Hair transplants are used to add more hair to an area on your head that may be thinning or balding. It’s done by taking hair from thicker parts of the scalp, or other parts of the body, and grafting it to the thinning or balding section of the scalp.

Worldwide, about 60 percent of men and 50 percent of women experience some form of hair loss. To address this, people often use over-the-counter products, including topical treatments like minoxidil (Rogaine).

Hair transplant is another restoration method. The first transplant was performed in 1939 in Japan with single scalp hairs. In the following decades, physicians developed the “plug” technique. This involves transplanting large tufts of hair.

Over time, surgeons began using mini- and micro-grafts to minimize the appearance of transplanted hair on the scalp.

Hair transplants are typically more successful than over-the-counter hair restoration products. But there are some factors to consider:

  • Anywhere from 10 to 80 percent of transplanted hair will fully grow back in about three to four months.
  • Like regular hair, transplanted hair will thin over time.
  • People with dormant hair follicles (sacs that usually contain hair beneath the skin but no longer grow hair) may have less-effective transplants, but a 2016 study suggests that plasma therapy can help up 75 percent or more of the transplanted hairs fully grow back.

Hair transplants don’t work for everyone. They’re mainly used to restore hair if you’re balding or thinning naturally or have lost hair due to an injury.

Most transplants are done with your existing hair, so they’re not as effective for treating people with:

  • widespread thinning and baldness
  • hair loss due to chemotherapy or other medications
  • thick scalp scars from injuries

Hair transplants range from about $4,000 to $15,000. Final costs may depend on:

  • your health insurance coverage
  • extent of the transplant procedure
  • availability of surgeons in your area
  • experience of the surgeon
  • surgical technique chosen

Because many insurance plans consider transplants to be cosmetic procedures, you may need to pay the entire cost out of pocket.

Overnight hospital stays and aftercare medications may also add to the final cost.

Simply put, a hair transplant takes hair you have and transfers it to an area where you don’t have hair. It is typically taken from the back of your head, but can also be taken from other parts of your body.

Before starting a transplant, your surgeon sterilizes the area where the hair will be removed and numbs it with a local anesthetic.

You can also request general anesthesia in order to stay asleep for the procedure. However, your surgeon will likely advise against it because it’s riskier than using locally injected anesthesia.

Your surgeon then performs one of two transplant methods.

Follicular unit transplantation (FUT)

FUT is sometimes known as follicular unit strip surgery (FUSS). To perform a FUT procedure, your surgeon follows these steps:

  1. Using a scalpel, the surgeon removes a piece of your scalp. The strip size is usually about 6 to 10 inches long but can stretch from ear to ear.
  2. They close the area where the scalp was removed with stitches.
  3. Your surgeon and their assistants separate the scalp strip into smaller pieces with a scalpel. They may split the piece up into as many as 2,000 smaller fragments, called grafts. Some of these grafts may contain only one hair each.
  4. Using a needle or blade, the surgeon makes small holes in your scalp where hair will be transplanted.
  5. The surgeon inserts hairs from the removed piece of scalp into the puncture holes. This step is called grafting.
  6. They then cover the surgical sites with bandages or gauze.

The specific number of grafts you receive depends on:

  • type of hair you have
  • size of transplant site
  • quality (including thickness) of hair
  • hair color

Follicular unit extraction (FUE)

To perform a FUE procedure, your surgeon takes these steps:

  1. They shave off hair on the back of your head.
  2. The surgeon than takes individual follicles out of the scalp skin. You’ll see tiny marks where each follicle was removed.
  3. As with the FUT procedure, the surgeon makes small holes in your scalp and grafts hair follicles into the holes.
  4. They then cover the surgical site with bandages or gauze.

FUT and FUE may each take several hours to several days to complete. In part, this depends on the amount of work performed by the surgeon.

If general anesthesia is used, or your surgeon thinks you’ll need extra recovery time, you may stay in the hospital overnight. But this is uncommon.

Once the surgery is done, your surgeon carefully removes any bandages. The area may be swollen, so your surgeon might inject triamcinolone into the area to keep the swelling down.

You’ll likely feel pain or soreness at the transplant site as well as in the area where hair was taken from. For the next few days, your surgeon will prescribe:

  • pain medications, such as ibuprofen (Advil)
  • antibiotics to prevent infections
  • anti-inflammatories, such as an oral steroid, to relieve swelling
  • medications such as finasteride (Propecia) or minoxidil (Rogaine) to help stimulate hair growth

Here are some aftercare tips for hair transplant surgery:

  • Wait a few days after the surgery to wash your hair. Only use mild shampoos for the first few weeks.
  • You should be able to return to work or normal activities in about three days.
  • Don’t press a brush or comb down over the new grafts for about three weeks.
  • Don’t wear any hats or pullover shirts and jackets until your doctor say it’s OK.
  • Don’t exercise for about two to three weeks.

Don’t worry if some hairs fall out. This is part of the process—transplanted hair may not grow much or seamlessly match the hair around it for a few months.

The most common side effect is scarring, and this cannot be avoided with any procedure. Other potential side effects include:

  • infections
  • crust or pus drainage around the surgical sites
  • scalp pain, itching, and swelling
  • inflammation of hair follicles (folliculitis)
  • bleeding
  • losing sensation around the surgical sites
  • visible areas of hair that don’t match the surrounding hair or are noticeably thinner
  • continuing to lose hair if your hair is still balding

Minoxidil and Propecia can also have side effects, such as:

  • irritated scalp
  • dizziness
  • chest pain
  • headaches
  • irregular heart rate
  • hand, foot, or breast swelling
  • sexual dysfunction

Visit the American Academy of Plastic Surgeons website for a reference to surgeons near you who perform hair transplants.

Here some tips for when you’re looking for a hair transplant surgeon:

  • Select only a licensed, certified surgeon.
  • Confirm a record of successful transplant procedures — ask to see a portfolio.
  • Read reviews about them.
  • Ask whether they accept your healthcare plan.

Talk to your doctor or a transplant surgeon before you decide to get either hair transplant procedure.

Understand that neither procedure is guaranteed to be successful but that scarring is guaranteed. You may also not be eligible for either procedure based on your hair volume or quality.