How do hair plugs work and what is the cost?

Hair thinning is a normal, common part of ageing, but it can also occur from illnesses, medications or physical trauma.

Regardless of the origins, hair loss can be difficult to deal with and it can affect a person's mental health and overall well-being.

The good news is that there are hair growth treatment options, both invasive and non-invasive, that can help you look and feel great.

You might have heard of hair restoration surgery — maybe you've seen a late-night ad or questioned a celebrity's sudden new hair transformation, or perhaps you are experiencing hair thinning yourself and are curious about how it all works.

Well, wonder no longer. We've researched the science behind hair transplantation and scoured through medically reviewed papers to give you all the info you need about hair restoration.

What are hair plugs?

As the authors of the study Evolution of Hair Transplantation note, there have been many radical advances in the field of hair restoration in recent years [1].

When we hear the term 'hair plugs' we might imagine thick, unnatural-looking hair that looks obviously applied to the scalp. Some of us have these images in our minds from poorly performed procedures done decades ago before the process was refined.

Hair plugs are, in fact, just one form of hair transplant.

These days, there are many treatment options available for people experiencing male pattern baldness or thinning hair, with two, in particular, being the standard methods.

Types of hair restoration surgery

Generally speaking, there are 2 main types of hair transplant procedures performed to address hair loss: follicular unit transplantation (FUT) and follicular unit extraction (FUE).

These are both commonly performed medical procedures but do differ slightly in their technique.

Follicular unit transplantation (FUT)

The FUT technique emerged in the 1990s, and as the authors from ZME Science explain, this was a decade of huge advancements in the field of hair transplant surgery and cosmetic procedures [2].

This method involves a technique whereby a surgeon removes a thin strip of skin hair from the back of the head, which is then carefully divided into small pieces, each containing around 1-2 hairs (hair grafts).

The next step of the procedure is transplanting these hair grafts into their new location (where thinning or balding has occurred), essentially creating healthy hair follicles.

These grafts are then placed into tiny cuts made in the scalp and then closed with stitches. After approximately 10-14 days, the stitches are removed, and the 'donor' hair area heals, usually in a linear scar.

With the FUT procedure, you would typically end up with a scar on the back of your head, but surgeons are usually careful to ensure this is as discreet as possible, and it most likely will be covered by hair.

Follicular unit extraction (FUE)

Follicular unit extraction (FUE, also sometimes referred to as follicular unit excision) is a procedure that involves removing individual hair follicles one by one into hair grafts and then placing these hairs into numerous tiny incisions on the scalp.

As opposed to the FUT procedure which involves removing a strip of skin, with the FUE procedure, the surgeon uses a tiny punch tool to remove the individual hair, adding healthy hair follicles to their new transplanted hair site one by one.

How do hair transplants work?

It's worth noting that all experts agree that hair transplants do not provide a 'cure' for baldness — they can treat it, but there is no guarantee that further hair loss won't still occur.

Hair transplant procedures have been utilised to treat hair loss, including female pattern hair loss, for decades now.

It's been acknowledged that these techniques are effective, but that the FUE procedure can achieve more natural-looking results [3].

Like all hair transplant surgeries, there are pros and cons to each medical procedure.

The FUE procedure takes longer for the surgeon to perform as it involves the removal and transplant of individual existing hair follicles onto the donor area but it can produce slightly better results with minimal scarring.

In essence, hair transplants work by hair transplant surgeons obtaining existing hairs from the body (from the back of the head, or even other areas of the body where more hair is present) and using them as donor hair for the scalp and thinning areas.

Do hair plugs actually work?

Medical News Today advises that there is a chance that some of the transported hair follicles will not "take" — this is similar to the language used when doctors refer to donated organs that are "rejected" [3].

These transported hair follicles can die, and no new hair will grow.

In addition, even successful hair transplant recipients may require a touch-up procedure. Like all medical procedures, it can take a few months for the body to settle into its new state and for patients and their doctors to assess the outcome.

Not everyone is over the moon with their results so a good doctor will keep expectations in mind before the surgery.

Touch-ups are generally a minimally invasive procedure but are definitely something to think about when researching and assessing the overall cost.

Things to consider

With the rise of 'lunch break' beauty techniques like anti-wrinkle injections being normalised, it can be easy to forget that most cosmetic procedures like hair transplants are, in fact, surgery.

The experts at BetterHealth recommend discussing with your doctor and taking time to research any treatments [4].

Some important things to keep in mind:

• Crucially, have realistic expectations. If someone is starting with not much hair at all, no amount of transplant is likely to transform that into a thick mane.
• Thin hair has slightly less chance of being successful than thick hair.
• It can take up to 9 months for the donor hair to fully take root.
• It can take time to find the right surgeon.
• Factor in recovery time when thinking of timelines.
• Smokers are at increased risk of complications from surgery (this is relevant to most surgeries by the way, if you need an extra nudge to quit!).

What are potential complications?

Like all medical procedures, there are risks that can come with hair transplants:

• General anaesthesia risks, including an allergic reaction
• Surgical risks such as bleeding or infection
• Scars that may be severe, raised, or bumpy
• Possible nerve damage including permanent loss of sensation
• Tissue death along the wound
• Death of the skin grafts and hair follicles themselves
• Further surgery to address any complications

How much do hair transplant procedures cost?

As BetterHealth advises, Medicare does not cover costs for cosmetic procedures such as hair transplants. Australian consumer advocacy group CHOICE estimates hair transplants can cost anywhere between AU$11,000 and AU$18,000 — but in some cases, up to AU$30,000.

Remember to include recovery costs into the equation, such as any loss of wages, pain medications and travel costs.

Low-level laser therapy can assist with any scarring but usually involves multiple treatments. And as mentioned previously, it's not uncommon for people to need a touch-up procedure. In fact, BetterHealth advises that "you will almost certainly need 'touch up' surgery to improve the look of your hair transplant".

There is also the time cost, as most appointments before and after the surgery will occur during business hours, and recovery is very individual.

Some people feel fine after 1-2 days but others report pain, inflammation and effects of the anaesthetic for longer.

So beyond a surgeon fee, there is a lot to factor into the total hair transplant cost.

Hair transplant alternatives to consider

Not everyone can afford hair transplants or has the patience or health to deal with potential complications that may arise.

Thankfully, there are other options available:

• Wigs or hairpieces: Gone are the days of the obvious toupee, it's not uncommon for men and women of all ages to wear wigs
• Talking to a counsellor or doctor about any distress caused by hair loss
• Using a specific shampoo and conditioner for thinning hair, like Pilot's Hair Growth Shampoo & Conditioner, a duo specifically designed to lay the groundwork for thicker, healthier, and happier follicles.
• Pilot also offers non-surgical treatment options. And best of all, it doesn't require any face-to-face appointments. Simply fill out the text-based online assessment and one of our local practitioners will create a personalised hair loss treatment plan just for you, which is then delivered in discreet packaging to your home.

Lastly, remember that you aren't alone. Hair loss is a common and normal part of ageing, and for some people, this can begin at a young age due to genetics.

While we are almost positive that the coolest things about you aren't what your hair looks like, hair loss can be uncomfortable and upsetting to deal with. You aren't vain for considering all your options, but remember that there are options available.

Photo credit: Getty Images