FUE Hair Transplant

Who it’s for

The good candidate has stable loss, a dense donor area, dark hair not too different in colour from the scalp, and a realistic idea of what a transplant can cover. Stable means the loss has slowed or been slowed by medication, usually with a couple of years of evidence behind it.

Age matters, because it is a guide to how settled the pattern is. A man of 24 with a receding hairline and a family history of going bald may still have some way to go, and a hairline designed once the pattern is clearer will suit him for life. Most careful surgeons want either an older patient or a younger one who is properly established on finasteride.

Donor supply sets the budget. Somewhere around 6,000 to 8,000 grafts is the lifetime figure for most scalps, and some people have less. A hairline and frontal third is often 2,000 to 2,500 on its own, and a crown can take the same again, so planning where the grafts go matters.

A few situations need more care first. Diffuse thinning that includes the donor area, where the supply itself may be unstable. Active, unmedicated loss in someone in their twenties. Scarring alopecias, which need a dermatologist first. And it helps to know that a transplant restores natural-looking coverage rather than the exact density you had at eighteen.

Before you book anything

Photograph your own head from four angles in flat daylight, and do it again every three months. Loss is too slow to see in a mirror, and having a year of your own photographs is the only way to know whether it is stable before someone operates on it.

How it’s done

The day starts with drawing. You sit up, and the surgeon marks the hairline and the area to be covered while you watch. Those pen lines matter more than anything that follows, and they are the part you have the most say in. Then the donor area is shaved, usually the whole back and sides, and local anaesthetic goes in. That is the part people dread and it is over in a few minutes.

Extraction comes next, and it takes hours. A punch, either a spinning micromotor or a manual tool, cuts around each follicular unit to free it from the surrounding tissue. Assistants pull the units out with forceps and sort them by how many hairs each carries. Out of the body, grafts sit in a chilled holding solution, and keeping that time short is one of the details a well-run clinic manages carefully.

Then the sites. The surgeon makes hundreds or thousands of small incisions in the recipient area, each at the angle and direction the surrounding hair grows, using blades or needles sized to the grafts. Angle and direction are where artistry actually lives. A transplant that looks wrong usually looks wrong because the hair points the wrong way, not because there is too little of it.

Finally the grafts go in, single-hair units at the front for a soft edge and multi-hair units behind them for density. In a standard FUE the placing is done with forceps; in DHI an implanter pen makes the site and places the graft in one motion. Placing is commonly done by skilled technicians working alongside the surgeon, which is why the whole team matters as much as the name on the door.

At the planning appointment

Ask the surgeon to draw the hairline while you hold a mirror, and do not agree to it until you have seen it on your own face sitting upright. It is the decision that shapes your result most, so take your time over it.

FUE recovery

The first fortnight is more socially awkward than physically hard. The recipient area is covered in tiny scabs, which look like a rash from a distance and like exactly what they are up close. Swelling often drops into the forehead and around the eyes on days two to four, which alarms people and passes. The donor area is sore and tight rather than painful.

Washing is the bit to get right. Clinics give a protocol, generally involving not touching the grafts for the first couple of days and then a specific gentle routine, and the point of it is that grafts are not properly anchored until around day ten. After that they are yours and you can behave normally.

Then comes a stage worth knowing about in advance. At around week three to six, most of the transplanted hairs fall out. This is shock loss, it is expected, and the follicles underneath stay put and grow new hairs on their own timetable. For a few weeks the area can look thinner than before surgery, and that is perfectly normal. People who know it is coming find it far easier to sit out.

Around week four

Expect the transplanted hairs to shed, and remember the follicles underneath are getting ready to grow. Shock loss is right on schedule, and knowing it is coming makes it much easier to take in your stride.

FUE scars

FUE leaves tiny scattered scars rather than a line. Every extraction leaves a round white scar under a millimetre across, and a 2,500-graft session leaves 2,500 of them across the back and sides. Individually they are invisible. Collectively, on a shaved head under bright light, they read as a faint stippled texture, and at a number one or shorter some people can see them.

The donor risk worth asking about is over-harvesting. Take too much from one area and you get a patch of visible thinning in the donor itself, which is hard to fix. A careful surgeon spreads extraction evenly, so ask how they spread it across the donor zone and what maximum density they harvest to.

In the recipient area there is no scar worth the name, provided the sites were made at the right size. Overly large sites can leave pitting or a cobblestone texture, which is a technique failure rather than an inevitability.

Sensation after FUE

Both areas go numb, and both come back. The donor area is usually numb or tingly for several weeks and occasionally a few months; the recipient area for rather less. Itching during regrowth is near-universal and is a good sign, irritating as it is.

A small number of people are left with a permanently altered patch of sensation in the donor area, most often at the upper edge. It is generally a curiosity rather than a problem. Persistent pain in the donor area months later is not normal and is worth going back about.

Risks and complications

Serious medical complications are uncommon. Most FUE problems are cosmetic and only show at the twelve-month mark, which is why choosing a careful team matters.

The early ones are minor. Folliculitis, meaning small infected bumps as hairs push through, usually treated with warm compresses or a short course of antibiotics. Infection proper is rare, because the scalp has an excellent blood supply. Bleeding is minimal. Swelling is universal and harmless.

The later ones are the ones to plan around. Poor graft survival, where some grafts do not grow, which only shows at around a year. An unnatural hairline, too low, too straight or with multi-hair grafts at the front edge that look like doll's hair. Over-harvested donor. And continued thinning of the native hair around the grafts, which medication helps prevent.

Shock loss can also hit the native hair around the grafts, not just the transplanted hairs. It usually recovers over months. In someone whose loss was already active, sometimes it does not.

FUE results

Judged at twelve to eighteen months, a good FUE gives a hairline that looks like it grew there and a frontal area with enough density to read as hair rather than coverage. Density works differently from what people expect. A transplant typically restores something like a third to a half of original density in the treated area, and the reason it still looks convincing is that the eye reads coverage, not follicle counts.

Two sessions are normal rather than a sign of failure. Many plans are designed as two from the start, the first building the framework and the second adding density once the first has grown out.

What turns a good result into a great one is planning: enough grafts for the area chosen, a hairline designed for how the face will age, and medication that keeps the native hair around the transplant. All three are within your control, and helping you get them right is what this site is for.

Alternatives to FUE

Before surgery, the drugs. Finasteride and minoxidil do not do what a transplant does, but they hold what you have, and in early loss they sometimes recover enough that surgery stops being necessary. A good surgeon will raise them with you.

Within surgery, the real choice is FUT, which takes a strip of scalp instead of individual units. It leaves a line rather than dots, yields more grafts in a single session, and on some scalps gives better survival. It is less common now and still an excellent option. DHI is a placement method rather than a different operation.

Then the options that are not surgery at all. Scalp micropigmentation tattoos the look of stubble and can be startlingly effective, alone or behind a transplant. A system, meaning a hairpiece, is better than its reputation. And a confident shaved look is a perfectly good choice too, with no maintenance at all.

Combining FUE with other surgery

FUE is routinely combined across areas in one session, most commonly a hairline with the area behind it. Adding the crown to the same day is where plans get overambitious, because the crown is a spiral that needs density to look right and it will happily absorb every graft you own.

It is also often paired with scalp micropigmentation a year later, to add the impression of density behind a transplant that grew well but thin. That combination is underused and it is one of the better value decisions in the whole field.

And keep your medication going alongside a first transplant. It is the simplest way to keep the result looking as good in five years as it does at twelve months.

FUE cost

Almost everywhere prices by the graft, which is why the graft count is the number to interrogate rather than the total. A clinic quoting 4,000 grafts against another's 2,500 for the same head is either planning to be generous with your donor supply or counting differently. Ask how many grafts, how they counted them, and what the price is per graft.

Then ask what happens if grafts do not grow. Reputable clinics have a policy, often a free or discounted top-up after twelve to eighteen months if growth falls short of a stated threshold. Ask for it in writing.

Lower prices usually reflect local costs and how a clinic is staffed. In some clinics the surgeon marks the hairline and technicians do most of the rest, sometimes across several patients at once. That can work well with an experienced team, and it is worth knowing which model you are choosing.

Choosing an FUE surgeon

Ask one question first and listen hard to the answer: who does what. Specifically, who makes the recipient sites, who does the extraction, who places the grafts, and how many patients the clinic runs in a day. In a good clinic the surgeon makes the sites, so it helps to know how many cases they cover in a day.

Then the numbers. How many grafts they think you need and why, what density they are planting at, and what maximum density they harvest the donor to. You want specifics, and you want a plan that explicitly accounts for the loss you have not had yet.

Then the photographs. Ask for results at twelve months and later, on people whose starting pattern matched yours, with the donor area photographed too. Few galleries show donor areas, and a clinic confident in its work will happily produce them.

Finally, ask what they would advise if you did nothing for two years and stayed on medication. A surgeon who plans around your long-term picture like that is worth travelling for.

At the consultation

Ask who will physically be holding the punch and the forceps on the day. Many clinics use skilled technicians for parts of the operation, and a good clinic will tell you plainly who is on your team.

Clinics that do FUE

Absolute Hair Clinic

Khlong San · Hair transplant clinic

Absolute Hair Clinic is a Bangkok hair restoration clinic on the Thonburi side of the river, led by two ISHRS Fellows, surgeon Dr. Kongkiat Laorwong and Chulalongkorn dermatology professor Dr. Ratchathorn Panchaprateep, for FUE and FUT.

In 1 clinic guide

Dr.Orn Clinic

Chatuchak · Hair transplant clinic

Dr.Orn Clinic : Medical Hair is a Thai hair clinic group founded in 2011 by dermatologist and ABHRS-certified hair surgeon Dr. Onuma Phanapiwat, now with five branches in and around Bangkok and FUE, FUT and long-hair transplants among its work.

In 1 clinic guide

Kamol Hospital

Wang Thonglang · Private hospital

A JCI-accredited private hospital in north-east Bangkok, founded by plastic surgeon Dr. Kamol Pansritum and in its purpose-built home since 2009, with its own hair transplant service.

JCI accredited In 1 clinic guide

Masterpiece Hospital

Dusit · Private hospital

Masterpiece Hospital is an AACI-accredited aesthetic hospital in Dusit, Bangkok, founded by Dr. Raweewat Maschamadol as a Siam Square clinic, with its own hair transplant team and more than 6,000 cases by its own count.

AACI accredited In 1 clinic guide

Mediren Clinic

Ratchathewi · Hair transplant clinic

Mediren Clinic is a Bangkok hair restoration clinic founded and led by Dr. Ben Butwong, President of FUE Asia, with branches in Bangkok, Nonthaburi and Ubon Ratchathani and FUE in every form as its craft.

In 1 clinic guide

Vejthani International Hospital

Bangkok · Private hospital

Vejthani International Hospital is a JCI-accredited private hospital in Bang Kapi, east Bangkok, founded in 1994 and caring for patients from more than 100 countries, whose Plastic Surgery Center offers FUE and FUT hair transplants.

JCI accredited In 1 clinic guide

Yanhee International Hospital

Bang Phlat · Private hospital

Yanhee International Hospital is a JCI-accredited, 400-bed private hospital in west Bangkok, open since 1984 and famous for cosmetic surgery, where hair transplants are done inside the hospital by FUE and FUT.

JCI accredited In 1 clinic guide

Frequently asked questions

Do the transplanted hairs fall out?

Yes, most of them, at around three to six weeks. The follicles stay and regrow from about month three. It is expected and temporary. See recovery.

Is FUE better than FUT?

Not inherently. FUE leaves dots instead of a line; FUT yields more in one session and sometimes survives better. See alternatives.

How many grafts do I need?

A hairline and frontal third is commonly 2,000 to 2,500, a crown often as much again, against a lifetime donor supply of roughly 6,000 to 8,000. See who it's for.

Do I have to take finasteride afterwards?

Not literally, but most surgeons recommend it, because medication protects the native hair around the grafts and keeps the result looking natural as you get older.

When will I look normal again?

Two to three weeks for the scabs and redness, then a temporary shed, then a genuinely good result from around nine to twelve months. See results.