Hair transplant decisions: suitability, safety and checking regulation

In follicular unit extraction, individual follicles are harvested from the donor area and implanted into the recipient area. In follicular unit transplantation, a strip of scalp is removed and divided into grafts. Both can give natural results in suitable patients. Transplanted hairs usually shed in the first weeks and regrow over many months, with final results taking up to a year or more.

• Stable, patterned hair loss diagnosed by a clinician.

• Sufficient donor hair of good quality.

• Realistic expectations about density and coverage.

• Good general health and willingness to follow aftercare.

• No active scalp disease or untreated scarring alopecia.

• Ideally, a settled pattern of loss, because young people with progressive loss may need further procedures and risk an unnatural look as loss continues.

Possible effects include bleeding, infection, swelling, numbness, scarring at donor or recipient areas, poor graft survival, shock loss of existing hair and an unnatural hairline. Poor planning can exhaust the donor supply. Results vary and cannot be guaranteed. Anyone promising unlimited density or guaranteed outcomes should be treated with caution.

Surgery does not stop miniaturisation of non-transplanted hair. Surgeons often recommend medicines such as minoxidil or, for men, finasteride to help preserve native hair. Discuss these before surgery, including their risks, and plan follow-up accordingly.

Ask who will perform the surgery, what their training and registration are and how many procedures they do. In the UK, doctors should be on the General Medical Council register. Ask whether technicians will perform any steps and what supervision exists. For clinics in England, check Care Quality Commission registration where required. Ask to see before-and-after photographs of real patients with similar hair type and explanations of complication rates. Be cautious about aggressive marketing, package deals and pressure to decide quickly.

Many people travel for hair transplants, attracted by lower costs. Standards vary between clinics, and problems can arise after returning home, when UK clinicians may be reluctant or unable to manage complications from a procedure they did not do. If you consider travelling, ask what aftercare is provided, who you can contact, how complications are handled and how consultations are done. Check the surgeon's credentials in the country concerned.

Recovery usually involves redness, scabbing and swelling in the first days, with scabs falling away over about a week or two. You will be advised on washing, sleeping position, avoiding sport and sun and which medicines to take or avoid. Transplanted hairs often shed before regrowing, which is normal but can be alarming if unexpected. Ask who you contact if you notice increasing pain, pus, fever or heavy bleeding, and arrange follow-up appointments before you commit to the procedure.