On this blog, I’ve often said that hair transplants are like Pringles, the chips. Remember their slogan? It’s once you pop, you can’t stop!
Unfortunately, hair loss is a progressive condition for most people. So even if you have a transplant and you’re happy with it, there’s a decent chance you’ll need another one eventually. Then another, and on and on.
It gets worse.
Women rarely make great candidates for the procedure. I’ll explain why momentarily. First, let’s review some fundamental facts about hair transplantation.
Hair Transplantation 101 – The Basics
Hair transplants involve moving hairs from a limited donor supply on the back and sides of the scalp. Those hairs are then placed into thinning or bald areas.
FUT and FUE
The two main hair transplant procedures of 2020 are FUE and FUT.
FUT (follicular unit transplant) is a strip surgery, where a small sliver of tissue is removed from the back and sides of the scalp. Hairs are taken from the strip and placed onto the areas of the scalp that are thinning/receding.
The #1 Benefit of FUT Surgery
- Better coverage overall
With a good surgeon, you’ll likely get a bit more value for your money with an FUT procedure. It’s most frequently recommended to men with significant hair loss, who want to achieve maximum coverage.
FUT Downsides
- Longer recovery times
- Scar that can be visible with shorter hair
- More intensive and invasive procedure
FUE (follicular unit excision) is a hair “harvesting” procedure performed via very small, circular incisions. It’s a less invasive procedure that allows some patients to return to work the following day.
If the donor zone is overharvested — something that happens quite frequently, unfortunately — then the patient will be left with noticeably thin hair in that area.
Currently, the majority of clinics in the US and abroad specialize primarily in FUE transplants. There are a variety of reasons for this. It’s more profitable for providers; there’s also less of a learning curve for new surgeons with the FUE method.
Also, the fact that it’s minimally invasive is viewed as a major advantage by many patients and providers alike.
Both procedures have their place as of 2020. Neither is inherently “better” than the other.
On the Donor Zone & Why Men Typically Make Better Candidates than Women
Picture the baldest man you know who doesn’t shave his head. Chances are, he has a stable supply of hairs around the back and sides of his scalp. If he were to have a hair transplant, that would be his donor zone.
I sometimes call the donor zone the “Dr. Phil zone.” Notice how the hairs on the sides and back of his scalp have been unaffected by androgenic alopecia, pattern hair loss. The rest of his head is slick bald.
Women thin in different patterns than men. Typically, their thinning is of the diffuse variety — meaning the hair thins throughout the entire scalp and in less conspicuous patterns.
Their “donor” supply often thins as well. Using thinning hairs in a transplant typically yields unnatural and/or undesirable results — and that’s the main reason why the procedure works better for men overall.
Are You a Candidate?
Although there are exceptions to the rule, women suffering from progressive, genetic hair loss rarely make good candidates for hair transplantation.
The procedure can work in some cases. Hair transplantation may be an option if you meet the following criteria:
1. Your Hair Loss is Under Control – In particular, if your hair loss is isolated to a particular area such as the hairline, then transplantation could be worth exploring.
2. You’re in Good General Health – You should be in good general health to consider the procedure, ideally with no other underlying diseases or afflictions linked to hair loss.
3. You have Medium or Coarse Hair – As a general rule, thicker hair yields better coverage.
Other Common “Fixes”
Hairline Lowering
Women born with naturally high hairlines may wish to re-frame their faces via transplantation.
Burns and Injuries
Again, provided the patient has a stable donor supply and the area to be filled is manageable, transplantation may be an effective solution for individuals who’ve suffered from hair loss as a result of a burn or injury.
Women with Symptoms of MPB (Male Pattern Baldness)
Some women develop symptoms that mirror male pattern baldness. Patients with distinct receding hairlines for example — without thinning in other areas — may be viable candidates for transplantation.
5 Tips for Choosing a Hair Restoration Surgeon
1. Look for reviews on sites like RealSelf and others.
You want to do your homework and carefully vet any surgeon you’re considering. It’s often said that a bad hair transplant is like herpes, because it’s something that stays with you for the rest of your life.
2. Review before-after pictures and testimonials.
Keep in mind doctors will only present their success stories on their websites. Chances are they’ve had plenty of unsuccessful surgeries too. But you definitely want to review the work they feature on their website, as these case studies could represent the “best-case scenario” for you.
Look for patients with similar “before” pictures if possible, then ask yourself if you’d be happy with a similar “after” result.
3. Look for a doctor affiliated with the International Society of Hair Restoration Surgeons.
The hair transplantation field is highly unregulated. Any doctor can declare himself a hair restoration surgeon with no additional training or certifications required.
The International Society of Hair Restoration Surgeons is a consumer-advocacy group, committed to helping their physician members achieve excellence in medical and surgical outcomes. Undoubtedly, not every surgeon in the society is a skilled one.
But you have a better chance of achieving a positive result with your transplant if you choose a doctor who’s affiliated with the ISHRS. They create and maintain standards for their members and serve as an industry watchdog of sorts.
4. Don’t Make Your Decision Entirely Based on Price
This is an investment. Hair transplantation is both an art and a science, and generally speaking, you get what you pay for.
5. Search Far and Wide for Your Surgeon
Considering the average cost of a hair transplant procedure can be anywhere from 6 to 15 thousand dollars, adding travel into the overall cost will be a minimal expense, relatively speaking.
It’s certainly possible you have a reputable and skilled surgeon in your area — and that’s were your search should start. But if you don’t find someone you like locally, don’t be afraid to look elsewhere. You may even end up saving money as a result.
Three Common Hair Transplant Mistakes
1. Not Using a Treatment to Protect Your Transplanted Hairs
If you have any degree of pattern hair loss, you should aim to protect your transplanted hairs — along with the hairs in the surrounding area — with some kind of preventative treatment regimen.
This regimen could potentially include minoxidil, finasteride, light therapy, or any of the top 12 hair loss treatments for women.
2. Seeking a Referral from a Non-Expert
It’s not uncommon for prospective hair transplant patients to seek referrals from their general practitioners. Some patients may even look to their hair stylists for recommendations.
Most people, medical professionals included, aren’t well-versed in the highly specialized field of hair transplantation. So be careful when/if you seek a referral for a qualified surgeon.
3. Not Considering Future Hair Loss
Some clinics (and patients) look for “quick fix” solutions.
Even if you don’t currently have pattern hair loss and are seeking to lower your hairline, you and your doctor still need to do a thorough genetic review and project your future losses over the coming years and decades.
Perhaps many women in your family start to thin out after they go through menopause. That’s quite common. Or, maybe women in your family are susceptible to certain illnesses that can cause hair loss, such as hypothyroidism and lupus.
Obviously, you can’t predict your follicular future with 100% certainty. But it’s important to review your family history of hair loss and take that into account before you have surgery.
Female Hair Transplantation – Conclusion
While typically regarded as a last resort, hair transplantation is a viable option for many women. Ideally, your hair loss should be stabilized before you have a procedure. And remember, women with genetic, pattern hair loss rarely make good candidates for surgery. Instead, they should consider treatment with proven remedies such as minoxidil and light therapy.
Robert Price is a writer, consumer advocate, and hair loss researcher with thousands of hours of experience in the field. His goal is to keep you out of the hair loss rabbit hole, underworld, or whatever you want to call it. He founded Hair Loss Daily, the unbiased hair loss blog, in 2016. You can learn more about Robert in the my story section of this website.