Where does hair loss usually start? 

Most men don’t go bald overnight – it’s a slow process. Most men first notice thinning around the temples or on the crown. “That’s the classic M-shaped recession,” explains Dr Manish Mittal, hair restoration surgeon and surgical director at Mittal Hair Clinic, who says male pattern baldness is usually genetic and follows a predictable path. “Over time, those patches can merge, leaving only a band of hair around the back and sides,” he says. For many men, that pattern helps surgeons predict where hair is heading. Dr Matee Rajput, hair transplant specialist and surgical director of KSL Clinics, adds that hormones, especially DHT, drive the process, gradually weakening hair follicles until they stop producing hair altogether.  

Can lifestyle make it worse? 

Yes. Genetics load the gun, but lifestyle can pull the trigger faster. Poor sleep, stress and high cortisol levels can all accelerate thinning, while nutrition also plays a role. “A diet lacking in protein or iron will eventually show in your hair,” says Manish. Smoking, heavy drinking and untreated scalp issues also make things worse. Hormonal issues, such as thyroid disorders or low testosterone, are another factor.  

How do you know if you’re ready for a transplant? 

The big question is whether you’ve got enough donor hair – the healthy, permanent hairs that sit around the back and sides of your head. These hairs are genetically resistant to thinning and can be moved to fill in bald patches elsewhere. “It’s all about supply and demand,” says Matee. “If your donor area is sparse, results will be limited. But if your donor zone is strong and your hair loss has stabilised, you’re probably a good candidate,” he explains. But if hair loss is still progressing, most surgeons recommend stabilising things first with medication. Dr Mittal agrees: “The best results come when hair loss has slowed and we can design something that lasts decades, which is why younger men often need to wait.” 

What are your options? 

The jargon can be confusing, but the principles are simple. There are two hair transplant techniques: follicular unit transplantation (FUT) and follicular unit extraction (FUE).

FUT is the more old-school method. It involves taking a strip of scalp and dissecting it into grafts (naturally occurring bundles of one to four hairs), which leaves a linear scar. “We don’t move single hairs – we move grafts, then distribute them carefully so the result looks natural,” explains Manish. This way, you don’t have to shave your head, but you do end up with a small scar at the back of your head.

FUE, meanwhile, is regarded as the new gold standard in hair transplants. Follicles are removed one by one using micro tools, leaving only dot-like scars that are almost invisible. But you usually have to shave the back and sides of your head. How do they compare? “Both work and can provide great results,” says Matee. “In a nutshell, FUT is more invasive while FUE is refined, discreet and better suited to modern lifestyles.”  

How do surgeons avoid that ‘plugged’ look? 

This is where artistry comes in – and why choosing the right surgeon matters. “We avoid sharp, straight lines – hair doesn’t grow that way naturally,” says Manish. Instead, surgeons use a feathered, irregular pattern that mirrors natural growth. Dr Rajput adds that age and face shape matter. “You don’t want a teenage hairline at 40. The final result has to work with your features and how your hair will change in the future.” 

What happens after surgery? 

One surprise for many men is that transplanted hairs usually shed after two to four weeks. “It’s part of the cycle – the follicle stays, but the shaft falls before new growth starts,” says Matee. The waiting game is real. Early regrowth typically begins after three to four months, with noticeable coverage by nine months. “Full results can take up to 18 months,” says Manish.  

When’s the right time to get one? 

Younger men may be keen to fix things early, but experts advise caution. “If you’re under 25, it’s unlikely hair loss has stabilised, so if you act too early, you risk creating a hairline that later looks unnatural as more loss occurs,” says Matee. For older men, the prescient issues are more likely to be donor quality and overall health than age itself.  

What if you’ve already lost a lot of hair? 

All is not lost – but expectations matter. “We focus on framing the face,” says Manish. “That might mean a more conservative hairline or combining a transplant with scalp micropigmentation to give the illusion of density.” For some men, it’s a staged approach. “You might need multiple sessions, supported with treatments like finasteride (a popular medication to treat male pattern baldness) or PRP,” says Matee.

What’s recovery like? 

You’ll need two weeks of care. That means avoiding heavy exercise, sleeping slightly upright and treating the scalp gently. “Swelling and redness are normal and settle quickly,” says Matee. Clinics usually provide sprays and shampoos to help protect the grafts. “The grafts are fragile in the early days – protecting them is everything,” adds Manish.  

Will the results last forever? 

The transplanted hair usually will, because it comes from areas resistant to DHT, the hormone responsible for baldness. But your natural hair will keep ageing, which is why maintenance is important. “We often combine surgery with medication, PRP or laser therapy to keep the whole scalp stable,” says Matee. Think of it as permanent but evolving – the work doesn’t stop after surgery.  

How much should you expect to spend? 

In the UK, expect £4,000-£10,000, depending on complexity. At the premium end, up to £15,000 isn’t unusual. “What you’re paying for is not just grafts, but the surgeon’s artistry and time,” says Manish. “It’s one area where you don’t want to cut corners. A botched transplant is far more expensive to repair than doing it properly the first time.” 

How do you avoid the cowboys? 

Do your homework. At a minimum, make sure your surgeon is GMC registered in the UK, has verified surgical training, and ideally belongs to international bodies such as the ISHRS (International Society of Hair Restoration Surgery). “Ask who will actually be performing each stage of the procedure,” stresses Manish. In reputable clinics, the surgeon designs the hairline, harvests the grafts and oversees placement – it’s not a job to be delegated to technicians you’ve never met. Red flags to watch out for include aggressive sales tactics, vague answers about qualifications, or clinics that offer a ‘one size fits all’ package. “If the consultation feels rushed or you’re promised unrealistic density in one single session, walk away,” says Matee. Other warning signs include suspiciously low prices, clinics unwilling to show authentic before-and-after results, or cases where the doctor’s role seems more supervisory than hands-on.  

Are there any alternatives? 

Hair restoration doesn’t always mean going under the knife. According to Dr Catherine Fairris, skin and aesthetics doctor, the non-surgical side of the industry has evolved into a serious option for men in the early stages of thinning or those wanting to delay surgery. Microneedling – using ultra-fine needles to trigger blood flow and growth factors – is often a first step, with visible improvement after a few months. PRP (platelet-rich plasma) injections take things further by concentrating your own platelets and re-injecting them into the scalp to stimulate dormant follicles. It’s usually done as a short course, then topped up every few months. More recently, polynucleotide injections have emerged that, Catherine says, “act almost like a fertiliser for the scalp, improving its environment and helping existing follicles perform better.”  

While these treatments don’t offer the permanence of a transplant, they come with minimal downtime, are far less invasive and can buy valuable time. They also slot neatly into a longer-term strategy: stabilising thinning, improving scalp health and, for some men, maximising the success of a future transplant.  

For more, visit MittalHairClinic.com, KSLClinic.co.uk & WessexSkin.com