There are no magic solutions to hair restoration but there are a variety of techniques that work. We aim to give you the information so that you can make the decision that suits you.

Hairloss surgery

Surgery is the only treatment available that will reliably and consistently replace hair in bald areas. The main type of surgery is hair transplantation, although scalp reduction can also be used on suitable patients.

Hair Transplantation

This minor surgical technique reliably and consistently restores hair, even to bald skin. It relies on the fortunate fact that even men who lose a lot of hair will not lose the hair above the ears and the back of their heads. There are plenty of men in their 70s walking around with the characteristic ‘horseshoe’ shape of remaining hair to prove this fact. For this reason, we work on the assumption that your hair loss will ultimately progress to stage 7 and only take hair from this region. This ensures that you will always have growing transplanted hair and that the donor area is always covered. In addition, this area (the donor area - photo 1) is more densely packed with hair follicles than the rest of the head, even before hair loss starts.

The ‘donor’ area

Men’s hair is thicker, bushier and faster growing on the back and sides of the scalp, which is why men traditionally have a ‘short back and sides’ haircut. This means that we can safely take hair from this region and move it to where it is needed (the recipient area - photo 5) without the donor area looking thin too. There is obviously a limit to how much hair can be removed, but experience has shown that six sessions is a comfortable average.

Because the hair that we remove is genetically programmed not to fall out through MPB, the hair will continue growing on the bald scalp, just as it would have done if it had remained in the donor area. That is why hair transplantation can give you your own hair growing again, and that is why it won’t fall out again. This basic theory has been shown to be true for the past 70 years.

Hair transplantation in detail

Hair grows not as single hairs, like teeth in a comb, but in little bunches called ‘follicular units’ (photo 4). These form the basis of our ‘grafts’. Follicular units typically average two hairs, but they can be just one hair or even four hairs. Because Nature grows the hair this way, it makes sense to put the hair back in this way to achieve the most natural look.

There are currently two methods of taking hair from the scalp: the strip method and the FUE method. Please note: the method of re-implanting the hair remains the same, irrespective of the method used to extract it.

Strip Method

Local anaesthetic is applied to the area we want to take the hair from. We then take a thin strip of that hairy scalp (photo 2) and individually separate all the follicular units (photo 3). These follicular unit grafts are then placed into pinprick incisions in the recipient area.

View a short video of a patient undergoing the strip technique
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FUE Method (Follicular unit extraction, aka FIT, FUSE, DHI and Woods technique)

FUE stands for Follicular Unit Extraction, a technique also variously known as FIT, FUSE, DHI and Woods technique. This technique uses a microscopic punch to remove each individual hair graft, in the same way as an apple corer removes the core of an apple. FUE is a relatively new technique, and only really established itself in the early years of this century. It still has some way to go in its evolution. Like all things, it has advantages and disadvantages, sometimes depending on patient preference or characteristics.

Click here to see a short animation of the FUE technique.

Features that are common to both techniques

Which ever technique is used, there is usually a slight delay while the hair ‘bulb’ re-establishes itself. Once that happens, the hair will appear again at about 12 weeks, although there can be significant time variations either side of this. It is also important to understand that the hair will initially be fine hair and will be hard to see until it matures further. By about six months after the procedure has been carried out, the hair should be noticeable. Transplanted hair will sometimes be more curly than normal while it matures, and can take up to 18 months to achieve its final quality.

How much hair is taken?

There is a limit to how big a strip we can in one session, just as there is a limit to the number of grafts that can be done and how close together we can get those grafts. This is why we usually need to do multiple sessions to achieve the desired level of coverage, with most men needing two or three sessions.

Prioritising hair distribution

Generally speaking, the hair at the front of the head is more important than the crown. When you look in the mirror or talk to someone, the frontal hair is what we see. If there is no hair at the front, you will be perceived as bald even if there is thick hair everywhere else. For this reason, it’s the distribution of your hair that matters, and that is what we focus on with hair transplantation.

As well as receding patterns of hair loss, we see many men with a ‘Prince Charles’ distribution: thick at the front but with a bald crown. Because they have strong front hair, they often do not think of themselves as bald until they catch themselves on CCTV or in a home video. Only then do they realise how much hair they have lost. We treat this style of hair loss using either transplantation or scalp reduction.

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Frechet Scalp Reduction

Scalp reduction is only performed on the crown area of the scalp, or ‘the monk’s bald spot’. In this procedure, the bald skin is removed and the hairy sides of the scalp above the ears are drawn together.

This is repeated a number of times until the bald skin has been replaced by the hairy scalp. It is quite a complex operation and is not suitable for everyone, but it can be extremely effective.