Start Here: Your Guide to Hair Restoration

First, work out what kind of loss this is

More than nine in ten cases in men are androgenetic alopecia, the genetic pattern loss driven by DHT. It recedes at the temples and thins at the crown, it is gradual, and it follows a recognisable shape.

Other kinds look different and are treated completely differently. Telogen effluvium is diffuse shedding across the whole scalp, usually a few months after illness, surgery, childbirth, weight loss or a nutritional problem, and it usually recovers on its own. Alopecia areata is patchy and autoimmune. Scarring alopecias are itchy, sore or scaly and destroy the follicle permanently, and they need a dermatologist quickly rather than a hair clinic ever.

So if your loss is sudden, patchy, diffuse rather than patterned, or accompanied by itching, pain or scaling, see a doctor before you buy anything. Get ferritin and thyroid checked while you are there. A treatable cause is worth more than any product on this site.

Before anything else

Take four photographs of your head in flat daylight, front, both sides and directly above, and put them somewhere you will find them again. Everything that follows depends on knowing what your hair was doing a year ago, and nobody remembers accurately.

Second, get to know your donor supply

A transplant moves hair from the back and sides of your head, where the follicles are genetically resistant to thinning, into the area that is thinning. The moved hair keeps that resistance, which is why a well-placed transplant lasts.

That supply is finite. Most people have somewhere around 6,000 to 8,000 grafts over a lifetime, and some have fewer. Hair taken from the donor area does not grow back there, so it is worth spending where it does the most good.

Some areas give far more back than others. A hairline and frontal third is commonly 2,000 to 2,500 grafts and returns more visible change than anything else, because it frames the face. A crown can absorb the same again and still look thin under overhead light.

Once you see it as a budget to plan rather than a single purchase, most of the decisions get easier, and you will know exactly what to ask when you compare graft counts between clinics.

Third, protect the hair you have

This is the step that makes the biggest difference to how a transplant looks in ten years.

Surgery places permanent hair where it is needed, and medication looks after the hair around it. With both in place, the transplanted area and your native hair stay in step, and the result keeps looking natural as you get older. Without medication, active loss can carry on behind the grafts and leave a gap, which is exactly what a good plan avoids.

Two drugs have real evidence. Finasteride blocks DHT and addresses the cause, and it is the one that changes your trajectory. Minoxidil prolongs the growth phase and thickens what you have, and you can buy it over the counter. Most people with active loss do best on both.

Give it twelve months and photograph the result. Expect a shed at two to three months, which is a sign the treatment is starting to work. Both drugs keep working for as long as you take them, so think of them as a long-term part of the plan.

If you start medication

Decide now that you will not stop during the shedding phase around month three. It is new growth pushing old hairs out, it passes within weeks, and staying with it is how you get to see what the drugs can do.

Fourth, choose the right moment for surgery

A good candidate has stable loss, a measured donor supply, and a clear picture of what a transplant does best: moving permanent hair to where it makes the most difference. Stable usually means a year or two of documented evidence, which is what your photographs are for.

Age is the rough guide to stability. Loss that starts in the early twenties usually has further to run, so the pattern may not yet show its final shape, and a hairline is best designed once it does. That is why careful surgeons often suggest a year on medication first. It is good planning, and it leads to a result that suits you for life.

Hair restoration has no referral system or waiting list, so you set the pace. Who a transplant suits sets out the criteria a careful surgeon uses, so you can walk into a consultation knowing where you stand.

Fifth, choose your technique

By this point you know what you need, and choosing the technique becomes straightforward.

FUE takes follicles one at a time and leaves tiny scattered dots that disappear under short hair. FUT takes a strip and leaves one fine line, yields more grafts in a single session, and on some scalps gives better graft survival. The deciding question is how short you will wear the back of your head: shorter than a number three points to FUE.

DHI is FUE with an implanter pen rather than forceps. It has genuine advantages for dense packing and for planting among existing hair, and it usually costs more, so it is worth asking what it adds in your case.

Body hair transplant extends the donor supply when you need more coverage than the scalp can provide, and repair refines or corrects an earlier transplant.

The things that shape your result most are your donor supply, a well-designed hairline, careful graft handling, and protecting the hair around the grafts. Get those right and each of these techniques can give an excellent result.

At every consultation

Ask who will perform each stage on the day, from extraction to placing the grafts. Often it is a team of technicians working with the surgeon, good clinics are happy to tell you exactly who, and knowing the answer lets you compare clinics like for like.

The order, in one list

1. Get a diagnosis if there is any doubt about what kind of loss this is.
2. Take baseline photographs, four angles, flat daylight.
3. Start medication and give it twelve months.
4. Photograph again. Compare. Establish whether the loss is stable.
5. Get your donor supply measured and written down.
6. Consult two or three surgeons, and compare hairline drawings before prices.
7. Choose who operates on who holds the instruments, not on the graft count.
8. Treat the front before the crown.
9. Stay on medication afterwards, permanently, and judge the result at twelve months, not three.
10. Plan any second session at twelve months, not before.

Steps three and four take patience, and they are what turn a good operation into a result you are happy with for decades.

Frequently asked questions

Should I just have a transplant and skip the drugs?

You can, and the transplanted hair will stay. Medication is what keeps the hair around it, so the result goes on looking natural as you get older. See protecting the hair you have.

I'm 24 and losing my hair. Can I have a transplant?

Possibly, once you know where your pattern is heading. Most careful surgeons suggest getting on medication and documenting a year or two first, which leads to a better-designed result. See choosing the right moment.

How do I know how much donor hair I have?

It has to be measured, with a densitometer or magnified camera, not estimated by eye. Ask for the number. See what you are spending.

Which technique should I choose?

It is easier to answer once you know your donor supply and your plan, and it mostly comes down to how short you wear the back of your head. See technique.

Is any of this covered by insurance?

Almost never, anywhere. The exceptions are occasional cover for reconstruction after burns, trauma or cancer treatment. See cost and funding.