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, understand what you are spending

A transplant does not create hair. It moves hair from the back and sides of your head, where the follicles are genetically resistant to thinning, into the area that is thinning. Nothing new is grown, and the hair that is moved keeps the properties of where it came from.

That reserve is finite. Most people have somewhere around 6,000 to 8,000 grafts in a lifetime, and some have considerably fewer. It does not regenerate. Hair taken from the donor area does not grow back there.

The prices are uneven. 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 rather than a purchase, most of the decisions in this field get easier, and the clinics offering you the largest graft counts start to look different.

Third, get the loss stopped before you move anything

This is the step people skip, and skipping it is the single commonest reason a technically good transplant ends up looking wrong.

Surgery does nothing to the hair around the grafts. If the loss is active and untreated, that hair keeps thinning, and within a few years there is a band of transplanted hair with a widening gap behind it. It looks as though the transplant receded. It did not; everything else went.

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 that looks like the treatment failing and is not. Both drugs work for as long as you take them and no longer, so this is a permanent arrangement or it is nothing.

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 quitting there is how people waste a year and conclude the drugs do not work.

Fourth, decide whether surgery makes sense yet

A good candidate has stable loss, a measured donor supply, and expectations that match a redistribution rather than a cure. Stable usually means a year or two of documented evidence, which is what your photographs are for.

Age is the crude proxy for stability. Loss that started at twenty-one tends to go further than loss that started at forty, and at twenty-four the pattern has barely declared itself, so any hairline designed now is designed against a shape nobody can see. Most careful surgeons will either decline or insist on medication first. A surgeon who declines to operate on you is doing the job properly.

There is no gatekeeping in this field. No letters, no assessment, no waiting list, no referral. You can book next week with a credit card, which means the only person applying criteria is usually the person selling you the operation. Who a transplant suits sets out the criteria a careful surgeon would apply, so you can apply them yourself.

Fifth, then worry about technique

By this point the technique question is much smaller than it looked at the start.

FUE takes follicles one at a time and leaves hundreds of scattered pinpoint scars. FUT takes a strip and leaves one line, yields more grafts in a single session, and sometimes survives better. The deciding question is how short you will ever wear the back of your head: shorter than a number three rules out FUT.

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 is priced as though it were a different operation.

Body hair transplant is what you reach for when the scalp donor is spent, and repair is what happens when one of the earlier decisions went wrong.

What actually decides your result is none of this. It is how much donor hair you have, who designs the hairline, how many grafts survive, and whether the loss around them was controlled.

At every consultation

Ask who will physically be holding the punch and placing the grafts on the day. In clinics at every price point the answer is often technicians rather than the surgeon, and the clinics that tell you plainly are more trustworthy than the ones that let you assume.

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. Treat the front before the crown.
8. Stay on medication afterwards, permanently.
9. Plan any second session at twelve months, not before.

Steps three and four are the ones people want to skip, and they are the ones that decide whether step six is worth doing at all.

Frequently asked questions

Should I just have a transplant and skip the drugs?

You can, and the hair around the grafts will keep thinning until a gap opens behind them. See getting the loss stopped.

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

You can find someone to do it. Whether you should is a different question, and the answer is usually to get on medication and document a year or two first. See whether surgery makes sense yet.

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 the last question rather than the first, and it mostly comes down to how short you wear the back of your head. See technique.

Is any of this covered by insurance?

No, anywhere, except occasionally for reconstruction after burns, trauma or cancer treatment. See cost and funding.