Crown Clinic’s surgeon Asim Shahmalak answers 5 most common questions about hair transplants

Dr Asim Shahmalak is one of the leading hair transplant surgeons in the world. He runs Crown Clinic in Manchester and has consulting rooms in Harley Street. His high profile patients include the model Calum Best, footballer Didi Hamann and the Coronation Street actor Jack P Shepherd. As well as hair transplants, Dr Shahmalak performs more unusual procedures including eyebrow, eyelash, beard and sideburn transplants.

How is a hair transplant performed?

Dr Asim Shahmalak said: “Hair transplantation is the only permanent long-term solution for baldness. Anyone who has experienced permanent hair loss may be a candidate for hair restoration surgery including men and women with pattern baldness.
People seek transplants for a number of reasons but the most popular is to restore or change the shape of their hairline. People with areas of scarring from injuries such as burns from an accident may also be suitable for a transplant.

There are two types of hair transplantation – FUE (follicular unit extraction) and FUT (follicular unit transplantation). With FUE, the donor hairs are removed individually from the back and sides of the scalp before being replanted in the balding areas. Famous FUE patients include my clients, model Calum Best and the Coronation Street actor Jack P Shepherd, who plays David Platt in the soap, as well as the footballer Wayne Rooney and the singer Robbie Williams. Around 80% of my patients now opt for FUE.

With FUT, the donor hair is removed all in one go by surgically cutting a strip of skin from the scalp. The donor grafts are then extracted from this strip by technicians under a microscope and then replanted in the balding areas in the same way as FUE. The most famous FUT patient is the TV doctor Christian Jessen, who had had two FUT transplants with me.

The main advantage with the FUE method is that scarring is minimal. I have also noticed a surge in men wanting to wear their hair short around the back and sides of the scalp – and this style favours FUE over FUT. With FUT, all patients have a linear scar where the strip is removed. If the patient wears their hair long, the hair covers up the scar. But FUT is not suitable for patients who like the hair short at the back or sides.”

Who’s getting it done?

Dr Asim Shahmalak said: “In terms of occupations, I treat a proportionately high number of people who work in the public eye. These could be actors, TV presenters and particularly leading sportsmen, notably footballers. Why do so many footballers have hair transplants? Because their image rights are worth millions and a significant proportion of their income comes from commercial endorsements. Brands want to work with stars who look young – going bald in your 20s is not a good look with sponsors. I treated the former Man City and Liverpool footballer Didi Hamann. He is now a successful TV pundit both here and in his native Germany. He had the procedure because he knows you need to stay young looking to prosper in TV. I also work with a number of footballers who come to me as private patients and would rather no one knew they had had help with their hair. I enjoy seeing their hair looking so much better when I see them on Match of the Day.

“Obviously hair transplantation is not available on the NHS and it is relatively expensive – about the same cost as changing your car. I treat a lot of successful businessmen and high achievers – men who often have highly stressful jobs. Stress is a factor in hair loss but this hair loss tends only to be temporary and any hair lost through stress tends to grow back. These high-flyers seek a hair transplant because they want to look good and retain their youthful looks – that can definitely benefit their careers.

“Around 10% of my patients are women who can experience permanent hair loss in the same way as men – only it is far less common. I also treat a lot of patients who come to me for ‘repair work’. They have had botched procedures at cheaper, unlicensed clinics abroad in countries like Turkey and are not happy with the results. I put the early flawed procedure right.

Why do people normally get them? e.g. receding hairline, male pattern baldness etc

Dr Asim Shahmalak said: “The main reason why people have a hair transplant is to look younger. The early onset of male pattern baldness can have a devastating effect on a man or woman’s confidence. There is some evidence to suggest that men with a full head of hair are more successful in their careers and earn more than men who are bald.
There is no doubt that the growth in the number of celebrities going public with fantastic results from hair transplants has been behind the boom in the number of procedures over the past five years. Bookings at Crown Clinic shot up by 25% after Wayne Rooney, Calum Best and Jack P Shepherd went public with their results. Men see their favourite stars looking ten years younger after undergoing a procedure and want the same benefits. Image is becoming all important and there is research to suggest that men with a full head of hair earn more and have more successful careers than balding men. This is certainly true of anyone in the public eye. Do you think Wayne Rooney would be as attractive to sponsors if he was completely bald, which he would be if he had not sought treatment for his male pattern baldness? Similarly, how many leading Hollywood heart-throbs are bald? You would struggle to think of more than a handful over the past 50 years. We all look better with a full head of hair.”

Is it painful?

Dr Asim Shahmalak said: “As with any surgical treatment, there is a small element of pain – starting with the anaesthetic to numb the area of the scalp being worked on. But any pain is minimal and not something which should unduly concern patients. At Crown Clinic patients are sedated with a local anaesthetic and remain conscious throughout the whole procedure. Most like to relax during surgery by watching DVDs. Some get so relaxed that they fall asleep as I remove or replant the hair grafts. I think that gives you a good idea of the level of pain experienced.”

Is everyone a candidate? Does it work better for some people than others? Is it always with your own hair?

Dr Asim Shahmalak said: “Reputable surgeons will not operate on patients under the age of 25 – largely because it is difficult to establish how a patient’s baldness will progress before that age.
Yes, it is always your own hair because the DNA match means the transplanted hair will settle well in its new home. Most donor hair is taken from the back and sides of the scalp where there is a permanent horseshoe of hair which remains constant for pretty much everyone, even men who suffer from severe male pattern baldness. Donor can be taken from other areas of the body such as the beard or neck (with men who have particularly thick beards). This hair is coarser than head hair and not such a perfect match as hair taken from the back and side of the scalp. For that reason, this neck and beard hair may be used as filler hair towards the back of the scalp and not in the most sensitive areas right at the front of the hairline.
Hair transplants are most effective on people in the relatively early stages of hair loss where the balding area is not excessive and there is plenty of donor to draw on. Prince Harry, for instance, who has spoken recently about his male pattern baldness, would be an excellent candidate for a procedure.
His brother, Prince William, on the other hand, is probably too far gone to benefit from a procedure. His male pattern baldness is too advanced and there is too big an area for a hair transplant surgeon to be able to provide adequate cover. There would be insufficient donor hair with Prince William.”