Do Hair Transplants Work? Everything You Need To Know

hair transplant working

Are you follicularly challenged? If the answer is yes, you've most likely considered having a hair transplant. Unfortunately, the negative connotations associated with surgical hair restoration still haven't faded from public perception. When the majority of people think of hair transplants, they think of those horrible 'hair plugs' that looked like doll-hair that were so common the 80's and 90's. Fortunately, those days are over. 

However, how do hair transplants work? How do you find the right surgeon, to ensure the procedure is successful? What's the recovery like? All of these answers will be answered, so keep reading.

History of Hair Transplants?

The first modern hair transplant was performed by a Japanese dermatologist by the name of Dr. Shoji Okuda, who performed hair transplant procedures on burn victims. Dr. Okuda published what is known as the "The Okuda Papers" which were published in the Japanese Journal of Dermatology and Urology. Dr. Okuda described his techniques as hair-bearing skin-grafts transplanted on to hairless areas. 

Unfortunately, his technique would be described today as 'hair plugs'.  However, the first hair transplant performed in the United States was performed by Dr. Norman Orentreich, who would go on to set the foundation for modern-day hair restoration through his papers published in the Annals of The New York Academy of Science in 1959.

Dr. Norman Orentreich published his theory on "donor dominance" and "recipient dominance" he believed that hair taken from the back and sides of the scalp would retain their genetic resistance to balding if transplanted to the top of the scalp. His theory proved to be true, and this is why hair transplant procedures work. 

How Do Hair Transplants Work?

Hair transplants work by moving genetically-resistant hair follicles into balding/thinning areas. Even in the most severe cases of baldness, most men and women retain a section of hair on the back and sides of the scalp. This area is called the 'donor' area. 

There are two methods of harvesting hair follicles from the donor area. When transplanted the hairs retain their genetic resistance to the hormone called DHT. DHT is responsible for triggering androgenic alopecia (genetic hair loss).

Follicular Unit Strip Surgery (FUSS)

The oldest method is called Follicular Unit Strip Surgery (FUSS), which involves a surgeon taking a strip of hair-bearing skin, and dissecting the strip into follicular unit grafts. These grafts contain 1,2,3, and 4 hairs per graft, which is how hair naturally grows on the scalp. 

The surgeon then transplants these grafts into micro-incision sites that are made in the balding area. This method leaves patients with a linear scar on the back of the scalp. 

Follicular Unit Extraction (FUE)

The second method of harvesting is called Follicular Unit Extraction (FUE), which involves a surgeon removing the follicular units one-by-one with the use of a surgical punch. The surgical punch is between 0.7mm to 1mm in circumference. This transplantation process is exactly the same as the strip procedure. This method leaves small-circular scars scattered across the back and sides of the scalp. This allows patients to wear their hair shorter than they would if they underwent a strip surgery. 


Immediately after surgery, the scalp is typically pink with tiny scabs forming around the micro-incision sites. The tiny graft incision sites heal rapidly within 7-10 days. After surgery, the scalp may experience some minor swelling and redness. Typically, the redness clears up and fades away after a few weeks, but can linger for months in fair-skinned individuals. 

Shedding and Growth

The majority of patients begin to shed their transplanted around the 3rd to 4th week following their hair transplant procedure. Some patients may experience telogen effluvium (shock loss). Shock loss is described as a chronic hair-shedding that can last for several months. Many patients may look even balder during this period, which many refer to as the 'ugly duckling' phase. 

The majority of patients begin to see noticeable growth around the 3rd to the 4th month after surgery. In the beginning, the transplanted hair is fine and colorless, which can make it difficult to notice at first. By the 6 months, most patients have grown a significant amount of transplanted hair. 

However, these hairs are not mature yet and will continue to grow thicker in diameter in the following months. In some cases, the transplanted hair may be curly and frizzy. This is a fairly common issue, and the hairs will straighten over time. 

There are three phases to a hair follicles life-cycle which are the anagen (growth) phase, catagen (transitional) phase, telogen (resting) phase. It is important to remember that each hair follicle is independent and will enter the different stages of their life-cycle at different times. 

Moreover, the time it takes for new growth to appear varies from person to person, some patients see growth within a few months and others take a full year. 

How To Find The Right Surgeon?

Finding the right surgeon is crucial for receiving refined results that will last a lifetime. It's important to find a surgeon who has a strong reputation built on their results, as opposed to marketing and advertisements. The surgeon should be patient-driven and not numbers-driven. Do not go to technician-based clinics that do not have a physician on-site. STAY AWAY!! 

Unfortunately, these clinics are becoming popular with the advent of FUE. These clinics hire fly-by-night unlicensed technicians with little to no experience. Needless to say, this is dangerous.

Visit the Hair Transplant Network's list of recommended hair transplant surgeons. Surgeons who are approved and recommended by the hair transplant network are thoroughly screened and vetted for excellence. There are two parts of the approval and recommendation process. 

First, the surgeon must provide proper documentation of their license and credentials, and an extensive portfolio of their results. However, the results must include patient-posted results, which is absolutely KEY! Afterward, if the surgeon appears to be worthy, the Hair Transplant Network submits his potential recommendation to their popular hair loss forum the hair restoration network. 

The hair restoration network has over 35,000 members which include hair transplant patients, advocates, and physicians. The recommendation is set up like a democracy, where patients, visitors, and physicians have a vote. This transparent process ensures that only the very best surgeons are approved and recommended.