I Got A Hair Transplant — Here’s What It Was Like (With Photos) *Updated*
If you’re reading this, chances are you’re probably considering getting a hair transplant.
I know that there are several articles (and even more videos on YouTube) about the procedure because I read and/or watched them as I was preparing to decide whether or not to go ahead. Ultimately I chose to move ahead.
First, quick note — there are two types of hair transplant — “FUE” and “FUT”. FUE is “follicular unit extraction”, and FUT is “follicular unit transplantation”. The difference is that FUE takes individual hair grafts (you’ll see below), whereas FUT involves cutting an actual strip of your scalp out and then cutting it up into the individual grafts. FUE is able to be “blended in at the donor site” better, whereas FUT will definitely leave a “bald patch” where they take it from.
OBLIGATORY WARNING — I’m including a few photos in this article that are a bit graphic (ie fresh blood is visible), as well as some somewhat graphic descriptions as well, so read on with caution if you’re squeamish.
The number one question people ask is some variation of “how are the results?”
The tricky thing is that the “full results” of this procedure typically aren’t realized for up to a year. I’m not even 25% of the way there. Basically, you get the transplant done and within a 4–6 weeks all of the transplanted hairs will fall out (this is normal), and it takes a few more months for them to all start growing back normally and permanently. And they don’t all grow back at the same time.
(also in case you weren’t aware, your hair grows in “cycles”, both head hair and body hair. but you can google that if you’re curious to learn more)
I’ve just got a few of those new permanent hairs sprouting right now. That said, I am confident and optimistic that my results will be great. I certainly intend to update this post later.
For full effect/reference, here is why I decided to have this procedure in the first place. The first picture doesn’t seem that bad, but because I have a sloping forehead, from the side my hairline looks almost half way back on my head. I wasn’t happy with it and knew it was only going to get worse.
The morning of the procedure, I was instructed to arrive at the clinic very early (5:45am!) to get prepped. The surgeon discussed the process with me again briefly, and drew guidelines for where the new hairline would be. He told me there is a “natural” forehead height for males as well as females, and so he couldn’t bring my hairline down too far or it would look unnatural even for a woman.
The main difference in male and female hair patterns tends to hinge on the crook at the sides, the corner above your temple. I remember hearing the senior surgeon mentioning “the patient is entirely bald in this area so make sure to put lots of density there”.
Many trans women resort to asymmetrical “comb-over” hairstyles (and/or bangs) to hide their hairlines and this gap at the corners. I could have potentially done this, but again, the natural slope of my forehead draws extra attention (I think) from the sides, so on one side it would still be very obvious. Plus, in the summer time I need to be able to wear my hair up or in a ponytail to not overheat as much, and that would expose my hairline a lot more. So this procedure felt necessary to me for my own comfort.
I don’t have any pictures from the actual procedure, I’m not sure if they would have allowed filming or photos during anyway. I was partly sedated and not 100% lucid through the whole thing which is probably for the best, the entire procedure takes a full day. I believe they started working on me around 7:30am and released me to my parents to take home at around 5:45pm.
Here’s how it all went down:
First the surgeon shaved the part of the back of my head where the donor follicular units would be extracted from. I had asked if they could take them from lower down on the back of my head, instead of leaving a hole in the middle at the back. I was told they must take them from a very specific spot, so I had no choice there.
I am very attached to my hair (both literally and figuratively) and honestly, the hardest part of the decision to get this procedure wasn’t the cost, it was knowing I’d be losing a large chunk of hard-grown hair that would take several years to grow back. I don’t even like going to get regular split end trims at the barber but know it’s necessary and this has been helped by the fact that I take 15,000mcg of biotin each day (so my hair grows faster than average), and over the last year I’ve transitioned to an all-natural hair care regimen which has also helped my hair growth. Seriously folks, kick those sulfates and silicones to the curb!
Next, they had me take the first dose of antibiotics, as well as the muscle relaxer/sleep aid, and I think also the first dose of painkillers.
Next, they took me to another room, and the senior surgeon reviewed the outline drawn on my forehead, and further explained some of the typical differences between natural hair patterns of males and females (I’m using those terms because this is more of a medical context). Then they applied freezing needles to my scalp around the area that had been shaved. The senior surgeon assessed the area and gave directions on where to take transplants from.
After a few minutes, I was taken to the actual surgery room. At first I laid on my stomach and they used a NeoGraft machine to take the donor samples. The machine basically drills into your scalp around each follicle to pluck it out, root and all. The machine then keeps the follicular units moist and warm to keep them alive and in the best possible state for surviving and being successfully absorbed and integrated in the recipient site.
The units are 0.9mm in diameter, which is darn small (I was told that when the FUE technique was first developed, the extracted units were 5mm each, which made them much more obvious and helped lead to the term “hair plugs”).
It wasn’t actually painful, but I could feel the machine boring into my scalp. Like, numbly I could feel the thunk, drill, extract, relocate, thunk, drill, extract.
I don’t know how long the total extraction process took, I was sort of in and out of awareness once I got used to the sensation of what was happening and determined that I didn’t have to worry about pain or anything.
I know after the extraction was complete, I had to flip over to my back. I can’t remember if I was given a minute to stretch or not. Of course, trying to remember details from 7.5 weeks ago when I was also drugged up at that time isn’t going to do much good.
I actually don’t even remember if I was given freezing or numbing on my forehead before implantation, I assume I was, but again, I was aware enough that I could feel the dull sensation of them poking the holes to insert the follicular units into. It didn’t hurt, but I could tell they were doing it.
I think during this part of the procedure (the home stretch), the muscle relaxer/sleep aid was wearing off, because while I was not aware of the time, I definitely started to become more aware of my body and the fact that I’d been laying down for basically 8–9 hours straight. My back started to hurt, and I started to squirm a bit. The surgical assistant kind of chastized me at one point. I was trying to move my lower half without moving my head, but obviously it wasn’t working.
When they finally finished, they helped me stand up, and then they helped me into a wheelchair. I was definitely still drugged and didn’t have full balance. They wheeled me to the parking garage to be picked up by my parents.
That was another non-negotiable thing — you’re not allowed to just go home by yourself via taxi or public transit. I had to have someone pick me up and escort me home (or to wherever I was going to stay to recover). I fully understand in retrospect, given how I looked, and that I was somewhat wobbly. It’s a liability and safety thing. They also strongly recommend that you have someone around and able to help you for the first few days of recovery. You shouldn’t try to do this completely alone.
In the car on the way home I had the presence of mind to take a picture of myself while there was still pretty decent light. You can pretty clearly tell a lot of individual dots from individual hair unit implantations.
Amazingly, even after the drugs all wore off, I wasn’t in pain. I woke up the next morning and wasn’t really in pain then either. I don’t know if that’s typical, but I was glad.
The image above shows what the back of my head looked like after getting the bandages off (2 days after the procedure). You can see all the little red dots from where a follicle had been punched out by the machine. The two big bloody spots were the “high density” spots I heard the senior surgeon mention. Once the hair grows back in, because the donor follicles were spaced out, you won’t be able to tell, the hair will look very normal. That’s one of the big benefits of FUE.
So, I can confidently say for myself the worst part of having this procedure done and the recovery process is having to sleep upright during initial recovery (this was echoed by someone else I know who had this procedure before me). Basically, you need to keep your head elevated (and above your heart) for about 10 days straight. This is to avoid extra blood pressure in/around your scalp from affecting the natural healing/recovery of the transplanted follicles.
My parents had this really comfy big reclining sofa chair, so I slept in that for the first few nights (I stayed with my parents from the Thursday night to the following Monday afternoon and went home then).
Sleeping upright at home was much harder and less pleasant. My apartment was without air conditioning at the time (we were mid-heatwave), and my place is small, so I pretty much had to pile up pillows in a corner and lean back onto them. It wasn’t fun and I didn’t sleep well for a few nights.
The first night I was allowed to sleep laying down again, I slept like I hadn’t slept in years. I slept for 10 solid hours, and my fitbit told me I got 2.5 hrs of deep sleep and 2.5 hrs of REM sleep. My typical on a good night for each is only 1–1.5 hrs for either. So I slept twice as well as usual that night and felt amazing the next day. Sadly things have pretty much gone back to normal since.
Anyways, I skipped ahead a bit.
Here are some pictures of the progress of the healing:
The above photo was taken the day after the surgery. All the blood had dried and basically started to scab up.
This was the evening of Day 2 of recovery, I had gotten the bandages off earlier that day, had some polysporin put over the blood/scab (left it like that for a while), then my mom helped me do the first rinse. I had to rinse my whole head gently with baby shampoo and warm water for 10 days.
No normal shampoo, no water pressure, still no touching the recipient site. Just fill a medium sized bucket with warm water and shampoo and gently pour it over my head once a day.
Here is a closeup of the recipient site after the first wash. You can see a bit of olive colouring — the bruising of my face/forehead from the procedure showed up a few days after and lasted for a couple of days. Not a big deal.
Below is another picture from a few days later once I was back home.
I was surprised that the scabbing stayed on not only through 10 days of washes, but even when I got the go-ahead on Day 11 of recovery to actually soak the scabbing in baby lotion for a couple of hours and then gently massage it, it was still pretty stubborn. Below is an example, most of the scabbing has been washed off, but a few bits remain around the base of my original hairline.
Here is a photo from once all the scabbing had been removed, and before most of the transplanted hairs had begun to fall out:
Once that all grows in fully, I do believe it’s going to look great. Of course as the new permanent hairs grow in, they aren’t growing in at the same time, so I’m glad I can just wear a hat/toque through the fall/winter to cover it. I chose to do this procedure in the fall on purpose.
Here’s how it looked after some of the hairs had fallen out, and with my hair combed more how it typically is (off centre part):
And from the side. As you can see, and like I mentioned earlier, doing a side part + comb-over hairstyle definitely helps to hide the forehead somewhat, but I’m still glad I got this done.
Here’s a better view of the recipient site almost a full month after the procedure:
This next one is from a little over a month after the procedure. As you can see most of the transplanted hairs had now fallen out.
As for the back of my head…
I don’t actually wear my hair like this post-procedure, I just did this to highlight for the evidence/comparison, even though they did shave a decent sized patch on the back of my head, it is easily and effectively hidden either by my hair fully down, or in a normal ponytail.
It is a bit trickier to wash now though.
First, if you are seriously considering this procedure, DO YOUR RESEARCH and ASK LOTS OF QUESTIONS. I actually had two consults with the clinic, because the first time I went in basically expecting them to spoon-feed me everything I needed to know (surprise, that isn’t how it works!), and realized later after doing a bit more reading that they had not. So I asked for another consult and asked a million questions from my research. When you’re going to spend this much money on something you want to make sure you know what you’re getting into and can trust in the service.
Costs vary, but you should expect at least $10,000 for 2,000 grafts. However, you might not need 2,000 grafts depending on your own situation. Maybe only 1,500, or 1,000? If you need more than 2,000 grafts though, you’d likely have to get the procedure done in multiple sessions and could be looking at closer to $20,000.
I booked it while they were having a promotion so I saved some money. I would say if you see a clinic offering 2,000 grafts for less than $10,000 and they aren’t having some kind of promotion or sale, I would be skeptical of the quality. It was explained to me that there can be a level of “artistry” involved in this procedure. Ie it is possible to purely just punch out the donor grafts and then punch them in at the front in a straight line (which is faster and easier), but was told that can lead to what the surgeon called “Ken Doll Hairline”. In other words, it does not look natural. So be aware and ask about this.
The place I went to did offer financing, but the research I did into the financing company did not make me trust dealing with them so I chose instead to pay for the procedure up front with a line of credit. I recognize that not everyone has this luxury.
As I mentioned before, the first 10 days are the hard part, but after that, it’s basically back to normal life for the most part. They do recommend that you take at least a week off work if you can manage it (mainly to avoid having to be seen by your coworkers with the bloody/scabby recipient zone on the front of your head and the bald patch at the back). But it really shouldn’t be a matter of pain. If you have a more physical job (like construction or athlete or something), then you’d definitely need to take a couple weeks off.
I’m told (and research corroborates) that the new hair won’t be fully realized until a full year has passed, so I had this done at the beginning of fall so ideally by spring when I’m not wearing a toque/hat all the time, I’ll have some new hair (maybe even bangs?).
I’m definitely looking forward to seeing the full results, and glad that this procedure is behind me. It wasn’t overly stressful, but as I said I’m very protective of my hair so I was definitely anxious. I’ll likely post an update around the 6 or 7 month mark.
2 MONTH UPDATE (Mid Nov 2018)
So it’s been a little over two months now. I’ve been trying my best not to check in the mirror every single day because I know it will seem like nothing is happening if I do. I might shoot a quick glance every few days, and take a really good look about once a week.
I had been concerned because it seemed like a lot of the hairs weren’t growing back, but more and more keep sprouting and slowly filling in the blank forehead space. They did say it takes upwards of a year to see the full results, and as I mentioned earlier in this article, your hair does grow in cycles and different areas grow at different rates.
So I have some patches that are already happily populated, and other spots I presume are going to take a few more months yet.
Here’s a look:
As I said, i keep worrying that some of the follicles are not going to regrow, but pretty much every day there’s at least one or two tiny little black spots just barely visible through the skin surface. Given that hair grows pretty slowly (even though I’m taking a ton of biotin each day to help speed it up), it makes sense why it takes many months for a bunch of new hairs to grow in.
UPDATE #2 — Jan 25th, 2019 (4 months later)
It has now been a little over 4 months since my transplant. The surgeon had told me it would take a while for the results to really show, upwards of 9 months minimum, but that after a full year I’d see pretty much the final, optimal results.
Progress had been slow thus far, but now between month 3 and month 4 I can see a very noticeable evolution. There are still some small patches that haven’t filled in yet, but we’re really getting there!
As you can see, the corners at the sides have filled in quite nicely, and there’s a patch around the middle of my forehead hairline that is also filling in pretty nicely. The spot below where I part my hair is also nice and thick. But as you can see there’s still a couple of spots that don’t seem to have new hairs sprouted yet. I hope that by my 6th month update they will have.
Quick reminder of where I started from:
UPDATE #3 — April 27th, 2019 (7 months later)
I completely forgot to do an update in March at the 6 month mark, but I just went to the salon to get my quarterly trim and the stylist actually said “I would have had no idea you had a hair transplant if you didn’t tell me, it looks very natural!”
I definitely think it looks better than it did before, but I’ve included an image below that shows why I’m partially disappointed with the result. I did speak to the surgeon back in March and sent him current pictures at the time, and he said it looks good and that I truly won’t see the ultimate final results for a full year, but I’ve seen virtually no change over the last 2 months. It really looks like what’s there now is all I’m going to get.
Again, an improvement still, and we’re always our own harshest critics. I have thought about “well, should I have gotten a brow lift/hairline lower instead?” and I realize if I’d done that, the corners wouldn’t have be filled in (and they’re the part I’m happiest about), and I’d probably be growing bangs out right now (because they make the incision for the brow lift just behind your natural hairline).
So I think I would have been unhappy about that for different reasons (even though now I’m still unhappy with my forehead.
Again, it’s definitely better than it was, and apparently no one can tell at a glance, but I can’t not see it, which is unfortunate.
UPDATE #4 — June 2019 (9 months)
I just had my 9 month follow up with my surgeon. He agreed with me that the density at the front is “sub-par”. This is after just getting my hair freshly re-dyed a dark chestnut brown:
As you can see, the middle is mostly about half as thick in density as my original hair.
The good news is when my hair is “styled” (ie combed to the side and not straight back), this is only visible from a foot or so away.
The surgeon mentioned that a “touch-up” could be done to fill in the front more, but that would obviously involve going through the procedure again (even if it was a shorter version). They said they would do another check in at the 1 year mark (so in Sept) and decide then.
I will also have to decide if I want to go through that again.
UPDATE #5 — Aug 2019 (11 months)
I meant to wait the full year to do another update, but I ended up getting my hair coloured again a bit sooner than planned. And that has historically been the best time for me to do update photos.
I have to say, it’s actually looking pretty OK to me at this point. Obviously the thin spots are still there, but again, when it’s styled, you can’t really tell.
I have thought about the possibility of getting the touch up done, and as of right now, I don’t plan to go that route. I did just have another minor surgery and really want to give my body a break from anything else for at least a year.
I have thought several times post-surgery “should I have just gotten a brow lift instead?” It would have probably been more expensive because I probably would have tied at least one other procedure in as well, and certainly would have been a longer recovery time.
Plus if anything “went wrong” with recovery for a brow lift (as I’ve seen examples of), then you almost have no choice but to get it fixed, which means another invasive surgery with another long recovery time. As I’ve learned, even recovering from minor surgical procedures can be a real inconvenience.
Also, I have seen photos of people who have gotten brow lifts and some of them have that “obviously had work done” look, some of them look more unnatural in my opinion.
I don’t know how much of that comes down to the surgeon and how much is other factors, but one of the biggest upsides of this procedure is that it does look pretty natural. There is also the risk that you could need a follow up procedure, but it wouldn’t be as big a deal. Definitely less invasive.
I can’t have a do-over so I’ve got what I’ve got. Hopefully this article was helpful or illuminating for you if you are considering this procedure.
FOOTNOTE — I have been contacted by a few readers of this article to ask how many grafts I got and how I feel about it now, well after the fact (“was it worth it?”).
I got 2,000 grafts.
Almost 2 years post-op what I can say is that I’m better off having had the procedure than not, but the results were disappointing in the end. The red circled spots in the images above never filled in any more, and there seems to have been a tiny bit more thinning in the spot where I normally part my hair.
On the bright side almost no one can ever tell I had a transplant, which at least speaks to the quality of what “turned out” from the procedure, but if you’re considering this procedure for yourself, DO YOUR RESEARCH.
If you’re going to spend the amount of money it costs (don’t cheap out!), make sure you pick a reputable clinic/doctor, read the reviews, look for before and after pics (posted by the patient, not the clinic), and if possible, talk to people who have had it done and are over a year post-op.
I hope that is helpful!
Here’s a very recent new picture of me so you can see how it’s looking now:
If you know what you’re looking for, you can kind of still see the thinness up front, but styling my hair like this hides 95% of it.