Barely a month goes by without another male celebrity admitting to a hair transplant. Earlier in the year, TV chef Gordon Ramsay was photographed leaving a Los Angeles clinic sporting the telltale surgical cap. Strictly Come Dancing judge Jason Gardener chose the show’s final episode to reveal his newly transplanted locks.
The latest reported fan is Michael Eavis, the 74-year-old Glastonbury Festival organiser, who has said he was inspired to consider the operation by Wayne Rooney. The Manchester United ace unveiled his replenished head on Twitter last month, telling fans that it was “still a bit bloody”.
This celebrity endorsement looks set to kick off a trend, with an estimated 10,000 men now getting surgical help to improve their crowning glory every year, and new hair-loss clinics reportedly sprouting at an alarming rate. But with at least one dentist now offering to restore follicular fortunes, how can men know if they are in the best hands? Or even if they are suitable candidates?
Hair-transplant surgery involves moving hair from an area of relative excess, such as the back and sides of the head, to the bald area at the top. Ultimately, this is an issue of supply and demand: there needs to be enough hair in the donor site to supply the demand on top. Unfortunately, not all men meet this criteria, including Eavis – judging from the extent of his baldness.
Male pattern hair loss is classified according to the Norwood scale, named after Dr O’Tar Norwood, the American dermatologist who described it in the Seventies. The scale describes seven distinct stages, from a full head and a teenage hairline to a horseshoe-shaped band at the back and sides. Men at the lower end of the scale do well with hair transplants where there is more supply and less demand.
The trouble is that male pattern baldness is progressive, so it is important to think about the future before proceeding with surgery. A man who is at stage three in his early twenties may well get an excellent result from a hair transplant at the time, but he could be destined for class seven in his forties, leaving him with a ludicrous island of transplanted hair at the front and a bald area behind. Aside from technical ability, one of the most important skills of any hair-transplant surgeon lies in making the decision when to operate, and when to say no.
The surgery itself, which involves thousands of tiny tissue grafts, is meticulous and painstaking. When hair transplants were first performed in the late Fifties, surgeons removed punch biopsies of hair-bearing scalp from the back of the head (similar to the circular holes produced by a paper punch), and plugged them into the bald area on top. The unfortunate results often resembled dolls’ hair, with small circular patches of hair growth surrounded by baldness. Techniques have moved on, and today’s transplants produce a more natural look, but they are also more technically demanding and need to be carried out by a highly skilled surgeon. A single operation requires some 4,000 to 5,000 tiny grafts of single follicular units, each containing between one and four hairs and a single sebaceous gland.
The hair is first removed from the back in a single strip, which a team of assistants carefully dissect into follicular units. The surgeon then creates incisions for the 4,000 or so grafts to be inserted, and the team of assistants delicately place the grafts one by one, in each tiny incision. It is exacting work, involving 12 to 15 professionals working between eight and 12 hours at a time.
There are relatively few centres in the world that have the level of experience and set-up to do this well, which may explain why celebrities such as Ramsay have travelled to the US, where the procedure can cost up to £40,000.
After surgery, most of the transplanted hair will fall out in the first few weeks and begin growing again three or four months later, with the final results not showing for 12 to 18 months. At the donor site, the scar from the incision usually fades to a fine white line, hidden beneath the hair that remains.
A newer method, using surgical instruments to extract hair follicles from the donor site one by one, has the benefit of avoiding the straight line scar at the back. Often marketed by clinics as the latest in “scarless hair transplants”, the technique is not universally accepted, with some specialists claiming that it damages follicles and reduces “yield”. Whether this technique eventually prevails, only time will tell.
Male pattern baldness is a source of enormous distress to many men who may be tempted by the promises of a new generation of hair clinics. However, prospective patients should think very carefully about the long-term implications and choose wisely when selecting with whom to trust their follicular fortunes.
The surgery itself, which involves thousands of tiny tissue grafts, is meticulous and painstaking. When hair transplants were first performed in the late Fifties, surgeons removed punch biopsies of hair-bearing scalp from the back of the head (similar to the circular holes produced by a paper punch), and plugged them into the bald area on top. The unfortunate results often resembled dolls’ hair, with small circular patches of hair growth surrounded by baldness. Techniques have moved on, and today’s transplants produce a more natural look, but they are also more technically demanding and need to be carried out by a highly skilled surgeon. A single operation requires some 4,000 to 5,000 tiny grafts of single follicular units, each containing between one and four hairs and a single sebaceous gland.
The hair is first removed from the back in a single strip, which a team of assistants carefully dissect into follicular units. The surgeon then creates incisions for the 4,000 or so grafts to be inserted, and the team of assistants delicately place the grafts one by one, in each tiny incision. It is exacting work, involving 12 to 15 professionals working between eight and 12 hours at a time.
There are relatively few centres in the world that have the level of experience and set-up to do this well, which may explain why celebrities such as Ramsay have travelled to the US, where the procedure can cost up to £40,000.
After surgery, most of the transplanted hair will fall out in the first few weeks and begin growing again three or four months later, with the final results not showing for 12 to 18 months. At the donor site, the scar from the incision usually fades to a fine white line, hidden beneath the hair that remains.
A newer method, using surgical instruments to extract hair follicles from the donor site one by one, has the benefit of avoiding the straight line scar at the back. Often marketed by clinics as the latest in “scarless hair transplants”, the technique is not universally accepted, with some specialists claiming that it damages follicles and reduces “yield”. Whether this technique eventually prevails, only time will tell.
Male pattern baldness is a source of enormous distress to many men who may be tempted by the promises of a new generation of hair clinics. However, prospective patients should think very carefully about the long-term implications and choose wisely when selecting with whom to trust their follicular fortunes.
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