In men most hair loss can be attributed to something called male pattern baldness where hair follicles on the top and forehead of the scalp are susceptible to the hormone dihydrotestosterone, (DHT). Acting over time, DHT causes shrinking and then death of hair follicles that are susceptible to DHT.

While there are certainly medicines and treatments that can often slow or even halt the loss of hair, the general consensus is that a hair transplant, in conjunction with a hair loss prescription medicine, is the only effective way to reverse hair loss.

About half the hair begins to exit the scalp at approximately three months. At six months about 40% of the hair is visible. And at 12 months 75% of the hair is visible. 15 months to 18 months is needed for the final results of the procedure can be seen.

Do I have to Transplant Hair Over the Entire Part of the Scalp That has Missing Hair?

Each patient is unique so our approaches range from the minimum to maximum amount of hair that will improve the patient’s appearance.

Some patients will fill in the front 1/2 or 2/3 to start, then fill in the remaining areas that are missing hair with later procedures.

Patients are completely awake and alert during hair surgery.

The procedure involves the use of a mild local anaesthetic, which allows the patient to watch television or sleep.

Finasteride (Propecia) is a prescription drug for men and is taken orally once a day. Pregnant women should not take or handle the tablets because Finasteride can cause birth defects.

Studies indicate that Finasteride stops hair loss on the scalp and can regrow hair. We recommend that all hair loss patients, including those with hair transplants take Finasteride.

Minoxidil (Rogaine) is a topical non-prescription medicine available to men and women. It is sprayed on the scalp twice a day.

For some, the hair growth is very thin. Studies show that Minoxidil works best on those younger than 30 who have been losing their hair for five years or less.

Yes. The best hair restoration is performed by experienced, qualified surgeons and their technicians. Hair loss restoration works extremely well and in almost all cases is virtually undetectable.

Because donor hair is removed from the back of the head it is not subject to the effects of DHT, the substance that causes male pattern baldness.

No matter where the hairs are transplanted, their resistance to DHT means that they are likely to survive and grow for the life of the patient.

In many patients experiencing hair loss, the use of medications like Finasteride are sufficient to control hair loss.

Early use of medication can delay or eliminate the need for a hair transplant.

In other cases, hair loss restoration surgery may be required along with the use of medications. An evaluation is required to determine whether a hair transplant is the proper procedure.

A hair transplant takes approximately six to eight hours depending on the size of the session.

A topical anaesthetic assures that the hair restoration procedure is virtually pain free.

For the first 2-3 days, most patients find that they only need to take over-the-counter painkillers, like paracetamol, if any discomfort occurs.

The number of grafts is essential to knowing if you will be getting a high quality hair transplant.

To get proper density and coverage the doctor knows how many grafts are needed and you should be cautious if they will not tell you.

At Timeless hair Transplant Clinic we always tell you the number of grafts we will transplant during your surgery.

Dr Luciano Sciacca is specialized in vascular surgery.

Along with his surgical training he has more than 10 years’ experience and is a Diplomate of the American Board of Hair Restoration Surgery (ABHRS). This is the only institution in the world that certifies doctors in the field of hair transplant surgery.

Medicine is not a perfect science and results cannot be guaranteed. However, about 92‐95% of the transplanted grafts are expected to grow.

Hair transplants take lots of practice to perfect. Dr Luciano Sciacca has performed over 2000 hair transplants in the course of 10+ years.

There could be several different reasons why your hair is falling out. You should be aware that it’s perfectly normal to shed an average of 50-100 hairs a day.

This phenomenon is called physiological alopecia or life cycle hair loss: as hair grows longer, over time it ages and eventually falls out. As that happens, a new layer of hair replaces the old one, ages, falls out, and is replaced by a new layer, and so on in a cycle.

Physiological hair loss can intensify between the months of October and December due to the stress undergone by the scalp over the summer period.

If you find yourself shedding significantly more than 100 hairs a day, you could be dealing with pathological hair loss, commonly known as balding. This means that your hair falls out but doesn’t grow back.

To distinguish between physiological and pathological hair loss, it is important that you monitor your scalp daily over a long period of time.

An obvious sign of excessive hair loss is when your hair falls out after washing or brushing it.

Alternatively, when your hair is dry and you run your hand through it, you may find several strands of hair tangled in your fingers.

You should consult a hair loss specialist to establish whether you are dealing with physiological or permanent hair loss.

Several lifestyle factors can contribute to hair loss, such as chronic stress and nutritional deficiencies, but a study from The Journals of Gerontology: Series A has demonstrated that nearly 80% of baldness among men is heritable.

In fact, the medical name for both male and female baldness, ‘androgenetic alopecia’, has two primary components to it: ‘androgen’ and ‘genetic.’

Androgens are hormones that play a key role in the growth of prenatal and puberty men, with their functions including hair growth regulation.

Researchers have found that hair loss is strictly related to androgens, especially dihydrotestosterone: increased levels of androgens in hair follicles can lead to shorter hair growth cycles and shorter, thinner hair growth.

In addition, there is a delay in the growth of new hair to replace the strands that are shed.

Although researchers believe that several genes are responsible for causing androgenetic alopecia, scientific studies have confirmed a strong correlation with one gene in particular, the Androgen Receptor (AR) gene.

The AR gene provides the instructions for protein synthesis in the name of the androgen receptor, allowing the body to respond appropriately to dihydrotestosterone and other androgens.

Studies have shown that changes in the AR gene increase the activity of androgen receptors in hair follicles, but it is not yet completely known how these genetic changes increase the risk of hair loss in men and women with androgenetic alopecia syndrome.

According to a myth, male pattern baldness (MPB) is inherited from the mother’s side: if your mother’s dad started balding in his 20s, common knowledge says that you’re likely to experience the same, hence the widespread belief in the existence of a maternal ‘balding gene’.

The truth of the matter is that genetic baldness is still not entirely understood, but researchers tend to agree that MPB is in fact polygenic, which means that it involves more than one gene.

While the primary baldness gene (AR gene) is indeed on the X chromosome, which men do get from their mothers, the genetics of hair loss is complicated.

There are probably genetic components that men inherit from their fathers as well.

Although the hereditary factor is slightly more dominant on the woman's side, research suggests that men who have a bald father are in fact more likely to develop male pattern baldness than those who don't.

This question is very common but is misinformed by a misunderstanding concerning the nature of a follicle: hair follicles can’t ‘grow back’ because they can’t be ‘lost’ in the first place.

A hair follicle is a tube-like structure within the first and second layers of your skin that holds your hair.

You’re born with over 5 million hair follicles in your body and over one million hair follicles on your head.

At the base of the follicle is the hair bulb, which is surrounded by nerve fibre allowing you to sense when your hair is moving or being touched.

Even when you pull out a hair by its root, you’re not in fact pulling out the follicle as this is a permanent structure of your skin.

Hair follicles are crucial because they’re responsible for growing hair, meaning that if they’re not functioning properly, your hair will cease to grow.

Follicles can indeed undergo damage, which may affect their ability to create strong pieces of hair.

If a follicle has been partially damaged, it may take two to four years for new hair to grow back.

Unfortunately, once a hair follicle has been deeply damaged it is permanent, meaning that no new hair will be able to grow back.

The Norwood Scale is the leading classification system used to measure, categorise, and keep track of the different stages of male pattern baldness.

The scale was originally developed by James B. Hamilton in the 1950s and was further improved by Dr O’tar Norwood in 1975, thus it’s also referred to as the Hamilton-Norwood scale.

The Norwood scale is commonly used by professionals who specialise in diagnosing and treating hair loss in men as it provides a useful visual system for classifying and measuring the extent of a man’s hair loss.

The scale classifies the stages of male pattern baldness on a scale of 1 to 7:

● Stage 1: also known as the control stage, at this point people still have a head full of hair, with no visible signs of baldness.

● Stage 2: at this stage, there is only minimal evidence of a receding hairline, typically around the temples.

● Stage 3: this is when hair loss starts becoming noticeable. When viewed from above, the receding hairline has taken on its typical M-curved shape.

● Stage 4: hair loss is now more severe and obvious, with hair being sparse or completely missing on the vertex scalp. Men with stage 4 hair loss typically have a thicker strip of hair separating their hairline from the balding area surrounding their crown.

● Stage 5: both balding areas on either side of the band grow bigger, and the band of hair itself becomes thinner and starts to split in the middle.

● Stage 6: male pattern hair loss around the temple spreads to the bald vertex, and the band of hair on top of the scalp is at its thinnest, or completely gone.

● Stage 7: although some hair may remain at the back and sides, the top of the head is completely bald.

A hair transplant takes an average of four to eight hours.

The procedure is usually carried out in one day, but if you are having a large amount of hair transplanted, you may need to return for a few hours the next day.

The actual duration of a hair transplant procedure may vary depending on several factors, including the size of the area under treatment, the amount of the grafts that will be implanted, and the technique being used.

The procedure begins as the surgeon removes the healthy hairs, either cutting a strip of skin with healthy hairs from your scalp, or removing individual hairs.

Before the surgeon can transplant the hairs, technicians prep the removed hairs and the surgeon gets the scalp ready for the transplant.

Once all the hairs have been transplanted, the scalp is bandaged and the patient is given instructions for at-home care and recovery.

Hair transplants are carried out under local anaesthetic, meaning that you’ll be awake but will feel no pain at all.

However, just like any other type of surgery, the days following treatment will inevitably cause you some discomfort.

The areas of the scalp that have undergone treatment will be tender, which will cause some redness and swelling for a few days. Having said that, the pain can easily be managed with mild pain killers.

Hair transplant is generally a safe surgical procedure and is associated with very few complications.

However, during the recovery phase, you may experience some hair transplant side effects. While many of these side effects are short-term and tend to cause limited discomfort, others could last for a longer time.

Below are some of the short-term and long-term side effects of hair transplants.

Bleeding

Blood spotting and occasional light bleeding from the donor area may occur 12 to 14 hours after a procedure.

Firm constant pressure over the area for up to 20 minutes will usually be enough for the bleeding to subside. Within the first 48 hours or so, if you were to bump your head in the recipient area and dislodge a graft, bleeding can be more prevalent. Firm pressure is also used in this case.

Swelling

Swelling in the forehead and eye area can commonly occur after hair transplant surgery.

Although this might be uncomfortable, it’s to be expected as you will have received a local anaesthetic that is known for having such side effects.

Additionally, your scalp will have undergone an invasive procedure: as the surgeon will have made incisions on it, some swelling after the hair transplant is completely normal.

Scarring

Scarring occurs after the FUE and FUT method of hair transplant.

With an FUE the extraction and transplantation of individual follicular units results in minimal scarring. The small wounds will heal within seven to ten days.

The scars resulting from an FUE transplant look like small dots and are much less visible with very short haircuts than one continuous linear scar that is naturally expected from an FUT.

During FUT, a small strip of the scalp is removed to provide the grafts needed for transplantation, leaving behind a linear scar from the excision.

You can expect your wound to heal completely within 10-12 days.

Your scar will continue to develop and heal over the first several months, taking about one year before reaching full maturation. By this point, the scar should be thin and white, making it barely noticeable if all post-operative instructions are followed.

Nerve Damage

Yet another side effect of the FUT method, nerve damage can last up to six months. The extent of damage depends on the depth of the wound and the area it covers.

Cysts formation

Cysts may appear as small skin-coloured swellings around the transplanted hair follicles, which can become erythematous and painful.

They result because of small grafts slipping under the skin, or from piggybacking one graft on top of the other.

Treatment consists of incising the cysts and expressing out the contents, using warm compresses or sometimes applying topical antibiotics.

Numbness

This is one of the commonly occurring long-term side effects of hair transplant and can last up to 18 weeks.

Those who suffer from numbness for a longer period should get medical care.

You should expect to see the first results of a hair transplant between eight to twelve months after the surgery, even though for some patients it may take up to eighteen months.

Bearing in mind that the exact timeline may vary for each patient, here is what you should expect in the 12 months following treatment:

First 7-10 Days

This is when your recovery will take place. By the end of the first week after surgery, the scabs from your extraction punctures will fall off and the hair in the donor area will start growing.

0-3 months

The first three months following a hair transplant are known as the ‘dormant shock’ phase. At this point, not only your hair won’t grow but it will fall out as your transplanted follicles start to shed. This is absolutely normal and should be no reason for concern.

4-6 Months

Around the beginning of month 4, your hair will start growing in. At first, the hair may look thin and curly, while your transplant areas will remain patchy. This is normal as different follicles will be at different stages of their growth cycles.

6-8 months

This is when fast growth starts happening. Your hair will fill, and you will finally see a big difference from before the surgery.

8-12 months

By the end of the year, your hair should have reached the ‘mature’ stage of growth, with your transplanted hair growing in thicker and at a normal rate of 1-2 cm per month.

H3: Do hair transplants last forever?

The short answer is yes.

The results of hair transplants are permanent as they generally last over 20 years and, in most cases, for life.

You may have noticed that even bald people usually have hair at the back and sides of their heads - this is because hair loss cannot affect those areas.

Consequently, after these hairs are transplanted to the area you’re balding in, they will maintain their resistance and stay on your scalp permanently.

Also known as the “vertex”, the crown is very commonly affected by male pattern hair loss (androgenic alopecia).

Crown hair transplant procedures may be done using the follicular unit excision method or traditional linear harvesting.

It involves the removal of individual hair follicles from the back and sides of the head and their re-implantation to the affected crown area.

Crown hair transplant procedures are generally considered to be the most technically demanding of all types of hair restoration procedures for several reasons.

In comparison to frontal hair transplants, crown hair transplants often require significantly more hair due to the angle at which the crown is viewed.

Additionally, extreme hair angle changes occur in the crown area in a spiral pattern, which must be meticulously recreated for a seamlessly natural result.

This may lead to multiple sessions being needed to complete a crown transplant procedure, depending on the extent of the baldness.

In principle, both men and women from all ethnic backgrounds and age groups are good candidates for a hair transplant.

There are however some important criteria that you must meet to be eligible.

The first requirement is that you display well-defined male pattern baldness or female pattern baldness.

Secondly, patients should consider having a hair transplant only once their hair loss has stabilised: a transplant will indeed cover the areas where you’re balding, but if your hair loss continues after surgery, you’ll be left with bald patches next to the transplanted areas.

It is also important to have enough healthy hair on the sides and back of the head, as these are the areas from which grafts will be taken during transplantation.

Finally, it is a good idea to have a hair transplant before going completely bald, as this will help the patient camouflage the early stages of the restoration.

There are several reasons why somebody may want to have a hair transplant procedure. While some of these are strictly medical, others are psychological and will vary from patient to patient.

Self-confidence boost

The experience of hair loss can be psychologically challenging, causing intense emotional suffering, and can even lead to personal, social, and work-related problems. A hair transplant procedure can help people regain their confidence, boost their self-esteem, and carry a normal and healthy life.

Natural-looking hair

Once your transplanted hair starts to grow and thicken, it will regain its old appearance, resulting in a full head of natural-looking hair.

Permanent solution

The results of hair transplants are permanent as they generally last for life. You may have noticed that even bald people usually have hair at the back and sides of their heads - this is because hair loss cannot affect those areas. Consequently, after these hairs are transplanted to the areas you’re balding in, they will maintain their resistance and stay on your scalp permanently.

Little pain and side effects

Hair transplants are carried out under local anaesthetic, meaning that you’ll be awake but will feel no pain at all. Additionally, hair transplant is generally a safe surgical procedure and is associated with very few complications.

Hair loss (alopecia) can affect not only your scalp but your entire body too and can be temporary or permanent.

Although alopecia is more common amongst men, anyone can experience it, including women.

Genetic hair loss is the most common type of hair loss, but there are many other reasons why you may be losing your hair. Below is a breakdown of the main causes responsible for hair loss.

Hereditary hair loss

Hereditary hair loss (androgenetic alopecia) is the most common type of hair loss, affecting an estimated 80% of men who suffer from baldness.

Androgenetic alopecia can be experienced by both men and women. It occurs in a predictable pattern known as male pattern baldness (MPB), or female pattern baldness (FPB).

MPB usually begins as an M-shaped receding hairline at the age of 20-30, while women tend to experience hair loss after menopause.

Age

With age, hair follicles stop growing hair, causing most people to experience some degree of hair loss. The hair on the scalp starts to thin and lose colour.

Alopecia areata

Alopecia areata is the medical term for a condition that causes the immune system to attack and destroy hair follicles, inhibiting the growth of new hair and leading to hair loss.

Alopecia areata can occur on the scalp, as well as inside the nose and ears. Some individuals may also lose their eyebrows and eyelashes.

Cancer treatment

Chemotherapy or radiation treatment can lead to partial or complete hair loss within a few weeks of starting cancer treatment.

Childbirth, illness, and other stressors

In the first few months after giving birth, some women experience more hair loss than usual.

This is because oestrogen levels increase exponentially during pregnancy, causing a temporary alteration of women’s hair growth cycles.

Besides pregnancy, there are other stressful events that can cause temporary hair loss, such as recovering from an illness or a surgical operation.

Dealing with a divorce, the loss of a loved one, or experiencing financial problems can also inhibit hair growth and lead to temporary or permanent hair loss.

Extreme hair care

Over time, extreme hair care such as perms, relaxers, and hair dyes can seriously damage your hair and contribute to hair loss.

Hormonal imbalance

Hair loss may be induced by hormonal imbalances, especially amongst women.

One of the most common conditions that are responsible for hormonal imbalances is known as polycystic ovary syndrome (PCOS), which may result from interrupting some types of birth control pills.

PCOS leads to the formation of cysts on a woman’s ovaries and to a temporary hormonal imbalance that can cause hair thinning or loss.

Nutrient Deficiencies

There are several vitamins and minerals that help your body to maintain a healthy hair growth cycle and cellular turnover.

Consequently, deficiencies in nutrients such as biotin, iron and zinc can alter hair growth patterns and lead to hair loss.

Some medications

Certain medications come with several side effects, including hair loss. If you believe that your hair loss is caused by a medication, you should not stop taking it before consulting your doctor.

This is because the abrupt interruption of some medications can lead to serious health complications.

Some of the medications that can cause hair loss include blood-thinning drugs, oral contraceptives, drugs for depression, anti-inflammatories, beta and calcium channel blockers, and several chemotherapy medications used to treat cancer.

Sexually transmitted infections

Some sexually transmitted infections (STI) can cause hair loss if left untreated. One example of an STI that is well known for causing hair loss is syphilis.

Short for Follicular Unit Excision, the FUE method of hair transplant is the most cutting-edge hair transplant procedure available at the moment.

During an FUE hair transplant, the surgeon will take hair grafts from the back of your scalp as individual follicles. Each follicular unit is extracted with a circular punch less than 1 millimetre in diameter and gently placed in a small hole that has been made at the recipient site.

After the process is complete, your scalp will be bandaged for a few days. After initially falling out, your transplanted hair will start to grow back in around six to eight months.

FUE hair transplants are permanent, minimal scarring (tiny round scars) and pain free, besides allowing for a shorter recovery time compared to more dated procedures.

Short for Follicular Unit Transplantation (also known as Strip Linear Excision), an FUT hair transplant involves a technique where a thin strip of skin bearing healthy hair is removed from a 'permanent' area of the scalp, harvested, and then transplanted to an area affected by hair loss ('non-permanent area').

During an FUT procedure, the donor area of your scalp will be stitched closed and then covered by surrounding donor hair, meaning that the incision will not be visible.

In order to isolate hair follicles, a team of hair technicians will use a scalpel to separate the original strip into thousands of grafts, which usually contain between one and four hair follicles each.

The next step of an FUT procedure will see the surgeon using a needle or blade and a microscope. At this point, the surgeon will make small holes in the scalp where the grafts need to be transplanted.

The grafts are then inserted into these holes at the donor site. Finally, the surgical site is covered with bandages or gauze.

The stitches will dissolve within 40-60 days and the donor area is left to heal with a small scar, which is usually not visible if covered by longer hair styles.

The main difference between an FUE hair transplant and an FUT hair transplant is how the hair is extracted.

An FUE procedure requires the extraction and transplantation of individual hair follicles, while an FUT procedure involves removing a long strip of the scalp, separating the follicles, and then transplanting them.

With an FUT hair transplant, the removal of a strip of hair from the donor area will leave a linear scar on the scalp, whereas the extraction and transplantation of individual follicular units via an FUE hair transplant results in minimal scarring.

In fact, a scar resulting from an FUE transplant looks like a small dot.

Many patients who have had an FUT hair transplant may wish to grow their hair longer to cover linear scars.

Finally, although an FUT hair transplant generally takes less time than an FUE hair transplant, the outcome will depend on the individual patient, and the actual amount of hair being transplanted.

The advantages and disadvantages of each hair transplant procedure are highly dependent on the individual patient and their desired outcome, in addition to other contingent factors that you may want to discuss with a hair transplant specialist.

A common cause of hair loss among the Afro and Caribbean community is traction alopecia.

This type of hair loss is not ethnically specific as it is induced by certain hairstyles that happen to be more popular among black people, such as braids, cornrows and dreadlocks.

These hairstyles can be very harmful to the hair because they pull the follicles, leading to micro-traumas of the scalp and, in some cases, to hair loss.

If you have Afro hair and you are in need of a hair transplant, you should be aware that Afro hair transplants are more difficult than those performed on Asian or Caucasian hair.

Afro Caribbean hair can differ greatly from white and Asian hair due to its curly pattern, which exposes the follicles of black people to greater risk of external traumas.

The curved shape of Afro Caribbean hair may also lead to complications during a hair transplant procedure as the risk of transection during the collection of grafts is higher.

On top of that, Afro Caribbean hair is drier and grows more slowly than other ethnicities.

Although the characteristics of Afro Caribbean hair make it one of the hardest types of hair transplant procedures, an Afro hair transplant patient will undergo the same hair transplant techniques that are normally used on Caucasians and Asians.

A sensible option for an Afro hair transplant is a technique called Follicular Unit Excision (FUE) - this procedure involves the individual extraction of healthy hair from the back and sides of the head, and their transplantation to the balding areas.

FUE is a minimally invasive procedure and is indeed a viable option for Afro hair.

When the extraction of Afro hair proves to be too difficult via FUE, a hair surgeon may decide to switch to Follicular Unit Transplantation (FUT).

The main difference between an FUE hair transplant and an FUT hair transplant is how the hair is extracted: an FUE procedure involves the extraction and transplantation of individual hair follicles, while an FUT procedure requires removing a long strip of the scalp, separating the follicles, and then transplanting them.

Hair transplantation has been adopted successfully for several years to fill out patchy eyebrows, restore absent eyebrows, and camouflage scars within the eyebrow area.

Eyebrows transplantation is a more recent procedure, which should only be performed by a specialist who specializes exclusively in surgical hair restoration.

People who have lost their eyebrow hair have a faded brow tattoo, or simply want fuller eyebrows may choose to get an eyebrow transplant.

You might also want an eyebrow transplant if you have a medical condition that causes hair loss like trichotillomania or alopecia areata, or if you have suffered from an injury that affected your skin, such as burns.

In order to select the donor hair for an eyebrow transplant, a surgeon will use a scalp or hair grafts to replace your current eyebrow hair with hair from your scalp, typically extracted from the lower part of the back of the head by FUE or FUT method.

The hair grafts are then checked under microscope and put into place at your eyebrows after a slit is made in your skin to make room for the graft.

Once your skin heals after surgery, the hair on your eyebrows will look more pronounced, reducing the need to use makeup or an eyebrow pencil.

Eyebrow hair transplants are more common among women, but men may also choose to undergo this cosmetic surgery.