10 things you need to know about having a hair transplant

POSTED: 14 January 2019

Crown Clinic's consultant hair transplant surgeon Asim Shahmalak is one of the best-known hair transplant surgeons in the world.

He gets asked all the time by the media for his key tips on having a hair transplant - here are 10 important things you need to know.

1 A hair transplant is the only permanent cure for male pattern baldness. The problem of thinning hair affects the majority of men at some point in their lifetime. According to the National Institute for Health Care and Excellence, around a third of white men under the age of 30 are losing their hair - this increases to 80% by the age of 70. Rates of hair loss are slower in black and Asian men.

2 Hair transplant procedures have never been more popular. According to the International Society of Hair Restoration Surgery there has been a 60% rise in the number of hair transplants globally in the last five years.

3 There are two common types of hair transplant procedure. The most popular is FUE (follicular unit extraction) - chosen by 80% of the clients at Crown Clinic including most of our celebrity patients: Calum Best, Homes Under The Hammer star Martin Roberts, former footballer Didi Hamann and Gogglebox star Chris Butland-Steed. Around 20% of our patients opt for the more traditional method known as FUT (follicular unit transplantation). The TV doctor Christian Jessen has had two FUT hair transplants at Crown Clinic with Dr Shahmalak.

With FUE, the donor hairs are removed individually from the back and sides of the scalp and then replanted in the balding areas. This means any scarring is minimal. 

With FUT, the donor hairs are removed all in one go by surgically cutting a strip of skin from the back or side of the scalp. The scarring for this method is more noticeable which is why it is not recommended for men who like to wear their hair shaved or short at the back and sides.

4 What causes male pattern baldness? The most popular cause is your genes. If you dad is bald, chances are you will be too. The baldness gene can also be passed down on your mother's side of the family - from her father, for instance. What happens biologically is a modified form of testosterone, the hormone dihydrotestosterone (DHT), attacks hair follicles on the scalp. The hairs produced by the affected follicles become progressively smaller in diameter, shorter in length and lighter in colour until eventually they shrink completely and hair stops being produced. DHT does not tend to affect hair on the back and sides of the scalp - which is why even the most heavily bald men (think Bobby Charlton) still have a horseshoe-shaped area of hair on the back and side of their scalp. This is where the donor hair for a transplant is sourced.

Your hair style can also contribute to hair loss. Crown Clinic's client Calum Best believe his baldness was accelerated by pulling his hair tight into a ponytail in his early 20s.

5 Can you slow down hair loss? Yes, you can. Dr Shahmalak recommends the use of clinically proven hair loss medication such as Finasteride (also known as Propecia) and Minoxidil (often applied as a mousse). These won't grow any new hair but scientific trials have shown that they can halt or slow down natural hair loss. It is why Dr Shahmalak sometimes recommends their use in conjunction with a hair transplant.

6 At what age should you consider a transplant? Dr Shahmalak will not operate on any patient younger than 25. He needs to establish the pattern of hair loss in a patient and that cannot be done prior to 25. 

7 How do you find a hair transplant surgeon who is right for you? You want to check that they are members of a reputable professional body such as the British Association of Hair Restoration Surgery of which Dr Shahmalak is a member. Look at a surgeon's testimonials - it is always a good sign if they have lots of recent happy patients.

8 Should you go abroad for surgery? Remember that all hair restoration clinics in the UK are tightly regulated by the Quality Care Commission. They are inspected every year and closed down if they don't meet rigorous standands. You do not get that kind of regulation in countries like Turkey where many clinics are unregulated. We have all read horror stories of patients having nightmare treatments at foreign clinics. The problem you have is remedying the damage or getting compensation if you have a poor treatment abroad. Would you want to take legal action through the Turkish courts?

9 What aftercare is needed? We recommend that patients take a week off work after a procedure. Almost all our operations are done on the day with patients travelling home on the day, but we ask them to take it easy for a week afterwards so they don't dislodge any of the transplanted hair. So, for instance, we recommend that you wear button down shirts rather than pull-overs or T-shirts - because pulling these over the head can dislodge the new hair. Patients also have to sleep upright for a few days afterwards.

10 When will I notice the difference? The transplanted hair starts growing back three to four months after a procedure. You will see a real diffference after six months but you won't see the full effects of the transplant until a year afterwards.

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