You don’t have to look far to find cautionary tales about hair transplants—those guys whose scalps look like Cabbage-Patch dolls instead of resembling authentic, home-grown heads of hair. But thanks to technological advancements in the past couple decades, the success stories far outpace the flubs. (You still need to do your due diligence, though, to choose the right doctor.)
If you’re considering hair restoration and want to look more like the second scenario than the first, you may be wondering what the most reliable hair transplant method is these days, and what emerging technologies we have to look forward to? (In other words, when the heck will stem cell transplants finally be available?)
For answers, we spoke with hair experts Ken Washenik, M.D., and Serkan Aygin, M.D. Washenik is a medical advisor for Hair Club, which advises guys nationwide on this very subject (and provides its clients with customized solutions). He is also the medical director of Bosley Medical Group—a name you might recognize for its transformative advancements in hair restoration. Aygin is a surgeon with more than 25 years of hair transplant experience, and is based in Istanbul, Turkey—an increasingly popular destination for the procedure, thanks to its high medical standards and relatively lower costs than what you might pay in the U.S. or U.K. (More on those Turkish hair transplants later in the article; I speak from firsthand experience there.)
How does a hair transplant work?
Here’s the best summary of how hair transplants work: “Donor” hairs are taken from the back and sides of your head, since those hairs aren’t genetically predisposed to hair loss. And, depending on how much hair you have vs. how much you need to be rearranged, the doctors might look for donor hairs in your neckbeard, too. (Though that’s rare, those hairs tend to be used for “filler” since they are texturally different from the ones that sprout from the top and sides of your head.
Anyway, those donor hairs are extracted with their follicle, and these “grafts” are then placed evenly around the recipient area (the crown of the head), as designated by the hair transplant surgeon; s/he will have decided how many grafts you’re receiving, and will draw a new hairline or “prescribe” how dense their team should fill in the thinning areas on your head. The team makes tiny little micro-cuts in your scalp, which receive those grafts one at a time. They are carefully angled when transplanted so that they grow at a natural angle and blend in with the rest of your hair.
After an awkward first month (more on the recovery below), the transplanted hairs will have mostly fallen out as their follicles begin new growth phases. Within half a year, you should see a generous expression of your new hair fullness—though results will continue to improve over 12 to 18 months, especially with an assist from hair loss treatments like finasteride and minoxidil.
How much does a hair transplant cost?
The cost and length of hair transplant operations—including the current gold standard, Follicular Unit Extraction—are determined by how many “follicular unit graphs” are being moved. This depends on the coverage desired by the procedure.
Beyond that, prices vary dramatically for these procedures. In addition to the amount of hair you’re transplanting, other factors that dictate cost include where you’re doing it (and even where in your home nation), the techniques or equipment being used, and the doctor’s experience or reputation. You could expect to pay upwards of $25,000 (RM120,000) for a hair transplant in major markets like New York and LA, especially from top doctors. The same procedure could be half that price in, say, Oklahoma City or Denver, but you want to make sure that the price you’re paying is worth the risk: A top doctor in most markets will be great, but don’t choose one just because their price is lower. Imagine the agony of looking at the regret in the mirror every day of your life, and knowing it was only because you wanted to save a few thousand bucks.
In the U.S., the average price is around $15,959 (RM76,316), according to a 2023 survey by the United Care Clinic.
How much is a hair transplant in Turkey?
In Turkey, you can pay as little as $2,570 (RM12,300) for a hair transplant, according to that same United Care Clinic survey. (Turkish costs actually decreased since 2021, along with Thailand and Australia—unlike all other markets surveyed.) That price excludes the cost of getting there and booking a hotel to stay in; many clinics will offer you a handsome package that includes hotels and transfers; honestly, it is so worth it to have that part of your experience covered.
Aygin says that the reason Turkey remains such an attractive option is because Turkey’s Joint Commission International (JCI) provides government incentives for these practices, which effectively offsets the costs for patients (from all over the world). That’s why a country filled with some of the best hair transplant surgeons also offers some of the lowest global prices. (That density of top-tier clinics helps keep prices competitive, too.)
The best way to ensure that you’re getting a fair price is to get multiple opinions. Don’t show your cards to any of the doctors—let them offer a rate to you, along with their proposed area of transplant cover, and how many grafts you’ll need (or are able to get, based on your donor area). Compare these critically, looking for similarities and discrepancies in the recommendations and the costs. Note the technologies they propose to use, and how they “sell” these procedures to you. Then, make an informed decision based on your own specific case.
Are hair transplants painful?
You will get different responses from each hair transplant surgeon and patient: In my experience, the only pain I felt was from the initial numbing, since they had to inject a few localized anesthesia doses around my scalp. They also administered controlled general anesthesia in my wrist, which prevented me from feeling any real pain as well. Other guys describe the experience as painful, but that might be because they opted against anesthesia and painkillers.
The clinic I went to (Dr. Aygin’s in Istanbul) gave me enough gas to stay alert if needed, but thorough enough to nod off as well; what was a six- to seven-hour procedure felt like 90 minutes to me, and I tell people that it wasn’t painful whatsoever. Plus, all of the aftercare painkillers I got helped me avoid any agony on the back end. You only take those for a couple of days; then you’re really in the clear in terms of discomfort, aside from the itching you get a few weeks later. The itching can get intense and annoying for a week or so (I remember this between weeks five and six). Then suddenly—it stops.
Is a hair transplant permanent?
The hairs transplanted from the backs and sides of your head are permanently fixed in their new location. So in that way, hair transplants are permanent. However, suppose you don’t use other hair loss treatments like minoxidil and finasteride (or even laser therapy caps). In that case, all of the original hairs up there will continue to thin and fall at a much higher rate. So, the terrific full results of a hair transplant are not permanent unless you pair the procedure with continuous, dedicated hair loss treatments.
How long does it take to recover from a hair transplant?
Transplant recipients will be able to return to work as soon as they wish, says Aygin. There is no medical restriction over this, as of now. Patients will have to wear a bathing cap in the event they are experiencing minor bleeding and to protect their newly transplanted hairs on the job. Your specific case will vary based on the nature of your work, keeping in mind that you will need to avoid pressure on the newly transplanted hair, as well as sweating and sun exposure, for up to a couple of months.
The scabs on your head should be healed entirely within 12 days, says Aygin, though some patients will experience faster recovery. You will likely experience light inflammation and itching through the first four to five weeks, and need to avoid intense sweating, hot water, high water pressure as well as tight ball caps, and side sleeping until around the one-month mark. Fair warning: that first month can be awkward and tedious.
The first week is the weirdest, too, especially if you experience any swelling. The clinic should give you the proper antibiotics, antiseptics, painkillers, and anti-inflammatories to navigate any initial immediate threats, but some people will still experience some ballooning around the brow, which takes a few days to make its way down your face before it flushes out into the body. It’s more of a humorous experience than anything else (and a humbling one), but you probably won’t feel much pain from the swelling, if any.
How long does it take to see results from a hair transplant?
Upon transplantation, your “new” hair resets its growth cycle, meaning it naturally falls out but leaves its follicle in place. Like any of your other hairs that naturally fall out and regrow, it will take as little as two months, and up to six months, to regenerate and reappear. Most patients will see their new hair in six months, but depending on the length they wish to showcase, or depending on how slowly their hair grows, it could take a year or more.
What’s the best hair transplant method currently?
“The current gold standard for hair transplants is called Follicular Unit Extraction,” says Washenik. “FUE is an advanced surgical hair restoration technique. It’s less invasive than traditional hair transplants. This surgical solution leaves no linear scar and requires no stitches. With FUE, one hair follicle at a time is extracted from your donor area.” (Typically the rear of the head, where hair loss does not otherwise occur. “It is then transplanted to your thinning or balding areas. FUE can be performed manually or via a robotic unit operated by your doctor. This is a one-day outpatient procedure so you can go home the same day as your surgery.”
You can transplant a few thousand graphs in one five- to 10-hour session, which is pretty standard fare. Thinner and more recessed heads of hair will need multiple sessions. Your hair will grow exactly as it did from the donor site, and takes well to both the crown and the hairline. “Transplanted hair doesn’t know you moved it,” Washenik says, stating that it will simply grow happily from its new home. He adds that it takes roughly one year before your hair is fully grown in and the transplant’s success is measured. That’s because the transplanted hair typically sheds itself entirely after a couple months, before regrowing from the new host site. This is natural, but it means that transplant recipients have to trust the procedure without enjoying the results for anywhere between six to 12 months.
What about stem cell hair transplants?
As for the future of the procedure, the rumors are true: Stem-cell hair transplants are being studied, and some experts have suggested they’ll be available later in 2024 or 2025, pending FDA approval, based on their research progress. (In 2017, Italian researchers found a 29 per cent increase in hair density around six months after subjects underwent a stem cell treatment, but similar trials in the U.S. hit the pause button.)
The procedure is being tested in various ways, but Washenik outlines the commonality between all methods: “Tissue is taken from a patient by the hair surgeon, [and the best] cells of choice are then extracted offsite, at the company’s facility. Cells are multiplied or used from early hair structure and these are sent back to the surgeon, who injects or implants them back into the patient. After six to 12 months, new hair is visible.”
Other studies are testing transplants using “allogeneic cells”, using cells from a different donor than the recipient. Washenik notes that steady progress is being made in this arena, too. (Though it’s only going to be desirable in specific cases, since someone with curly red hair probably won’t want hair transplants from someone with straight brown hair.)
But until stem cells are out of clinical trials—and until they prove to generate effective results—FUE remains the consumer’s gold standard.
How do you find the right hair transplant doctor?
First and foremost, says Aygin, you need to ensure that your doctor has a direct tie to the field of hair transplantation—either through accreditations in dermatology or plastic surgery. Given that you have so many options, look for a doctor who differentiates themselves by participating in clinical studies or writing medical articles.
Better yet, look for someone with at least 10 years of experience with FUE methods. This duration of experience will ensure that they have completed thousands of transplants—if not tens of thousands. This experience, coupled with the doctor’s efforts to stay up to date on new techniques, medical advancements, and industry standards, should help you land a good doctor.
And once you find a candidate, make a good effort to pore over their “before and after” images, as well as the reviews on any pertinent site—not just the claims that they post on their own website. Be wary of someone with a perfect score and only a small handful of reviews. Yes, you want a near-perfect score, but you should understand that not every patient is going to be 100 per cent satisfied with the reality of their results. That’s the small margin of error you should account for when looking for a very high average score, along with a very high amount of reviews.
Once you select your doctor, make no financial exchange until you can understand what he or she is proposing for the procedure. It’s OK to shop around for different opinions, but only go with a doctor who can ensure that their staff is able to communicate everything to you in your own language (if you’re traveling abroad for the procedure) and if that doctor can clearly communicate an outline of the grafting session(s) and recovery period.
They will need to first assess your hair loss and existing density in order to make this outline. Aygin emphasizes that it’s important for your doctor to provide this information upfront, in order to build your trust and confidence in the doctor’s work. They should also communicate to you what machinery will be used, and present you with various options and techniques (which might alter the price slightly). Any doctor you consider should be using the latest equipment, and you may have to get a few quotes or do some Googling in order to ensure that your doctor is using the most advanced, trusted procedures.
What mistakes should you avoid when getting a hair transplant?
Dr. Aygin emphasizes that some patients will only have one chance at this in their life. This depends mostly on your existing hair loss and the amount of hair that is possible to transplant unnoticeably from your “donor area” in the back of your head. So, you want to get it right—and you’ve ideally chosen a doctor who can help get it right. (That in itself is the biggest mistake people make—choosing an inexperienced doctor.)
The second common error is made by the guys who go into a clinic abroad; it’s a smart financial choice, but it would be a mistake if the clinic doesn’t have translators available for you throughout the procedure. It is imperative that everything is communicated clearly during this time, especially because the rules for a speedy recovery will greatly impact your final results. You need somebody on staff who can answer any pressing questions and clearly dictate these expectations and guidelines—and the same goes for the procedure, too.
Who is the best candidate for a hair transplant? Is it ever “too soon” or “too late” to receive one?
There is no ideal age for a hair transplant, says Aygin. “The ideal time is when an individual starts to get concerned and feels unhappy about his or her hair. This can range between the age of 20 to 75.”
However, he brings up the point that hair loss will naturally continue after the hair transplant, just as it was progressing prior to the procedure. And some people just may not have enough hair in their donor area to cover a single transplant.
“Even if an individual continues to experience hair loss after hair transplantation, it is still possible to undergo another session,” he says. (The interval between two sessions must be at least six months.) “The most critical aspect here is to preserve the donor area for future hair transplant sessions. An experienced doctor will naturally be able to foresee the likelihood of an individual’s future hair loss and will carry out the first hair transplant accordingly. But, if the donor area of an individual is weak and the area to be covered is wide, this means that there may be no chance of undergoing a second hair transplant session in the future, and the hairline should be designed taking this into account.”
There are various phases of hair loss that your doctor will assess, on a scale of A to F, with A being the least amount of loss. “There are a lot of patients in phase A who undergo the procedure. Individuals in phase F also opt for hair transplantation. The number of patients who undergo hair transplantation within each of these phases are generally equal. A patient in phase F generally has more realistic expectations. Most of these patients understand that they do not have such a strong donor area to obtain similar hair transplant results as those in phases A and B. Showing ‘before and after’ photos of former patients (in the same phases of loss) can provide these patients with a clearer insight on what to expect from the operation. This will also enable the patient to undergo the operation with more confidence.”
How should I care for my hair after a hair transplant?
“After hair transplantation, we recommend our patients to use minoxidil and finasteride,” says Aygin. These supporting medications provide positive results to individuals both who have and have not undergone hair transplantation.” In short, the methods you used before your transplant are just as important to maintain afterward—and they may be the reason you can enjoy your new hairline for an extra decade or two.
For the uninitiated, minoxidil (the generic name for Rogaine) is a topical foam or liquid that helps improve blood flow and nutrient delivery to the hairs on the crown. This strengthens them and prevents thinning or hair fall. Finasteride (the generic for Propecia) is an oral supplement for men, which suppresses the hormone that leads to hair thinning and loss. So, while minoxidil improves sustenance, finasteride improves defense. It’s important to talk to your dermatologist about both, however, especially finasteride, because it requires close monitoring of your sex drive and ability to get an erection. (A small percentage of men, between one to two per cent, report these sexual side effects, and must decide whether or not to continue with the medication.)
Previously published on Robb Report USA
Photography: Lead image – Mostafa Meraji via Unsplash