Men and Hair Loss: Should You Have a Transplant?

Bald may be beautiful, but what if you're just not ready to go there yet? Maybe you've tried a medication like finasteride to slow the thinning you see on top. If that hasn't worked, and you're really losing sleep over losing your hair, you might consider a hair transplant.

Hair replacement surgery has come a long way since the days when men were left with large "plugs" of hair that screamed "transplant." Today's results look much more natural.

Hair transplantation is likely to cost $5,000 or more. Before you decide, find out what to expect and whether you're a good candidate.

Are You a Candidate for a Hair Transplant?

You need to have enough healthy hair on the back and sides of your head to transplant to the thin or balding spots. Your dermatologist or plastic surgeon can tell you if you do.

Transplant Surgery

The surgeon removes small pieces, or grafts, of scalp from the places where your hair continues to grow. These may be micro-grafts of only one or two hairs, mini-grafts of a few hairs, or larger grafts of up to 40 hairs.

The grafts are inserted into tiny slits or holes the surgeon makes in your balding scalp. Single-hair grafts are usually used for the soft hairline. Mini- grafts go behind those, and then large grafts, so your hair gradually becomes denser. The hair on the back and sides of your head usually grows throughout your life, so you don't have to worry about losing it after it's transplanted.

Surgery can take up to 8 hours, but you'll go home the same day. Depending on things like how dense you want your hair to be and how much scalp you need to cover, you may need several sessions of surgery and several months between them to heal fully. The entire process can take as long as 2 years.

Recovery From Transplant Surgery

For the first day or two, you may have pain, discomfort, and swelling. Within several weeks, much of your newly placed hair will fall out. This is normal. It will start to grow back within 3 to 4 months, at about half an inch per month.

You'll also need to take the drug finasteride indefinitely so you don't lose any more naturally growing hair. Side effects are rare but can include sexual problems like erectile dysfunction.

Risks of Transplant Surgery

Hair transplantation is generally considered safe, but risks include:

• Infection
• Bleeding and some scarring
• Patchy hair growth, which can often be corrected
• Grafts that fail to take, which would mean repeating the surgery

Other Surgical Hair Replacement Procedures

Hair transplantation is the most common way to fill out your hairline. Others include:

• Scalp, or alopecia, reduction. The surgeon removes bald scalp and stretches the remaining scalp up to replace it. This may be done along with transplantation. It's only an option if your scalp can be stretched enough, and you may need more surgery if you continue to lose your hair.
• Scalp flap surgery. Part of your bald scalp is replaced by a flap of scalp that still has hair. This type of surgery is usually reserved for scalp problems you're born with or get from an injury.

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