Everything you need to know before doing a hair transplant

My name is Chris Gerrits Jans and I am the owner of Moquer Hairstyling and Grooming. Today I will tell a personal story, because I think it could prove useful for many men. In 2017 I did a hair transplant, because I also experienced heredity male pattern baldness and I am not the only one.

I will tell you about my personal experience. This blogpost is not sponsored and I am not a medical professional, so always consult with your doctor before considering a cosmetic surgery, because a hair transplant is a medical procedure with local anaesthesia. A hair transplant is also not the answer for everybody, because not all hair loss is caused by male pattern baldness. So, always consult a medical professional.

How it started

April 2017 (a few months before the hair transplant)

When I was about 15 or 16 years old, I already noticed that my hairline was receding. My problem was a so-called widow's peak. The rest of my hair is actually very thick and every time I go to a barber, then they always tell me how thick my hair is, so your hair-type does not say much about the likelihood of getting hereditary male pattern baldness.

Hereditary male pattern baldness is caused by the hormone dihydrotestosterone, usually shortened to DHT. It is unclear if these genes are carried on by your mother's side or father's side. In my personal case it is definitely something that runs in my father's family (my dad is bald himself) and not so much in my mother's family (my mom's brothers are not bald).

When I was about 18 years old, I already made myself the promise I would do a hair transplant whenever that would be possible. A hair transplant is not cheap and usually your health insurance will not cover it because it is considered a cosmetic procedure. The years that followed I was in university and I had no money to do a hair transplant.

Moquer has been founded in 2014 and has been my fulltime job since. In 2017 I saved enough to start thinking about a hair transplant, so I started to gather information.

What is a hair transplant?

Bald on top, but the sides and the back are still covered.

Usually when the male pattern baldness starts, it begins either with a receding hairline, the earlier mentioned widow's peak, or at the crown of your head. The hair at your sides and the back will not fall out when you experience male pattern baldness. When doing a hair transplant they take the hairs from the back or your sides and transplant it one by one either to your crown or to the front, wherever you experience the hair loss. The whole hair follicle including all the DNA is transplanted. This means that hairs that have been transplanted will never fall out anymore.

In the past they had another method where they actually take a strip of skin including hair from the back of your head from which to take the hairs. That is quite the procedure and it will leave a pretty big scar, so nowadays that method is not begin used anymore in the Netherlands.

I did my hair transplant in the Netherlands and one of the first things they will do is checking if you actually have enough donor hair. That means that you need enough hair on your sides and back to transplant. With newer methods it is actually possible that some of the transplanted hair follicles that have been taken from the back are actually growing back there, but this is not always the case. That is why you need enough donor hair, because otherwise you will get a bald spot at the donor area.

I had plenty of donor hairs because I have very thick hair. You would not be able to notice if the hair at the back of my head would be slightly thinner. I was 25 years old when I actually did the hair transplant. My aim was to do it as young as possible, because then I could transplant the hairs back and take finasteride (also known as Propecia) to prevent the rest of my hair from falling out. Read this blogpost if you want to know more about finasteride and male pattern baldness. Always consult with a doctor before you start taking any new medication. Finasteride has severe possible side-effects!

The treatment

I had no problems at the crown of my head, but I had a problem with a receding hairline, so that is where I had my hairs transplanted. When you are doing a hair transplant they are actually not talking about hairs but about grafts. A graft can contain 1 to 5 hair follicles, but usually it will contain about 1 or 2.

When you arrive at the clinic you are not allowed to have any hair products in your hair because that does not work well with the procedure. They marked the receiving area to where all the grafts would be transplanted to and told me I would not get a straight hairline anyway. It is possible in theory, but when you get older it would look unnatural at some point and you need a bigger donor area.

After they marked the area I laid down on the treatment table. In the end I would spend almost 8 hours in total on that table. The picture above is how it approximately looks, but at the headrest there is a hole where you can rest your forehead. After that they shaved a strip of hair off at the back of my head and that is where they would get the grafts from. In my case they took about 1000 grafts. To remove a graft from your skin they use a hollow needle. You will get local anaesthesia when this process starts. They told me it was the same anaesthesia that a dentist uses. They use a needle to apply the anaesthesia and you need it multiple times throughout the day. Luckily you do not see it and you just feel a small pinch.

A hair transplant with about 1000 grafts can be done in 1 day. When you want more grafts, then the procedure will take 2 days or longer. In my case it was a pretty long day, because I arrived at 10 am and left the clinic at 6 pm. So, it took about 8 hours including a short lunch break. The majority of this time you are lying face down while they take the grafts one by one. They group the grafts based on the amount of follicles, so they can transplant them to the front and make it look natural.

Personally this part of the hair transplant was the most annoying. You lay on your stomach and on your face. You will become a bit stiff and maybe experience some pressure on your jaw. The process of taking the grafts from the back took about 4,5 to 5 hours. The actual transplant of the hairs to the front will take less time.

When the grafts are being transplanted you are allowed to sit up straight in the chair, so that means you will be able to watch some television. In my case they had some episodes of Friends on and during the procedure you can also just have conversation with the practitioners. When it was 6 pm all the grafts had been transplanted to my receding hairline and the treatment itself was finished.

After the treatment

When can you shower again?

After the treatment they do not recommend driving home yourself, because you have been laying down a lot and had local anaesthesia. Taking public transport is no problem.

The donor area, where they took the grafts from, is sensitive and may bleed a little bit. They will give you some bandages if necessary. The receiving area is also red and sensitive. You are not allowed to wear a hat that day, because the grafts are not allowed to move. After 1 or 2 days after the treatment the grafts are just as secured as your regular hair, so you can wear a hat if you like to cover up the wounds.

The first few nights after the hair transplant you are not allowed to sleep on your stomach to prevent the grafts from moving. You will also get a bandage to lay your head on when sleeping, because otherwise you will get some blood or fluid in your pillow. But all of that will be over after a few days when the wounds heal.

It is also not allowed to wash your hair for one week and they advise you not to use an anti-dandruff shampoo for the next few months, because these shampoos are relatively harsh. When the first week has passed, they actually want you to vigorously wash your hair with a normal, mild shampoo, because all the scabs need to be washed away. After that you can just resume your regular hair care routine, but without using anti-dandruff shampoos.

The cost of a hair transplant

All right, let's talk some numbers. The cost of a hair transplant is based on the amount of grafts that will be transplanted plus an intake fee. I did my hair transplant in the Netherlands and I paid 2,85 euro per graft and 650 euro intake fee. That brings the total cost of my hair transplant to 3500 euro. For that amount I only restored a small area, so you can imagine the cost can go up quickly if you are doing a very extensive hair transplant, assuming you have enough donor hair.

When you have a hair transplant with 1500 grafts your cost will be about 5000 euro and when you need 2000 grafts the price will go up to 6500 euro. If you happen to be bald completely the cost will go over 10.000 euro. The number of grafts you need also depends on your hair colour. When you have a lighter hair colour, you will need more grafts to make it look dense enough. Usually, light hair is also slightly thinner.

Some men go abroad for their hair transplant because it can be cheaper. It also depends on the kind of treatment you are choosing.

The final result of the hair transplant

The final result will take a while. It takes about 9 months before the final result is visible. The reason for this is because all the transplanted hairs will fall out after the treatment. They fall out because the hair transplant was a bit of a shock to them, so that is all normal. After a while the hair will start to grow from the transplanted follicle, but they each follow their own schedule. About 80 to 90 percent of the transplanted follicles will start to grow again after the initial fall out. The percentage depends on the individual.

Before and after the hair transplant

Before the hair transplant

After the hair transplant

That is why you have to come back for a few check-ups in the next months after the hair transplant. That way they can check if everything goes according to plan. So, primarily you just need to have patience before you can experience the final result. In my case I just restored a small part of my receding hairline, and most people did not even noticed that I did anything. People do not pay that much attention generally. It has been said that other people will only notice that you are going bald when you already lost 40% of your hair.

I primarily wanted to stop the process of balding, so I did the hair transplant to fix part of the problem and started to take medicine to stop the male pattern baldness itself. All the transplanted hairs will never fall out, but the rest of your hair can still fall out. Some men are doing multiple hair transplants over the years to tackle that problem. Especially when you choose not to take Finasteride or Propecia, then your only solution is more hair transplants. I choose to take finasteride to solve my male pattern baldness. Read this blog for all information about finasteride and male pattern baldness. Always consult with your doctor if you consider taking any medication, because the potential side-effects can be severe.

Conclusion

In my case the hair transplant went well, and I am happy with the result. I am aware I still do not have a straight hairline, but it does not bother me enough to do another hair transplant anytime soon. And I have been taking  finasteride for two years now and I luckily do not notice any side-effects personally. So, I do not experience any hair loss anymore and on some spots it almost seems there are hairs growing back.

So it seems I fixed my hereditary male pattern baldness in my case. I restored part of the hair I lost and the medication keeps the rest on my head. I do have to take this medication the rest of my life, because when you stop, the hair loss will happen progressively. I am very happy with my decision and apparently it also reflected on my self-confidence. In the past I basically never got any compliments about my hair, but nowadays I actually get some. The result of the hair transplant is not even that noticeable in my opinion. I may not have a super straight hairline or super stylish hairstyle like some hairstyling YouTubers, but I am happy with my hair and that is why I did it!

And then this...

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