Hair transplant — it does not add hair, it moves the hair you have

In male pattern hair loss the places hair goes are fixed. The hairline and crown go first, and the back and sides largely stay.

That difference is the basis of this operation. Follicles at the back respond less to the hormone that drives the loss, and they are understood to keep that property after being moved. This is called donor dominance.

So the operation is taking follicles from the back and planting them one by one where hair is gone. There are two ways to take them. FUT removes a strip of scalp and dissects the follicles out, leaving a line of scar at the back. FUE punches follicles out one at a time, leaving many small dot scars.

Here is the fact that matters most. This operation does not make hair. It moves what is there, and the place it came from is left emptier. The total count is unchanged.

Surgery does not stop the hair loss. Hair you did not move keeps falling. If only the transplanted hair remains and the space between thins out, the result looks wrong — so medication (finasteride, minoxidil and others) is usually assumed alongside it. Those are settled in consultation, and this site does not cover them.

The transplanted hair falls out once. Most of it sheds at two to four weeks and regrows from three to four months. Not knowing about that gap makes the operation look like a failure.

Existing hair can also shed temporarily (shock loss). It usually returns.

There will be scars. One line at the back with FUT; many dots with FUE. Cut your hair very short and they show.

The operation is very long. Handling follicles one at a time means four to seven hours, awake under local anaesthetic.

If the grafted area suppurates or you run a fever, report it.

There is a limit to how much can be moved. The number of follicles the back can spare is a lifetime budget. Spend it all at once and there is nothing left when the loss progresses further. The younger you are, the more this arithmetic matters.

If the loss is still progressing, try medication first. Drawing a hairline without knowing how far the loss will go can leave transplanted hair standing alone like an island a few years later.

Do not set the hairline too low. A low line reads worse with age, and undoing it means punching the transplanted hair back out.

Not smoking matters. Whether grafted follicles take depends on new vessels growing into them.

Do not touch or press the grafted area for the first few days.

It cannot be undone. Follicles taken do not go back, and hair growing at the wrong angle or in the wrong place has to be punched out surgically.

It takes close to a year to see the result. This is the slowest operation on the site.

Factor in that the total does not change. It is a trade: accept a thinner back to fill the front. If density at the back is low to begin with, that trade may not work.

The cause may not be male pattern loss. Alopecia areata, scarring alopecias, thyroid disease and iron deficiency are different problems where this operation is not the answer and sometimes must not be done. Diagnosis comes first.

Whether to have it done is settled with a doctor, and it is better not to settle it on one consultation alone.