10 things you need to know about having a hair transplant

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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.

Our Surgeon

Dr. Asim Shahmalak

Dr Asim Shahmalak is a world-renowned hair transplant surgeon who performed the UK’s first eyelash transplant in 2009. He runs Crown Clinic – one of Britain’s most successful and best known hair transplant clinics. He has treated a number of high-profile industry leaders and celebrities including the medical broadcaster Dr Christian Jessen, best known for Channel 4’s Embarrassing Bodies.

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Spurs manager Antonio Conte is one of a number of people in football who have benefitted from a hair transplant.

Another is the Liverpool manager Jurgen Klopp, who has been very open about seeking help with his hair.

Conte, 52, looks completely different in the before and after pictures shown on this page and is likely to have had several procedures to boost his hair.

Like a lot of men, Conte started losing his hair in his late 20s and early 30s when he was a successful player in the Italian league and playing for the Italian national team.

He was pictured several times during this time showing all the signs of advanced male pattern baldness.

Since becoming such a successful manager, Conte has had at least two hair transplants to cover up the bald areas at the front of his hairline.

It is likely he would have opted for a FUE (follicular unit extraction) procedure. This is where the grafts are removed individually from the back and sides of the scalp and then replanted in the balding areas.

Around 80% of patients coming to Crown Clinic to our consultant surgeon Asim Shahmalak now opt for FUE.

This is a big change on five years ago when the majority of our patients chose the more traditional method of hair transplantation known as FUT (follicular unit transplantation) or strip surgery.

The advantage of FUE over FUT is that there is less scarring. Most FUE patients are simply left with some red pin pricks where the donor hair is harvested and replanted which go away after a few weeks.

Famous Crown Clinic FUE patients include the Coronation Street star Jack P Shepherd, model Calum Best, and the football pundit Didi Hamann.

FUE is slightly more expensive than FUE because it requires more time to carry out. This is because the donor grafts are removed individually rather in one single strip of skin which is surgically removed, which is what happens under FUT.

Crown Clinic’s most famous FUT patient is the TV doctor Christian Jessen who has had two FUT transplants with Dr Shahmalak. Scarring is greater with FUT and all patients are left with a lined scar on the scalp where the strip for the donor hair is removed. This soon heals and if you wear your hair relatively long, like Christian Jessen, it is very difficult to see the scar because the hair grows over it. However, the scar is visible if you like to wear your hair short or shaved, like Calum Best, so we recommend FUE for all patients who like their hair short. Around 20% of Crown Clinic patients still prefer FUT. There is evidence to show that slightly few grafts are lost in the donor hair harvesting process by removing the grafts in one go – so that is an advantage of FUT.

Conte has not spoken about his hair transplants, so we don’t know for sure which method he chose.

Whichever one it was, he is to be congratulated on his choice and the work of his hair transplant surgeon because he has an excellent result.

Dr Asim Shahmalak from Crown Clinic is one of the world’s leading hair transplant surgeons.

He is the surgeon to the stars and has performed procedures for celebrities including Jack P Shepherd from Coronation Street, the model Calum Best and the TV doctor Christian Jessen.

He has pioneered new hair transplant procedures in the UK such as eyelash, eyebrow, beard and sideburn transplants.

His main clinic is close to Manchester Airport and he also has consulting rooms in Harley Street.

A former general surgeon in the NHS, he switched to hair transplantation private practice 15 years ago and is one of the most acclaimed surgeons globally in FUE (follicular unit extraction) and FUT (follicular unit transplantation) hair transplant procedures

Are more women enquiring about hair transplants/procedures/treatments and if so why? Is demand growing?

Asim Shahmalak said: “Yes, more women are enquiring about hair transplants. They are still far outnumbered by men but around 10% of my patients are female.

“Most of them come because they have permanent thinning hair and this can be even more damaging to a woman’s self-esteem than a man’s simply because it is more unexpected and it can have a devastating impact on a woman’s confidence.

“I also treat increasing numbers of women for eyebrow and eyelash transplants. Most eyebrow transplants are down to women permanently damaging their brows due to over-plucking. Hair is transplanted from the scalp and replanted in the brows.

“I also do eyelash transplants on women. I was the first surgeon in the UK to perform an eyelash transplant here – way back in 2007 on a young woman from Greater Manchester. Most eyelash transplant patients seek treatment after suffering from trichotillomania – a condition where sufferers rip out their eyelashes due to psychological issues. Hair is extracted from the scalp and replanted in the upper eyelid. Because it is scalp hair, it goes as it would on the scalp when replanted in the eyelid so it can curl when longer and needs to be straightened. I provide kits so patients can do this themselves.

“Demand is growing for general female hair transplants. The reason for this is greater awareness that hair transplantation is the only long term solution to permanent hair loss in women.

“There is also a lot of concern about hair extensions and the damage they can cause to the scalp. Women can wreck their hair with hair extensions which can pull out their natural hair and cause permanent damage to the scalp.

“Lots of women have seen successful male transplant patients such as Calum Best or Jack P Shepherd and thought, ‘That could work for me, too.’”

Why have women been slower than men to enquire about hair procedures?


Asim Shahmalak said: “I think women have been slower than men to enquire about hair transplants in the past because they thought that hair transplants were a ‘man thing.’ You didn’t read about women having procedures and there was this assumption that while women could benefit in lots of ways through plastic surgery – breast enhancements or browlifts or facelifts – hair transplantation was not for them. One of the reasons is that a lot of female hair loss is hormonal and non-permanent. The hair eventually grows back and so hair transplantation is not necessary.

“However, a significant number of women do suffer permanent hair loss for a number of reasons including the same hereditary reasons which is the main factor in men going bald. A receding hairline at the front ages a woman far more quickly than a similar condition in men. You expect some women in their eighties or nineties to have thinning hair, but not in their forties or fifties. It is those younger middle aged women who are coming to me for help in increasing numbers.”

Are more younger women enquiring about hair transplants/procedures/treatments and if so why?

Asim Shahmalak said: “Yes, more young women are inquiring about treatments and there is a simple reason: vanity. In the age of social media, where we can all enhance our appearance with photographic filters, a hair transplant is like having a permanent positive filter on your hair. You can wave goodbye to bad hair days and have the hair you have always wanted every day.

“So many young people want to look their best when sharing pictures on Facebook and Instagram and come to me for procedures which will improve their self confidence and how they present themselves to their friends and the world on social platforms.”


Are more women going through the menopause enquiring about hair transplants/procedures/treatments and if so why?

Asim said: “Menopause is a natural physiological process that all women experience at some point in their lives. During this time, the body goes through numerous physical changes as it adjusts to fluctuating hormone levels. Many women have unpleasant symptoms during menopause, including hot flashes, mood swings, and insomnia. Hair loss is another common occurrence.


“Hair loss tends to be subtler in women than it is in men. Most women experience overall hair thinning rather than noticeable bald spots. The thinning can occur on the front, sides, or top of the head. Hair may also fall out in large clumps during brushing and showering.

“Research suggests that hair loss during menopause is the result of a hormonal imbalance. Specifically, it’s related to a lowered production of estrogen and progesterone. These hormones help hair grow faster and stay on the head for longer periods of time. When the levels of estrogen and progesterone drop, hair grows more slowly and becomes much thinner. A decrease in these hormones also triggers an increase in the production of androgens, or a group of male hormones. Androgens shrink hair follicles, resulting in hair loss on the head. In some cases, however, these hormones can cause more hair to grow on the face. This is why some menopausal women develop facial “peach fuzz” and small sprouts of hair on the chin.

“For women going through menopause, the cause of hair loss is almost always related to hormonal changes. However, there are many other factors that can contribute to hair loss during menopause. These include extremely high levels of stress, illness, or a lack of certain nutrients. Diagnostic blood tests that can help rule out other causes of hair loss include thyroid tests, and/or a complete blood count.

“Hair loss may make you feel self-conscious about your physical appearance, but the condition isn’t permanent in most cases. Obviously where it is non-permanent a hair transplant is not appropriate.

“However in some cases the hair loss is permanent and a hair transplant is appropriate. We have seen growing number of post-menopausal women seeking help for the same reasons of vanity that attract younger women to the clinic.”

Do you have any concerns about the hair transplant industry, particularly the popularity of going abroad?

Asim Shahmalak said: “I have great concerns about the numbers of patients of both sexes going to countries such as Turkey for hair transplant procedures.

“Do you really want to take a risk on such an important decision on what could be a completely unregulated clinic? The main drawback of going abroad for a procedure is that patients have almost no recourse if the procedure goes wrong or they don’t get the result they desired.


“Do you really want to start legal proceedings in a Turkish court and would you have the first idea about what to do? If you need further care from the surgeon, you will need to fly thousands of miles for a remedy which again may not work. It may be a little more expensive to have treatment in the UK but it is money very well spent.


“One of the main areas of my work is repair surgery. Patients come to me after having a terrible experience in a country such as Turkey and ask me to repair the damage. In most cases, I can help and sort out their problems but, in a few cases, nothing can be done and patients can severely damage their appearance by going to an unregulated ‘cowboy clinic’ abroad.


And I would be keen to know if you have any case studies of women who have had the procedure who would be able to tell me about their experience?


Asim Shahmalak said: “Most of my female patients would rather not be fully named and pictured when talking about their hair transplant procedures.


“But several have been so pleased with the results that they are okay to share pictures and their experiences in a way where they are not fully identified. Here are some of my very happy former female patients.”

He maybe the world’s richest man, but all those riches could not save Elon Musk’s hair.
That is why the founder of the Tesla car company transformed his appearance with a hair transplant.
You can see the remarkable change in his appearance in the before and after pictures below.

His hair is clearly thinning at the front in the before picture on the left, taken in his 20s.

Fast forward more than 20 years and the 50-year-old Musk has a full head of hair in the after picture on the right.

Musk will almost certainly have had a Follicular Unit Extraction transplant – chosen by 80% of the patients at Crown Clinic.

With FUE, the donor hair is extracted individually from the back and sides of the scalp – keeping any scarring to a minimum.

Celebrity patients of our consultant hair transplant surgeon Dr Asim Shahmalak who have had FUE transplants include Jack P Shepherd from Coronation Street, the footballer Didi Hamann and the model Calum Best.

Dr Shahmalak also offers the more traditional method of hair transplantation, FUT – follicular unit transplantation.

With FUT, all the donor hair is removed in one go by surgically cutting a strip of skin from the scalp. The donor grafts are then extracted from the strip by technicians and replanted in the balding areas of the scalp by Dr Shahmalak in the same way as FUE.

The TV doctor Christian Jessen has had two FUT transplants at Crown Clinic with Dr Shahmalak. We don’t recommend FUT for patients who like to wear their hair short or shaved because the scarring is more noticeable than FUE. If you grow your hair slightly longer, as Christian Jessen does, the scarring cannot be seen.

Whatever method he chose, Elon Musk is to be congratulated on his transplant – his new hair looks fantastic.