzzing it all, to make it easier on them and to just endure the next scabby month with a full view of our dome, as opposed to picking scabs out from a nest of hair.
Then, after numbing you, the technicians will start extracting the grafts using a little push-pen device that just engulfs the follicle and scoops it up cleanly and intact. They’ll do this to as many grafts that they have predetermined, and will spread out the efforts around the back and sides of your hair, so that they don’t leave you too patchy or sparse. (And no, it won’t scar when it heals. The latest tech is scar-free.)
Another team studies all of the grafts under a microscope and sorts them by their number of hairs. This will allow them to place more sparse grafts near the hairline, to create a softer and more natural hairline; you want those grafts with 3-5 hairs all concentrated around the crown. (Just so that they can redistribute them evenly up top the head, too. This way you don’t get a bunch of single-hair grafts on one side, and a bunch of 4-hair grafts on the other.)
After you take a bathroom break, they will make tiny incisions for the new grafts up top the head, in which the transplanted hairs are meticulously angled so that they grow in the same natural direction as the rest of your hair up there. The technicians will transplant these grafts one at a time, unlike in the past when they would shove a bunch of them together at a vertical angle. (This is what we know as “hair plugs”. Thank god that’s in the past.) And the best technologies even allow one singular motion of incision + implantation, which makes the process faster and also heals quicker, too.
You should expect the procedure to last about 4-8 hours, but with the anesthesia it will only feel like a couple hours in total.
Hair Transplant Recovery Process
Once the procedure is done, you have a very special and awkward month ahead of you. Yes, you can technically go back to work a couple days later, but why not give yourself a few days off? It’s not every day you rearrange 10,000 hairs…
If you flew somewhere for the procedure (even as far as Turkey), then be sure your return flight is no earlier than the following evening. You will want to visit the clinic the day after the procedure to remove the head dressing and do some cleanings, plus assess the scene, so don’t try to hurry away any sooner.
Above all, don’t fall asleep horizontally for a couple nights to avoid intense facial swelling (I really fumbled the ball on that one—it’s a story for its own article or video). Also, be certain to use whatever anti-inflammatory and antibiotic remedies they give you, for as long as they prescribe them.
The swelling will move slowly down your face over the first week until it’s gone. Every clinic will give you its own advice on the month ahead but the general thinking is this: Do not apply intense pressure or wear anything restrictive on the top for the first couple weeks. Avoid sweating, direct sun exposure, hot water, and high water pressure for that first month. Loose bucket caps are probably the best bet whenever you go outside.
You’ll definitely look awkward for a week, even if you chose not to shave the top of your head, since the back will be shaved and scabby. (You’ll also have mild swelling, which might be weird to showcase to colleagues.) Maybe plan to work from home for a while, and keep the Zoom camera off that first week. After a month, you should be able to resume everything normally, though you may still feel some itching and have lingering inflammation into weeks 5 or 6, which will eventually reside. To me, the itching was the worst part, particularly around weeks 4-5.
The transplanted grafts will stay in place for 3-4 weeks, and everything will scab over in those first couple days. The scabs should fall by day 10 or so, and you’ll have a blissful few days where you can actually see what your new hair will look like, since it’s all up there on display without scabs. But then the follicles began to fall out up until about day 30 or 35. By then, you’ll be back to your pre-transplant hairline for a few months. Not to worry, because those follicles are beginning their new growth cycle, and will steadily sprout between months 3 and 5.
By month 6 or 7, you should have the full results at a buzzcut’s length, though additional hairs and added density will continue for another 6-10 months—especially assuming you’re using minoxidil and finasteride, hair supplements, and possibly even adding LLLT, hair supplements and maybe even PRP to the mix. Again, if you aren’t willing to do any hair loss treatments indefinitely (especially minoxidil and/or finasteride), then you should not get a hair transplant in the first place.
How Long Do Hair Transplants Last?
Remember this: A hair transplant is permanent. But that doesn’t mean that your great results are permanent.
The hair you are born with on top of your head is genetically predisposed to shrinkage from dihydrotestosterone (or DHT), which is a testosterone byproduct that causes male-pattern baldness. And strangely enough, the hair follicles on the back and sides of your head are not susceptible to this shrinkage and loss. So, by transplanting those hairs up top of your head, you are permanently lodging them. They won’t fall out the same way the previous hairs did. But all of those remaining hairs up top—the native ones to that crown area—are still predisposed to falling.
Again, as I mentioned before, you will be mixing hairs from the back and sides of your head with those up top. Because of this, the full “results” of a hair transplant (which are visible around 7-18 months after the procedure) are not permanent.
So consider this a warning! You need to incorporate proper hair retention treatments in advance of a hair transplant (1 year or more is ideal) in order to ensure that you start the transplant with as manys trong, thick hairs as possible. Then, after the transplant, you’ll keep taking these treatments so that the native hairs never thin and fall. Otherwise, you’ll be left with only the newly transplanted hairs, which will probably look pretty weird on their own, too. (Like, maybe it’ll give you a donut hairstyle.)
My Hair Transplant
I got my hair transplant in June 2020, and really love my results. My partner got his in April 2023 and it has transformed his confidence as much as mine did for me. They both look natural, and we both got the fullness we were promised; compared to one another, I knew my results were going to be more dynamic, since I have thick hair and was sprouting 3-4 strands per follicle. He was more in the 1-3 range of hairs per follicle, so his potential for fullness wasn’t going to be as much as mine (also since his strands are thinner in general).
I have straight hair and started with a severely recessed hairline and plenty of crown thinning. I also have Vitiligo and had two stark bald spots atop my head where the white hairs once resided. The transplant even filled in those spots. Now I almost have too much hair—a nice problem to have. I was taking topical minoxidil and oral finasteride for 2-3 years prior. Today I take topical versions of both to maintain the fullness, as well as hair loss
Here is a look at my bald spots, recession, and mild thinning before the procedure, as well as what it all looked like once the scabs were in place.
And here is what I looked like before and after—these results really started to appear by month 6 or 7, but got fuller over the first year and a half. Again, I am 4.5 years post transplant now, with the same results because I follow the necessary hair retention regimen to keep the hairs full.
As for my partner André’s hair transplant: He has thin, wavy/curly hair. He started with a severely thinning crown, which he had improved after taking topical minoxidil for 3 years before his procedure. He continues to take minoxidil now, but has switched from topical to oral.
Here is a shot of his transplant area, as well as a rear view of the donor area as it heals in that first week or so. You can see it is a little thinned out due to his fine hair and lower density, but when he has it grown out a couple weeks, it looks fuller.
Then, here is him before and after; he had his transplant a year prior to this image, which means he probably even experienced more fullness in the few months after this image was taken.
Again, we both went here in Istanbul—it’s a referral link, so note that I receive a kickback if you book.
The Future of Hair Transplants
Hair retention and growth technology has come a long way, and I think we’re just a few phases away from the next big leap ahead, be it a vaccine to prevent hair loss, or stem cells that allow every guy to keep his hair if he wants it. Until then, a modern transplant remains the best way to bring your hair “recovery” all the way across the finish line—but only assuming you’ve got the other proactive and preventative hair loss efforts in place first.
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