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The Bald Truth: Everything You Need to Know About Hair Restoration in 2020

Until stem cell transplants are viable and clinically approved, there's one method that stands out against the rest.

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You don’t have to look far to find cautionary tales about hair transplants—those guys whose scalps look like Cabbage-Patch dolls instead of resembling authentic, home-grown heads of hair.

But there are also plenty of stories about men whose transplants look really, really good: successful procedures that erased years from a hairline and gave the subject the youthful gusto to match. If you’re considering hair restoration and want to look more like the second scenario than the first, you may be wondering what the most reliable hair transplant method is these days, and what emerging technologies we have to look forward to? (In other words, when the heck will stem cell transplants finally be available?)

For answers, we spoke with hair expert Dr. Ken Washenik. He’s a medical advisor for Hair Club, which advises guys nationwide on this very subject (and provides its clients with customized solutions). Washenik is also the medical director of Bosley Medical Group—a name you might recognize for its transformative advancements in hair restoration.

beautiful young muscular guy in bathroom at morning. handsome caucasian half-naked man after shower. hygiene, people concept; Shutterstock ID 1660221193; Notes: RR digital

Shutterstock / Roman Chazov

“The current gold standard for hair transplants is called Follicular Unit Extraction,” says Washenik. “FUE is an advanced surgical hair restoration technique. It’s less invasive than traditional hair transplants. This surgical solution leaves no linear scar and requires no stitches. With FUE, one hair follicle at a time is extracted from your donor area.” (Typically the rear of the head, where hair loss does not otherwise occur. “It is then transplanted to your thinning or balding areas. FUE can be performed manually or via a robotic unit operated by your doctor. This is a one-day outpatient procedure so you can go home the same day as your surgery.”

The cost and length of FUE transplants—and any transplants, really—are determined by how many “follicular unit graphs” are being moved. This depends on the coverage desired by the procedure. You can transplant a few thousand graphs in one five- to ten-hour session, which is pretty standard fare. Thinner and more recessed heads of hair will need multiple sessions.

Your hair will grow exactly as it did from the donor site, and takes well to both the crown and the hairline. “Transplanted hair doesn’t know you moved it,” Washenik says, stating that it will simply grow happily from its new home. He adds that it takes roughly one year before your hair is fully grown in and the transplant’s success is measured. That’s because the transplanted hair typically sheds itself entirely after a couple months, before regrowing from the new host site. This is natural, but it means that transplant recipients have to trust the procedure without enjoying the results for anywhere between six to 12 months.

Procedure for stimulating hair growth mesotherapy. Hair transplant in men.; Shutterstock ID 1661503774; Notes: RR digital

Shutterstock / Yuliya L

As for the future of the procedure, the rumors are true: Stem-cell hair transplants are in clinical studies, and Washenik suspects that they’ll be available in the UK and Japan by 2022 or 2023, based on their research progress. The US had clinical trials underway, but not currently. Thus, they’ll need to first resume clinical studies before they can make progress towards consumer availability.

The procedure is being tested in various ways, but Washenik outlines the commonality between all methods: “Tissue is taken from a patient by the hair surgeon, [and the best] cells of choice are then extracted offsite, at the company’s facility. Cells are multiplied or used from early hair structure and these are sent back to the surgeon, who injects or implants them back into the patient. After six to 12 months, new hair is visible.”

Other studies are testing transplants using “allogeneic cells”, using cells from a different donor than the recipient. Washenik notes that steady progress is being made in this arena, too. (Though it’s only going to be desirable in specific cases, since someone with curly red hair probably won’t want hair transplants from someone with straight brown hair.)

But until stem cells are out of clinical trials—and until they prove to generate effective results—FUE remains the consumer’s gold standard.

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