Anyone who’s thinking of having a hair transplant... MUST READ THIS FIRST

Modern methods mean no one will guess you’ve had one – just make sure an actual surgeon is doing the op

JUST a decade ago, few doctors specialised in hair transplants for men desperate to ward off the ageing process and restore some of their youthful vitality. Today, the number is far higher. Such has been the explosion in demand — driven by an ever-lengthening list of celebrities and sporting icons investing in a new look for themselves — that there has also been a boom in ‘transplant tourism’.

Cities such as Istanbul in Turkey have emerged as a popular destination for people seeking a new style but at a bargain-basement price, with some offering transplants, flights and accommodation for as little as €2,500. In Ireland it can cost up to €10,000.

In most cases, losing your hair is due to male pattern baldness caused by genes and testosterone levels.

But it’s not balding men in their 50s and 60s driving this trend. Instead, a new generation of young male customers is looking to tackle thinning crowns at a much earlier stage, while others aren’t losing hair but simply want to reshape their hairlines to look better on social media.

Many clinics report that more than 40 per cent of their clientele are in the 25 to 34 age bracket — and some even younger.

More women are also jumping on the bandwagon, with many looking to combat the thinning that often occurs in mid-life as a result of the menopause.

But as many people have discovered, the sector is a minefield — plenty have spent their hard-earned thousands on botched procedures that fail to live up to the sales promise. Worse still, it’s costing victims even more money to put it right. So Magazine has teamed up with some of the world’s leading hair-transplant experts to compile this must-have guide for anyone considering splashing out on a new image.

MAKE SURE IT’S A REAL SURGEON DOING THE OP

SHOCKINGLY, at some hair clinics, transplant patients have little to no contact with a surgeon at all. The procedure can instead be carried out by a ‘technician’ — a member of staff who has gone through a training course in preparing patients and assisting during surgery.

The most common hair transplant method used today is called follicular unit extraction (FUE), where the head is shaved and about 4,000 grafts (8,500 hair follicles) are removed individually from where they are plentiful.

Thousands of tiny incisions – each a millimetre-or-so wide — are then made in the receding area for the follicles to be implanted.

‘Results are more natural than they were ten years ago,’ says Dr Kieran Dayah, lead transplant surgeon at the Wimpole Clinic in London. ‘FUE means fewer visible scars and quicker healing — it means, done right, no one will be able to spot the patient has had a transplant.’

But in some clinics, one surgeon might be on hand to do the incisions and oversee a team of five or six technicians — but the bulk of the work is done by nonmedical staff. It’s how they are dealing with the ever-rising demand. At some overseas centres, untrained staff do the entire op, claims The British Association of Hair Restoration Surgery (BAHRS) — the body which represents specialists in the field.

It says this raises the risk of botched surgery and even potentially dangerous infections.

The International Society of Hair Restoration Surgery (ISHRS)

in 2019 warned that some cutprice overseas hair clinics were using taxi drivers and Syrian refugees to do transplants after luring in customers with the promise of a cheap transplant. It claimed that some patients were being left scarred and disfigured.

BAHRS president Dr Christo- pher D’Souza says: ‘In the UK, the General Medical Council (the body which polices doctors’ standards) states that hair-trans- plant incisions should only be done by a GMC-registered doctor. A technician can then place the implants, but ideally it should be done by a surgeon. At some of the black-market clinics overseas, the technician does it all.’

Dr Zafer Cetinkaya, lead surgeon at the Estenove Clinic in Istanbul — one of the country’s leading hair-transplant centres — Matt Phillips at his wedding, left — six years before his transplant, above says that with some 750,000 people a year visiting Turkey alone for transplants ‘there simply aren’t enough qualified doctors to carry out all these procedures’.

He adds: ‘A hair transplant is a lengthy procedure, often taking five to six hours. Certain parts may be performed by technicians, and this is not unique to Turkey. The critical parts, such as incisions into the scalp, must be done by a qualified doctor — there’s no margin for error.

‘But there are many clinics, including some of the very famous ones in Turkey, that only work with technicians and there is no doctor present during the operation. That’s absolutely not our approach.’

ASK ABOUT THE RATE OF CORRECTIVE SURGERY

DONE properly, hair transplants have a 97 per cent chance of success. The key to a clinic’s competence therefore is its rate of corrective surgery — the proportion of patients who need follow-up procedures to mend shoddy work.

Ideally, it should be only one or two per cent, experts say. The ISHRS says more than one in 20 transplant procedures are done to put right work that was bodged first time round.

Typical blunders include hairlines that are positioned too low or too straight to look anything like normal, poor siting of follicles so that hair grows in clumps, or hair that’s growing in a completely different direction to that around it.

‘We do hundreds of cases every year to repair botched transplants from countries such as Turkey,’ says Dr Dayah. ‘In most cases the hairline has not been done to look natural, or they used the wrong number of grafts. When you’re doing hairlines we always recommend single grafts at the front where the hair is normally soft and natural. Some clinics instead do multiple grafts which look clumpy and dense — you want that in the middle of the hair, not the front.’

YOU CAN BE TOO YOUNG FOR A NEW HAIR-DO

IT may be gaining popularity with men in their 20s and 30s, but the fact is many men should, if possible, try to avoid a transplant too soon, say top specialists. That’s because we are all born with a finite amount of hair follicles — once they’re surgically moved they don’t regenerate in that spot.

So a man in his 20s who has thousands of follicles extracted from the back or side of his head to tackle a widow’s peak or slightly thinning crown might — when genetic hair-loss has progressed much further — end up regretting wasting so many at an early stage.

‘Ten to 15 years ago a hair transplant was something for middle-aged men who were pretty bald, but now it’s for people trying to address hair-loss at an earlier stage,’ says Dr D’Souza. ‘But that can create problems. If they continue to lose hair as they age they may end up with tufts of hair at the front and nothing on top.’

He claims many young men are better off using the over-the-counter medicine minoxidil or prescription drug finasteride for several years to try to stabilise any hairloss before finally resorting to a transplant. All patients who undergo a transplant are encouraged to keep using both treatments for life to prevent further loss.

JUST ONE PROCEDURE MIGHT NOT BE ENOUGH

MORE than 42 per cent of patients have more than one transplant in their lifetime. In fact, almost one in ten need at least three procedures before they achieve their desired results. It largely depends on factors such as age, the severity of hairloss and the availability of healthy follicles to be repositioned.

Dr Cetinkaya says: ‘The key factor here is the individual’s type of hair-loss.

Some men have a type where the hairline recedes early on but then stabilises. In such cases, they might not need any further treatment.

‘So, as a practice, we’re often cautious about performing transplants on men younger than 25 because hair-loss patterns are often not fully established yet.

‘If a man is experiencing significant hair loss before 25, we’d typically expect that process to slow down as he ages, and then we can better evaluate the need for a transplant.’