Medically reviewed by Kristin Hall, FNP
Written by Our Editorial Team
Last updated 7/6/2021
If you’ve noticed your hairline creeping back and have a suspicion that your bald spot is looking a bit shinier lately, there’s a good chance you’re part of the male pattern hair loss club.
We know… This club kinda sucks. BUT...
The good news is you have company — up to 85 percent of men will experience hair loss at some time in their lives.
The better news is that hair loss treatments and solutions abound.
In this piece, we’ll explore what a FUT hair transplant is, who qualifies for this surgery (and who doesn’t), the process, the benefits, risks and some alternative hair loss treatment options if surgery isn’t your thing.
The name sounds complicated, but it’s actually pretty straightforward.
Follicular Unit Transplantation (FUT) is a type of hair restoration surgery that relocates hair in “follicular units” (aka naturally occurring groupings of hair).
These units can contain one, two or three hairs and their associated skin, nerves, muscle and blood vessels.
The small size of the units allows for great versatility in where they’re placed on the head. Because of this, hair transplant surgeons can create hair patterns that closely mimic natural hair patterns.
The grafts are also large enough that a full restoration can often be achieved in just one or two sessions.
Other factors that should be considered are:
If you’re 25 or older, you’re a great candidate for FUT surgery.
As a general rule of thumb, surgeons should only operate on patients older than 25 because future hair loss patterns are more predictable.
Also, expectations for the outcome of surgery are generally more unrealistic in patients younger than 25.
Men with thicker hair can expect to obtain much denser coverage — and therefore achieve better aesthetic results — versus men with thinner, finer hair.
Men whose scalp donor sites have greater than 80 follicular units per cm2 are excellent candidates and the outcome will be maximum fullness.
Men with donor hair density less than 40 follicular units per cm2 are considered poor candidates for FUT surgery, and the surgeon should set expectations accordingly.
Men hoping to correct frontal baldness can expect the most dramatic results, and therefore represent the best candidates.
Expect your surgeon to reiterate that concentrating grafts in the frontal scalp will provide maximum long-term density and minimal aesthetic risk.
Men with lighter skin tones and lighter hair colors (i.e., blonde, red) are better candidates to those with black hair since the color contrast between hair and skin is less noticeable.
However, proper technique helps mitigate most problems with transplanting dark-haired patients.
Men with realistic expectations of results and a history of compliance with hair loss medications and treatments (i.e., minoxidil, finasteride, platelet-rich plasma) are ideal candidates for FUT hair transplant surgery.
As with all medical procedures, there are some potentially exclusionary criteria, or “red flags.” This includes men who have:
Unrealistic expectations of the surgery outcome
Certain mental illnesses
Donor site miniaturization
Unusual hair loss pattern
Many broken hairs
Unexplained or visible scarring
Scalp or skin pain, burning or itching
Now that you’ve read through the criteria, you may be thinking you’re a good candidate for FUT hair transplant surgery. The next step is to cover what the surgery will look like.
During the FUT hair transplant procedure, a surgeon cuts a strip of skin from your scalp, usually from the back of your head.
The exact size of the strip depends on the number of follicles needed to cover bald spots, but the strip usually doesn’t exceed one to 1.5 centimeters (0.4 to 0.6 inches) wide.
Once the individual follicles are removed from the strip, they’re re-inserted into your scalp.
Now, let’s run through the full hair transplant procedure so you can have a better understanding of what’s involved from start to finish. Here’s the step-by-step process:
Step 1. The surgeon will re-draw your hairline, mark the area of hair extraction and take photographs for your medical record. You may have the option of taking a sedative before surgery. Local anaesthesia will be applied to your scalp to numb it.
Step 2. The hair at the donor site, where your hair is removed from, will be trimmed to about two millimeters.
Step 3. The surgeon will cut out the strip of skin with the hair follicles that will be used as a graft. You’ll stay awake during the extraction process. Determining the right size and location of the donor strip maximizes the yield and prevents problems such as widened and/or visible linear scar.
Step 4. A technician will remove individual hair follicles from the strip and prepare them for transplantation.
Step 5. The surgeon will close your scalp with sutures.
Step 6. The hair follicles will then be inserted into the balding parts of your scalp in a pattern that looks natural.
Step 7. An antibiotic and bandages will be applied to your scalp.
Most people see results from the surgery in six to nine months. However, some people have to wait up to a year to see results.
It’s important to note that between two and eight weeks after the surgery, the transplanted hair will fall out. This is normal.
By the third month, the hair may look thinner than before you had the transplant. Again, this is normal.
There’s no way around it — FUT surgery is expensive.
This hair restoration technique can run the gamut anywhere from $3,000 to $15,000 or more, depending on where you live, the individual surgeon, the complexity of the procedure and other factors.
In addition to the reinvigorated pep in your step knowing you have a full head of luscious hair, the number one benefit is that it’s a permanent solution to male pattern hair loss.
That means you won’t ever need to worry about wigs, toupees, spray-on concealers and messy topical medications.
In general, complications after FUT hair transplantation are rare, given the vigorous blood-supply to the scalp, which allows for quick healing and low rates of infection.
Nevertheless, potential risks include:
Swelling caused by excess fluids (edema)
Inflammation of the hair follicles (folliculitis) of the transplanted hair
Numbness of the scalp
“Shock” loss, an uncommon but concerning complication characterized by shedding of native hairs at the donor or recipient site. This is likely a result of stress and microtrauma sustained during the surgery and — most importantly — is generally temporary. Patients should receive reassurance that the majority of the hairs shed will return at three to four months.
Epidermal cysts and ingrown hair, which may set off an inflammatory response affecting the entire graft population.
Infection, which affects less than one percent of patients. Treatment includes exfoliating with warm compresses, twice-daily shampooing and antibiotics.
If you’re not quite ready to take the plunge into surgery, here are some other non-invasive (but totally legit) hair loss solutions you can try:
Topical minoxidil has been considered safe to use; however, some people experience side effects after application.
The most common side effect of minoxidil on scalps is irritant contact dermatitis. Typical symptoms include itchy and scaly skin.
Finasteride is an FDA-approved medication for the treatment of hair loss in men, and belongs to a class of drugs known as 5-alpha-reductase inhibitors.
According to a clinical study, at two years, an increase in hair growth was demonstrated in 66 percent of men treated with finasteride, compared with seven percent of men treated with placebo.
It is important to note, however, that the hair loss medication needs to be taken on a continuous basis, or else new hair will be lost, typically after about a year of stopping the medication.
Wigs and toupees are another alternative to an FUT hair transplant. Some toupees are incredibly realistic and are adhered to the scalp with glue.
This type of customized toupee can last for months if properly cared for.
FUT hair transplant surgery is an incredibly effective solution to male pattern hair loss. However, it also comes with its fair share of risks and downsides.
If you’re not ready to take the plunge into surgery, there are a number of alternative hair loss solutions for men, including medications, wigs and toupees.
Make sure to talk to your healthcare provider about the hair loss solution that may be right for you.