Losing our hair is a nearly universal experience: one shared by men and women, across age groups and area codes. But you’d almost never know it.

Why?

Because, as NCOA’s Amanda Krisher explained, we go to great lengths to disguise it.

“Hair is so deeply entwined with society’s and our own personal beliefs about vitality, that losing it can feel embarrassing,” said Krisher, who serves as Associate Director, Behavioral Health at the NCOA Center for Healthy Aging. “And pop culture tends to reinforce that. It’s rare to see celebrities ‘of a certain age’ who don’t have a youthful-looking head of hair.”

In other words, even they feel compelled to conceal a receding hairline—or cover up a bald spot. Which is perfectly okay, Krisher said. “What anyone does with their appearance is their choice,” she said. “Especially if it boosts their confidence and self-esteem.”

The same holds true for the rest of us. And what’s great about celebrity culture? It empowers us with more options.

“We hear a lot more these days about famous people getting hair transplants,” Krisher explained. “Sure, there’s always gossip around that. But greater awareness helps to bust taboos, which I see as a silver lining.”

But what, exactly, is a hair transplant? Where do you get one? How much does it cost? Will it even work?

If you’re curious about hair restoration and whether it’s right for you, this guide walks you through the basics.

What is a hair transplant?

Simply put, a hair transplant takes hair from one part of your scalp and puts it on another. The goal is to encourage new growth in one or more areas with significant thinning or complete baldness.

Also called “hair restoration,” a hair transplant is a surgical procedure. To get one, you go to a plastic surgeon or specially trained dermatologist (skin doctor). Depending on your unique situation—which includes your hair loss type, the condition of your scalp, and other factors—your doctor will determine the best method(s) to replace the hair you’ve lost.

Common hair transplant techniques

First, a quick clarification. While you may see “hair restoration” and “hair transplants” used interchangeably, there is a subtle difference. Hair restoration is an umbrella category; hair transplants fall under it. There are other, less common, types of surgical hair restoration not covered in this article. These include more extensive procedures like scalp reduction, flap surgery, and tissue expansion.

Hair transplantation is a specific type of hair restoration that uses grafting to achieve results. There are two main techniques that most surgeons will use:

• Follicular unit strip surgery (FUSS)
  Also called follicular unit transplantation (FUT), this procedure includes several steps. First, the surgeon very delicately slices out a thin ribbon of hair-bearing scalp from the back of your head and stiches the area closed. This strip can be up to 10 inches long.
  
  Next, the surgeon separates the strip of donor tissue into hundreds of tiny grafts. Each of these grafts contains one or two individual hairs. Then, the surgeon places the grafts into the scalp where you want new hair to grow. Generally, this involves using a needle or scalpel to create microscopic holes and “planting” the hairs into them. (This is likely where the term “hair plugs” came from).
• Follicular unit extraction (FUE)
  This is a newer, less invasive form of grafting. Instead of slicing out an entire strip of donor scalp, the surgeon starts by removing individual hair follicles. These extractions are so small that they heal on their own without stitches.

After that, the process is similar to FUSS: the surgeon prepares the transplant area(s) and plugs the grafts into them.

Key considerations

Follicular unit strip surgery and follicular unit extraction both can be effective. Before you choose one over the other, it makes sense to thoroughly weigh the pros and cons of each. These include:

• Preparation
  Both FUSS and FUE are outpatient (same-day) procedures that don’t require anesthesia. Prior to either procedure, your surgeon will clean your scalp and inject a local numbing agent so you won’t feel a thing.
  
  Depending on your health and lifestyle, you may need to stop taking certain medications and make other adjustments several days or more before the surgery itself. Your primary care provider and surgical team can go over these instructions with you.
• Recovery
  Generally speaking, healing after FUE tends to happen more quickly than it does after FUSS, though the reasons are unclear.
  
  Also keep in mind that, as we age, our scalp tends to lose some elasticity. That means it could take longer for incisions and grafts to heal fully, regardless of procedure. The scars from hair transplantation may also be more noticeable.
• Aesthetics
  For FUSS, your surgeon will not need to shave the back of your head where the grafts come from. But the procedure will leave a long scar at the donor site that your existing hair may not fully cover.
  
  For FUE, your surgeon will shave the back of your head where the grafts come from. This hair will grow back and—once it does—will fully cover the healed-over extractions.

In all cases, it’s important to review your complete medical history with your doctor before getting a hair transplant. Do you have any existing medical conditions that preclude the surgery? Will you need to adjust or stop taking any medications? Are you physically able to tolerate the procedure?

Is a hair transplant effective?

Yes, for many people, a hair transplant works remarkably well. However, as with most things in life, your results may vary. Your age, overall health, and even your expectations all can impact the outcome.

Factors affecting success

The most satisfactory results depend on a combination of the following:

• Your hair loss type. With some exceptions, the best candidates for hair transplantation are people with androgenetic alopecia (AGA).
• Your hair loss pattern. It’s important that you have one or more areas of healthy hair growth to serve as the donor site. And grafts work best in spots of concentrated hair loss.
• Your age. In addition to reduced scalp elasticity and longer healing times, certain medical conditions that are common as we get older can negatively impact success.
• Your surgeon. Look for someone with demonstrated experience in hair transplants, preferably built over many years with many patients using the latest techniques.
• Your compliance. To achieve the best outcome, it’s critical that you follow all of your surgeon’s post-operative care instructions, some of which may span several weeks.
• Your expectations. A hair transplant creates a convincing illusion of thicker hair—but it won’t restore all of the hair you once had.

How much do hair transplants cost?

There’s no hard-and-fast rule that governs the price tag. According to data published by Statista, you can expect to pay around $13,610 for this procedure in the United States. But that cost can vary widely depending on things like:

• Where you live (state / region / country)
• Which procedure you choose (FUE typically is more expensive than FUSS)
• How many grafts you need
• Who performs your surgery

Typically, because hair transplants are elective and considered cosmetic, most insurance plans including Medicare won’t cover them. The office or clinic where you see your surgeon might offer a payment plan, however. Ask about costs and financing ahead of time so you know what to expect.

And don’t overlook the intangible value, Krisher advised. “Hair loss can be devastating to our mental health,” she said. “If you can afford the procedure, and it helps restore your self-esteem as well as your hair, the results are truly priceless.”

How do I find the right hair transplant clinic?

Research is key. Just because a clinic advertises prominently doesn’t mean their surgeons are competent or their patients happy. The following checklist can help you evaluate your options:

• Check medical credentials. At minimum, your doctor should be a board-certified plastic surgeon or dermatologist who specializes in hair transplants. Are they ABHRS certified?
• Determine relevant experience. Has your surgeon successfully treated older patients? How many?
• Read patient reviews. Search for testimonials (and complaints) online to get a sense for the surgeon’s approach, manner, and results. Look for before-and-after photos, too.
• Schedule a consultation. Get a gut feel for the practice and the surgeon during an in-person meeting. Ask questions and assess their professionalism and your comfort level.
• Consider the location. How far is the transplant clinic from home? Can you easily get to it and back, or will you need to spend money to stay nearby for post-operative appointments?

Post-transplant care and recovery

You can go home the same day of your FUSS or FUE procedure. If you are employed, you typically can return to work within 3-5 days. Still, your surgeon will ask you to follow some post-operative instructions to ensure optimal healing. Depending on your situation, these may include:

• Elevating your head during sleep
• Rinsing your scalp with sterile saline for several days
• Avoiding strenuous activity for a week or so
• Washing your hair and grafts with gentle shampoo after 3-4 days
• Applying minoxidil (brand name Rogaine) for a specific amount of time

Your hair transplants should last indefinitely. In the beginning, the hair will fall out; this is normal. Provided your grafted follicles remain healthy, they will continue to grow, shed, and regrow hair throughout the rest of your life.

Over the long term, you may also want to use hair care products and techniques that help support and maintain your new hair.

The bottom line

Hair transplants are a type of surgical hair restoration best suited for people with androgenetic alopecia (age-related pattern baldness). Modern techniques, including follicular unit strip surgery (FUSS) and follicular unit excision (FUE) use grafting to stimulate new growth and create the illusion of fuller, thicker hair. While the procedure can be expensive and Medicare generally won’t cover it, the psychological benefits can truly be priceless.

Sources

Patrick M. Zito, et al. Hair Transplantation. StatPearls Publishing. February 12, 2024. Found on the internet at https://www.ncbi.nlm.nih.gov/books/NBK547740/

Cleveland Clinic. Hair Transplant. Found on the internet at https://my.clevelandclinic.org/health/treatments/21519-hair-transplant