According to someone who’s just had one.
Warning: Contains graphic imagery including blood
A hair transplant wasn’t on Liam Stretch’s 2024 bingo card.
The 28-year-old Christchurch-based editor says he held his own prejudices around the procedure, having seen the countless TikTok videos of men travelling abroad and returning looking “a
He’d been fighting a losing battle with his receding hairline since his late teens, but says it started to get “really bad” over the past couple of years.
His quest for a fuller head of hair started with a prescription for topical minoxidil (a medication used for pattern hair loss). Then came the flurry of natural remedies like rosemary oil and tools like derma rollers, said to stimulate hair follicles and promote new hair growth.
Nothing worked.
It wasn’t until an interview with former Married At First Sight New Zealand star and entrepreneur Samuel Levi that Liam’s stigma around the procedure took a permanent pivot. Samuel had attended a newly opened hair transplant clinic across the Ditch and seen incredible results.
A thorough consultation followed, where Liam’s candidacy was assessed by reviewing his medical history, determining the pattern, extent and stability of hair loss, evaluating the amount of sufficient healthy hair in the donor area (usually the back of the head or sides of the scalp) and expectations for results (usually seen between 12 to 18 months post-procedure).
Interestingly, Liam was asked if he’d ever suffered from body dysmorphia, a condition which can be triggered by balding or hair loss.
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Advertise with NZME.Ten days later he booked a ticket to Sydney to visit Dr Will Jarvis and his team at Elite Hair Clinics.
“When that conversation came about, I thought: “Well, why not? I’m in my late 20s now, there are a few things I could do for some self-care and give myself that love that my body deserves,” says Liam.
Hair loss, in particular male pattern baldness, is more common than most would think says Dr Jarvis, adding that approximately 30% of men are affected by age 30, 50% by age 50, and up to 80% by age 70.
The onset of male pattern baldness typically occurs between ages 20 and 25, Dr Jarvis explains, with the likelihood and severity increasing with age.
For Liam, hair loss isn’t a topic that commonly crops up during catch-ups with his mates, and if it does, it’s usually in the form of banter.
“The way most males might talk about it is like banter, which is actually hurtful. Even if it’s banter, you begin to internalise what’s been said and that’s a negative thing,” Liam says, adding he hopes that his story helps lift the stigma around hair transplants.
“I’m all for people doing it if they’ve got the financial capability and the time to do something about it [hair loss] and make themselves feel better.”
The prep
Ahead of his August 28 appointment, Liam was advised to steer clear of coffee, alcohol and cigarettes, along with foods or medications that would thin his blood or increase his blood pressure during the 10-day window before the procedure.
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Advertise with NZME.It was recommended he arrive in Sydney a couple of days ahead of his appointment to get settled and visit the clinic.
For best results, Dr Jarvis advised Liam to shave his head prior to the procedure, meaning the team could better assess the treatment area.
The procedure
At 6.45am on August 28, Liam arrived at Elite Hair Clinic, a stone’s throw from Sydney Opera House in the heart of the CBD.
Their team of doctors, technicians and registered nurses are trained in FUE (Follicular Unit Excision) hair transplants with more than 25 years’ combined experience performing the procedure on people’s scalps, beards and eyebrows.
As Dr Jarvis explains, FUE is Elite Hair Clinic’s preferred hair transplantation technique as it’s less invasive than other methods and offers patients a faster recovery time than Follicular Unit Transplantation (FUT) - think days not weeks of downtime. After FUE, patients can engage in light activities within a week and resume their regular activities within a month
Put simply, it calls for: “Extracting individual hair follicles directly from the donor area using small, cylindrical punches to leave minimal scarring,” he says.
FUT is another common technique, but Dr Jarvis says this method requires removing a strip of the scalp from the donor area, dissecting it into individual follicular units and transplanting them to the balding area, leaving a linear scar on the scalp.
The post-procedure downtime for FUT is significant, with most patients having stitches removed after 10-14 days and being left with a linear scar (which is covered by new hair growth).
At Gro Clinic, a hair loss specialist with clinics located in Sydney, Melbourne, Brisbane, Gold Coast, Perth and Auckland, a third type of hair transplant is available.
Precise Follicle Placement (PFP) is touted as an elevated take on the FUE method, with the team claiming better control over the depth, direction and angle of each inserted follicle to ensure results that blend naturally with existing hair. This method allows technicians to place hair follicles closer together, for improved density and thickness.
During PFP transplants, follicles are placed with minimal impact to the scalp, meaning scarring is kept to a minimum and blends with the hair as it grows.
After a series of ‘before’ photos were taken, Liam had his head shaved again before the team explained the minimal risks involved, including prolonged numbness or what to do in the unlikely event that the transplant fails.
Together with Dr Jarvis, Liam decided on where his new hairline should sit to give the most undetectable result. “We agreed on a pretty natural approach that will age well with me, and not look too artificial as I grow older,” Liam says.
Spread across 10 hours, the procedure is split into three phases: harvesting (where follicles – known as ‘grafts’ – are taken from the donor site), preparing the recipient area and transplanting grafts.
“Follicles are harvested from the donor area, recipient sites are fashioned with a micro-scalpel and finally planted with the grafts at the correct depth and direction to mimic natural growth,” Dr Jarvis explains.
If a day-long procedure sounds mind-numbingly boring (or scalp numbing in this case) then you’ll be grateful to learn that regular breaks are offered, and Liam says they stopped plenty of times for snacks and a lunch break.
At the time of his procedure, Charli XCX’s Brat had just dropped, which Liam says helped to pass the time.
In the harvesting phase, local anaesthetic was used to numb Liam’s scalp, before a technician got to work taking every third or so follicle from the back of his head.
A meticulous process, especially when you think that the average person has 100,000 hair follicles on their head.
For Liam’s procedure, 4900 grafts were collected, which were then passed on to a team who counted, cleaned and processed each one by hand, helping to prepare them for implantation at the recipient site.
“This sounds a little bit gross, and you can feel it but you’re not in any pain, because you’ve got anaesthetic. You can feel the sensation of thousands of tiny little holes on the area where the hair is going to be implanted,” Liam says.
Next came Liam’s prep steps ahead of implantation, which included an optional exosome treatment that helps with recovery and growth. The treatment sees exosomes (which are derived from stem cells) injected into the scalp at sites of hair loss to help repair the scalp tissue, enhance the survival of transplanted hair follicles and stimulate new hair growth.
It’s also said to help patients avoid what’s known as the “ugly duckling phase”, when everything is a bit uneven, and hair is growing at different rates (thankfully everything does tend to catch up eventually).
Dr Jarvis says the best grafts are those that contain two, three or four hairs per follicle, which will achieve better hair density. Some single hair grafts can be taken, but generally they’re planted with other singles to give the illusion of thickness.
All hair types can be grafted, including ultra-thick or curly hair (which gives a better result than fine or straight hair as you’re less likely to be able to see through the hair to the scalp).
A graft’s survival rate is largely dependent on blood flow to the area, along with the density at which grafts are placed per square centimetre around the head.
By 5pm, the team of 12 people who had been working on Liam put down their tools.
The aftercare
The following day, Liam returned for a clean and was given an aftercare sheet to follow which included advice on everything from which medications to take along with tips on how to keep the area clean and protected.
Dr Jarvis says rest during the first week is a must.
“Patients can wear a soft cap four days after the procedure and start getting back to normal life,” he says. “After 10 days, any residual scabbing will be washed off and the grafts will have taken root firmly.”
The risk of infection is generally pretty low, Liam says. He was advised to use saline spray on day one post-procedure, and pathenol foam on day two to help speed up the healing process.
Avoiding sun exposure is a must, so instead Liam was given a soft cap to wear for three months while out and about. Back sleeping is also recommended, using a neck pillow to prevent too much movement.
While Liam says the aftercare process was very gentle, the worst part was the itching.
“Because everything’s healing it gets quite itchy. And you can’t touch it of course, which is the most frustrating part,” he says.
Liam’s top tip for anyone interested in hair transplants is to take a support person along. He travelled with his aunty (a former nurse) who helped care for him at their hotel during the couple of days post-op before the pair flew back to Christchurch.
The cost
Now for the million-dollar question, how much does a hair transplant cost?
The price varies depending on the clinic, the number of grafts required, and the team involved. Most clinics will charge per graft. At Elite Hair Clinics, this starts at $3.40 per graft and decreases for larger cases, Dr Jarvis says.
Liam had 4900 grafts; you do the math.
Additional recovery therapies, like Liam’s exosome treatment, are a further cost.
In New Zealand, some clinics charge as much as $14 per graft, while in Turkey, you can expect to pay between $1 to $4 per graft.
The results
Dr Jarvis says most patients are delighted with how their scalp looks during the first month, before the shedding (or aforementioned “ugly duckling” phase) sets in, which can go on for a few months.
By month four or five, patients can expect the hair to begin to grow in earnest, with results continuing to improve for 12 months for the frontal area and 18 months for the crown area.
While transplanted hair is generally permanent, Dr Jarvis adds that non-treated areas can continue to experience hair loss. Most patients will be prescribed a hormone blocker (finasteride) to help thwart hair-loss hormone dihydrotestosterone, along with hair growth medication minoxidil.
Transplanted hair looks best when it’s slightly longer (say 4 or 5cm from the scalp) which will help give a more natural result, otherwise the difference in density and diameter with existing strands can make transplanted hair more obvious.
Despite only being three months post-op, the impact Liam’s hair transplant has had on his confidence and mental health has been life-changing.
“It has improved things, but I think it’ll be different once again after I can take my hat off and walk around outside as normal,” he says.
“I feel more confident already, even though I’ve just had something major done to me.”
Treatment alternatives
Hair transplant not for you? Try one of these more conservative therapies instead.
Medications
The most common medications to treat hereditary hair loss include minoxidil and finasteride (both of which are often prescribed to use post hair transplant to boost results).
Minoxidil comes in liquid, foam and shampoo forms and can be applied to the scalp twice daily to help regrow hair, slow the rate of hair loss (or both) across a period of six months.
Finasteride is a prescription drug available in pill form which helps to slow hair loss, but needs to be taken ongoing to maintain results.
Other oral medications include spironolactone or dutasteride which promise similar effects.
PRP (platelet rich plasma)
While PRP is most commonly associated with facials to boost collagen and restore glow to skin, the treatment is equally effective when used to combat the effects of hair loss by restoring thinning hair and treating balding using natural stem cells.
It consists of centrifuging a sample of the patient’s blood to separate the platelet rich plasma, which is rich in growth factors. This is then injected into the scalp to stimulate hair growth. For best results, it’s recommend to try monthly PRP treatments for a minimum of three months.
PRP can also be added into any post hair transplant treatment plan to enhance overall results.
Laser therapy
Clive Hair Clinics in Auckland, Wellington and Christchurch offer low-level laser therapy to help address hair loss. A helmet-style device is placed on the head for the duration of the 25-minute treatment, which uses 282 lasers and LEDs to stimulate cell metabolism at a follicular level to treat genetic hair loss.
At-home options are also available, and are priced upwards from $900.
Microneedling
The Hair Clinic, with clinics in Auckland’s Remuera and Howick, provides both scalp microneedling and PepFactor treatments to stimulate stem cells in the hair follicle and supercharge growth.
PepFactor sees peptides and nutrients combine to regenerate new tissues in the hair and scalp, and is injected into the superficial layers of the scalp. It’s said to increase the size of the hair follicle, and promoting growth by replicating the hair’s anagen (or active) phase in the hair growth cycle.
Microneedling and PepFactor can be paired with a course of minoxidil or PRP to enhance results.
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