Understanding hair loss

1) What are the main causes of hair loss?

Hair loss occurs when the cycle of hair growth is disrupted, resulting in the hair shedding faster than usual, re-growing poorly or not growing back at all. The most common cause of hair loss is hereditary male and female pattern baldness. However, the following conditions can cause hair loss, or alopecia, in men and women:

  • Medical conditions, including thyroid problems and anaemia
  • Drugs and medication side-effects
  • Stress and trauma
  • Dietary disorders
  • Excessive tension on the hair scalp from wearing certain hairstyles, such as tight braiding (traction alopecia)
  • Hair-pulling disorder in which there is an irresistible urge to pull out hair (trichotillomania)
  • Immune system attacking hair follicles to cause patchy hair loss (alopecia areata)
  • Scarring alopecia or scalp infections, requiring careful dermatological management

2) How often is hair loss genetic?

The most common form of premature hair loss, androgenic alopecia, or male pattern baldness in men, is much more likely to affect men with a family history of hair loss.

The hair loss is caused by the production of a testosterone derivative called dihydrotestosterone (DHT). Some men are genetically predisposed to be abnormally sensitive to DHT.

3) Are there different forms of hair loss?

Yes but by far the most common form of premature hair loss is androgenic alopecia, which in men is known as male pattern baldness (MPB). MPB will affect up to 70% of men at some stage in their lifetimes. Androgenic alopecia is surprisingly common in women, female pattern baldness (FPB), affecting some 30% of the female population at some stage in their lives.

4) When do people start experiencing hair loss?

It varies hugely. For some men, male pattern baldness can take effect in the late teens or early twenties while others will remain unaffected well into their 50s. In woman hair loss can occur at any age but is most often associated with hormonal imbalances during the menopause.

Hair loss is different to sudden hair shedding, telogen effluvium, which can occur at any point during someone’s life if the body undergoes a trauma or stressful event but will later grow back.

5) Why is hair loss more common in men than women?

Hair loss is more common in men because the most common form of hair loss, androgenic alopecia, is associated with a testosterone derivative, called dihydrotestosterone (DHT). Since men product far more testosterone than women, they are much more likely to be affected by this.

6) How can hair loss affect someone psychologically?

Hair loss can really damage people’s confidence and feelings of self-worth. Recent research carried out by The Maitland Clinic a quarter of men and 14% of women worry about going bald. Nearly a fifth of men admitted they would feel less confident if they went bald. According to Men’s Health Forum 40% of men have noticeable hair loss by age 35 and 60% of hair loss sufferers would rather have more hair than money or friends.

7) How can someone minimise their chances of hair loss?

Hair loss can have many different causes but a healthy balanced diet can help slow the process. Skipping fried food for example may reduce oil-gland activity, slowing the switch from testosterone to DHT, according to some research. There are also a number of non-surgical hair loss treatments available such as the once-a-day pill Finasteride, which blocks the formation of DHT, and Minoxidil, a foam which boosts blood flow to the hair follicles stimulating growth.

8) What is the earliest age you can lose your hair?

Men can start losing their hair in their teens as their body starts producing more testosterone and therefore DHT. For women early hair loss can be triggers by medical conditions such as hormonal imbalances or lifestyle factors at any age but it is rare for women to suffer significant hair thinning before the menopause.

9) Why do men and women lose their hair as they get older?

As you age, the rate of your hair growth slows. More follicles go into the final resting phase, and the hairs that remain gradually become fewer, finer and shorter. This is a normal process and is known as involutional alopecia.

However, there are many other types of alopecia which can occur earlier in life, leading to premature loss of hair. There remains much scientific debate about why some hair follicles have a shorter growth cycle than others, but hair loss could be influenced by a whole range of factors including genetic predisposition, abnormal hormonal levels, underlying medical conditions, stress and even diet.

10) What are the common myths associated with hair loss?

There are a number of common myths associated with hair loss. Here are a few of the most common misconceptions:

Hair loss comes from the mother’s side – not true, it is often genetic but comes from both parents

Washing hair in cold water will prevent baldness – not true, it will boost circulation but not hair growth

Hair products cause hair loss – not true, gel, wax and spray have no effect on hair loss

Wearing a hat will cause baldness – not true, hair follicles don’t need to breathe, they get their oxygen from the blood

Regular brushing of the hair and scalp will prevent hair loss – not true, this will boost circulation but will not stop hair loss as circulation and hair loss are not related

Cutting your hair will not prevent hair loss – not true, cutting your hair just makes it appear thicker as hair is thicker nearer the roots

Shampoo and sun cause balding – not true, neither of these affect the hair follicles

Two claims that are true are that very tight hair styles and the chemicals in some hair dyes can cause hair loss.

11) Will I need to take medication (finasteride) before the procedure?

In most cases male pattern hair loss is progressive and doing something to prevent or slow ongoing hair loss is recommended. We recommend that most men with androgenic alopecia (male pattern hair loss) consider the use of finasteride (Propecia) tablets. Patients not taking finasteride will be advised about alternative non-surgical treatments such as platelet-rich plasma (PRP), minoxidil (Regaine) and low level laser therapy.

12) For what reason would I not be a candidate for hair transplant surgery?

There are many factors which influence whether or not we would recommend surgery. In most cases hair loss is progressive and the majority of patients will benefit from trying non-surgical options and/or medication first. To read more about who makes a good candidate for surgery click here.

Types of treatment

1) What non-surgical hair loss treatments are available?

Finasteride

Finasteride is a once-a-day pill that blocks the formation of DHT, which is the hormone that causes follicles to shrink and eventually stop growing hair. This can stabilise hair loss and even thicken hair when used early enough. We tend to see the best results in the crown and mid-scalp areas, but it can also help with frontal recession.

Finasteride is a prescription-only medicine (POM) and is not recommended for women. Our doctor will discuss the benefits and possible side effect and advise whether it is a suitable option for you.

Minoxidil

Minoxidil takes the form of a liquid or foam applied directly to the scalp. It works by helping blood flow to the hair follicles, stimulating and prolonging the hair growth phase. Both men and women can benefit from it and most products are available without prescription.

Laser treatment

Low-level laser therapy (LLLT) can be an effective option for men and women looking to prevent hair loss and to encourage new growth. When applied to the scalp, laser light is absorbed by the hair follicles in the form of energy, improving blood flow and stimulating cell metabolism.

This can slow or reverse the miniaturising process in weaker follicles, and result in faster, thicker hair growth in healthy follicles. For both men and women, it can mean a significant slowing of the hair loss process, and can result in increased hair volume.

The laser process is painless and non-invasive, with negligible side effects. It can be carried out in our practice or conveniently in your own home.

2) How effective are these non-surgical hair loss treatments?

Non-surgical hair loss treatments are often effective in the early stages of male and female pattern baldness. Minoxidil, which can be used by men and women, has been shown to prevent further hair loss in four out of five users.

Laser treatment can lead to a significant slowing of hair loss in both men and women, and can result in increased hair volume.

3) What are the risks associated with non-surgical hair loss treatments?

The risks associated with non-surgical hair loss treatments are low. Like all medical treatments there can be side effects associated with Finasteride and Minoxidil but these are rare and most are not serious.

Low level laser therapy is painless and non-invasive, with negligible side effects.

The Maitland Clinic’s team can talk you through the pros and cons of using hair loss medication, foam or laser treatment, and advise on the best products and routines to keep your scalp and follicles healthy.

4) Are there any side effects caused by non-surgical hair loss treatments?

There can be side effects associated with Finasteride and Minoxidil but these are rare and most are not serious.

Finasteride can in some cases lead to decreased libido. More serious side-affects include allergic reactions and depression.

Minoxidil can sometimes cause burning, stinging or redness when applied. Very rarely it has more serious side effects when absorbed through the skin or having triggered an allergic reaction.

Low level laser therapy is painless and non-invasive, with negligible side effects.

The Maitland Clinic’s team can talk you through the pros and cons of using hair loss medication, foam or laser treatment, and advise on the best products and routines to keep your scalp and follicles healthy.

5) What surgical hair loss treatments are available?

There are four types of surgical hair loss treatment carried out at The Maitland Clinic. These are:

Follicular unit transplant technique

Follicular unit extraction

Beard and eyebrow hair replacement

6) When should you consider a surgical treatment?

Non-surgical treatments can help patients in the early stages of hair loss but when hair loss is more advanced surgical treatment is a better option to restore a healthy head of hair.

The earliest stage of male pattern baldness that requires treatment is stage III on the Norwood Scale, when there is noticeable loss at the temples.

Dr Ball and his team will spend time getting to know each patient in order to advise them on the pros and cons of each treatment.

The hair transplant procedure

1) How does a hair transplant work?

There are different hair transplant methods but in its most basic form a hair transplant involves taking healthy hair follicles from a part of the scalp where hair is genetically programmed to keep growing for life and transplanting them to the areas affected by hair loss.

2) Where does the hair used in a hair transplant come from?

The hair comes from an area patient’s scalp where hair is genetically programmed to continue growing for life. This is typically at the back of the head.

3) What types of hair transplant are available?

There are two types of hair transplant carried out at The Maitland Clinic. These are:

Follicular unit transplant technique

Follicular unit extraction

 

4) What do each of the different hair transplant procedures involve?

Follicular unit transplant technique involves taking a thin strip of hair-bearing skin from an area of the scalp where hairs are genetically programmed to continue growing for life. The strip of skin is then divided into tiny follicular grafts, each containing about four healthy hair follicles, which are individually transplanted into an area of hair loss.

Follicular unit extraction involves transferring hair grafts from the area of the scalp where hairs are genetically programmed to continue growing for life to areas affected by hair loss. The difference is that rather than removing a strip of donor skin from which to dissect the follicular units, FUE extracts individual follicular units directly from the scalp, leaving only tiny dot scars.

 

5) Which type of hair transplant is considered the best?

All the different types of hair transplant are extremely effective with natural looking results but different methods have different advantages.

Follicular unit transplant technique requires only a local anaesthetic and is virtually pain-free. The whole process can take between 4 and 12 hours depending on the size of the recipient area and the number of grafts that need to be transplanted.

Follicular unit extraction has the advantage of avoiding the linear scar left by FUT as individual follicular units are taken only leaving tiny dot scars which are covered by hair. Because it leaves minimal scarring FUE is ideal for people who like to keep their hair short, such as a number 1 or number 2 haircut.

It may also suit younger patients and those who only require a relatively small number of grafts in the hairline.

Again, FUE requires only a local anaesthetic and is almost completely pain-free, but it is significantly more time-consuming than FUT. A typical FUE treatment would require extracting up to 2,000 grafts and might take 10 hours, while larger cases may require more than one day in surgery.

 

6) Can someone have a hair transplant at any age or stage of hair loss?

The earliest stage of male pattern baldness that requires treatment is stage III on the Norwood Scale, when there is noticeable loss at the temples. However, modern techniques such as those practised at The Maitland Clinic mean that good results can be achieved even when the hair loss is much more advanced. For a hair transplant to work there does need to be hair still covering areas of the scalp in order to harvest the healthy follicles so someone who is completely bald cannot undergo a hair transplant.

7) How many hours will the hair transplant procedure take?

We only have one surgical patient a day, so time can be taken to ensure the best results. Each patient will be with us for a period of 8-10 hours on average.

8) How do hair transplant surgeons create a natural look?

The art of a skilled hair transplant surgeon is in studying the patients head to map out their natural hairline and the areas suffering hair loss. The surgeon must then carefully place each individual follicular unit to create a natural hair line and covering develops.

9) What preparation is needed before a hair transplant?

You need to ensure you are full informed of all the options and what they will involve before you decide on any one course of action. In an initial telephone and then face-to-face meetings at The Maitland Clinic, our patient advisor and doctor will listen to you and take the time to understand your particular situation and your goals.

We’ll give you clear guidance on all of the options available to you, the pros and cons of each and the costs involved. We’ll also give you full information about the kind of result you can realistically expect to achieve.

But we will never forget that if you decide to undertake a treatment with The Maitland Clinic, you are a medical patient under the care of our doctor, not merely a paying customer. Before recommending any particular course of treatment, we’ll take into account your age, your medical history and your general health and wellbeing. You can enter our surgery safe in the knowledge that you are receiving not just the best possible hair restoration treatment, but the best possible medical care.

10) What sort of aftercare is needed?

When you leave The Maitland Clinic after your treatment, we’ll provide you with everything you need to take care of your grafts in the first few weeks, including instructions for washing your hair and medication to manage any initial discomfort.

We provide state-of the-art Liposomal ATP aftercare sprays which optimise the healing and growth of your precious grafts.

The day after the procedure Maitland clinic staff will carry out a complimentary no contact hair wash. Patients are advised to wait at least six days after the procedure before undertaking a contact hair wash. By around day ten the patient’s head should be scab free.

But far beyond that, we see our patients as lifelong beneficiaries of our hair care service. You’ll be able to stay in contact with us for ongoing support and help on monitoring your hair growth progress, looking after your scalp, and preventing any potential problems.

You’ll be able to return to us for check-ups and maintenance procedures, giving you a lifetime of professional hair care.

11) How painful is surgery?

The only part of the procedure during which you will feel any pain is the local anaesthesia with numbing injections. These are similar to injections at the dentist. The injections take around 5 to 10 minutes to administer in the donor and recipient areas. We apply a vibrating massage device to the area being injected in order to “distract the nerves” and reduce the discomfort from the needle. The local anaesthesia provides around 2 to 3 hours of numbing effect on the scalp. Dr Ball will need to repeat the local anaesthesia but aims to do so while the skin is still numb so that the injections are more comfortable. 

12) Does the procedure have any side effects?

There can be some minor side effects associated with hair transplants such as bleeding, itching, swelling and bruising but with the correct aftercare such effects will be short lived, lasting a couple of weeks at most.

Certain medical conditions such as bleeding disorders may preclude FUT, but there may be other factors that mean Dr Ball will advise an alternative treatment.

Your age, the quality of your donor hair and considerations about future hair loss will all affect whether FUT is the best option for you.

At the consultation stage, The Maitland team talk to each patient and get a full overview of their medical and hair loss history to ensure the most appropriate treatment is chosen.

13) My hair loss bothers me now in my twenties. Why can't I have a hair transplant now and undergo more surgery as I lose more hair?

Whilst we do understand that hair loss at a young age is distressing and can greatly affect confidence and self-esteem, it is rarely a good idea to have surgery to restore a youthful hairline. Hair loss is progressive and we all have a limited amount of donor hair that can be moved from the sides and back of the scalp. Stabilising hair loss is essential before surgery in all young patients in order to improve the chances of having enough lifetime donor supply to create a natural appearance. 

14) Who will be carrying out my hair transplant?

Dr Edward Maitland Ball is the owner, medical director and surgeon at the clinic. Dr Ball carries out every procedure assisted by his world-class team at The Maitland Clinic.

Dr Edward Ball has been at the forefront of bringing world-class surgical hair replacement techniques to the UK.

A member of the Royal College of Surgeons, His background is in cosmetic medicine, general practice and plastic surgery. Trained in microsurgery and dermatology, he remains a valued member of the skin cancer surgery team at University Hospital Southampton. He was handpicked to undertake his Fellowship in Hair Restoration Surgery in Beverley Hills, California under the mentorship of Dr. Craig Ziering. He subsequently became Clinical Director of Ziering Medical UK, before founding The Maitland Clinic in 2015.

Dr Ball himself became one of the first patients to undergo an FUE hair restoration procedure using the revolutionary ARTAS® Robotic System. This gave him an invaluable insight into the experience of hair loss and hair loss treatment, and puts him in a unique position to understand and empathise with patients who are considering undergoing surgery

15) How long have you been carrying out hair transplants?

The Maitland Clinic was opened in January 2016 but Dr Ball had been a hair transplant surgeon since 2011. He was the clinical director at Ziering UK in London between 2012 and 2014. You can read more about his credentials and experience here.

16) What should I look for in a hair transplant surgeon?

Dr Ball was featured in GQ magazine where he discussed 7 points you should look for in a hair transplant surgeon. For more detail please read here.

17) Who will be carrying out each aspect of the procedure?

With follicular unit excision (FUE) Dr Ball designs the hairline and the hair coverage and extracts all the grafts himself. He makes all the recipient area incisions and decides on the areas that are safe to extract grafts from. Our team of highly experienced technicians implant the grafts under Dr Ball’s guidance. 

18) What method do you use to extract the grafts?

At The Maitland Clinic, Dr Ball extracts all the grafts personally. Dr Ball uses a variety of punch devices depending on the hair and skin characteristics of the patient. In most cases, he uses a handheld, motorised, hybrid punch, controlled by a foot pedal.

19) What size punch is used to extract my FUE grafts?

This depends on the patent’s skin and hair characteristics and typically ranges from a 0.85mm to 0.95mm punch size (external punch diameter). Dr Ball extracts a few test grafts initially to size the best punch for the individual patient. This also helps to determine the size of the blade Dr Ball uses to make the recipient site incisions.

20) What involvement do technicians have in my procedure?

All surgical aspects of the procedure are carried out by Dr Ball, but he has a highly skilled team of full-time hair technicians who assist him in theatre. They will dissect, trim and count the grafts in an FUT and FUE procedure. Also, as Dr Ball performs FUE graft extractions, he has an assistant technician beside him to collect and count the grafts. It is Dr Ball who determines the hair transplant design and the angle, direction and density of the new hair through his recipient site incisions. The technicians place the grafts into Dr Ball’s recipient site incisions during both a FUE and FUT procedure. Dr Ball’s small team of technicians are frequently complimented on their highly professional and friendly approach to their work, inspiring confidence in our patients every day. 

21) Do you perform non-shaven FUE?

There is a good deal of confusion as to what non-shaven FUE is. At some clinics, it implies shaving a large area of the donor area and covering the area with your existing long hair. In other instances, the term implies shaving the donor area completely but not shaving the recipient area. It can also imply that neither the recipient nor donor areas are shaved. At The Maitland Clinic, in certain appropriate cases, we do perform FUE with a non-shaven donor and/or non-shaven recipient area. Due to the increased technical challenges associated with non-shaven FUE we tend to restrict use of the technique to smaller cases. Shaving both the recipient and donor areas is generally preferable when possible.

22) How long will the transplanted hair last?

Provided you are fit and healthy, most transplanted hairs should last a lifetime. However, not everyone has permanent and healthy donor hair. The health of your scalp and hair will be assessed during your consultation with Dr Ball.

23) Should I shave my head or do you do this for me?

It helps Dr Ball to properly assess your scalp and plan your hair restoration if you keep your hair at its usual length for the day of surgery. If required, he will shave your head during your pre-operative consultation on the afternoon before or the morning of your procedure. For this reason, you may wish to bring a hat or hooded top to the pre-operative consultation.

24) Will I be asleep or awake for surgery?

All surgery is carried out under local anaesthetic, so you are awake for the whole procedure. However, Dr Ball offers a mild oral sedative (diazepam or Valium) which helps to relieve anxiety and helps you to relax during the procedure. 

25) What can I do during the procedure?

Patients find the procedure comfortable and are able to watch a range of films and TV shows on our various streaming services. Some prefer to listen to music or have a snooze.

26) How short will I be able to wear my hair after FUE or FUT?

Both procedures leave scarring as you are removing the entire follicle that produces the hair. This reduces the overall volume of hair in both cases, but in different ways. FUE reduces the overall density of the entire safe donor area. It leaves small dot scars which, in most cases, can be concealed with a grade 1-2 hair length. The more hair that is removed using this method, the more difficult it becomes to conceal the scarring, so a longer hair length can be required. 

In FUT, a strip of tissue is removed, leaving a line scar. The appearance and width of the linear scar is partly dependent on surgical skill but also largely influenced by a patient’s individual skin type and healing characteristics. In most cases, we suggest it will be necessary to wear your hair around a grade 4 to conceal the scar. 

27) Is an FUE hair transplant permanent?

The transplanted hairs will grow for a lifetime as they are resistant to the hormone DHT that causes male pattern hair loss. More information can be found on our blog page discussing this topic here.

28) Am I likely to be a better candidate for FUE or FUT?

During the consultation your expectations, donor hair and scalp will be assessed. Some patients are better candidates for FUE and others for FUT. The amount of donor hair required and the length you like to wear your hair at the sides and back will influence which procedure is most suitable for you.

29) Which hair transplant technique is best?

There are advantages to both FUE and FUT and no technique is better than the other when it comes to growth following surgery. Please read our blog on the subject here.

 

30) Does FUT provide more grafts?

In most patients, FUT will provide more grafts in one procedure and over the course of several procedures. To maximise donor supply a combination of FUT and FUE can be the most effective way of harvesting the most grafts from the donor area. Scalp laxity (mobility) will influence whether more grafts are available using FUT or FUE.

31) What does an FUT hair transplant scar look like?

Everyone heals differently so we can never predict exactly how your scar will appear after an FUT procedure. Dr Ball does his very best to leave you with a fine line scar and incorporates the trichophytic closure technique to encourage hair to grow into the scar itself. Healing characteristics and age will have a factor in what the scar looks like. You can see a video of a patient’s scar following nearly 4000 grafts in one session here.  

32) I had a hair transplant elsewhere and my hairline looks unnatural. Can it be fixed?

It is possible to fix a poor surgical outcome and Dr Ball has vast experience in such cases. Pluggy, unnatural-looking hairlines can be improved by either removing coarse hair and larger grafts or transplanting fine single hairs in front of them. These inappropriate grafts can be removed using the FUE method and implanted further back in the scalp. The healing is typically very good in the hairline and scarring tends to be very subtle. 

33) I had a previous transplant and want to conceal my FUT/strip scar. How is best to do this?

There are several ways to try and help reduce the appearance of a strip scar. If the scar is wide and the laxity allows, it might be advised to revise the scar. This would involve cutting out the scar tissue and replacing with a new scar. There are no guarantees that method can create a finer scar because your own healing characteristics are often the determining factor. 

Another option for concealing a scar involves placing grafts extracted by the FUE method into the scar tissue. Some patients also have success with scalp micropigmentaton (SMP) into scars.

The consulting process

1) What is the process for undergoing a hair transplant procedure?

In a face-to-face meeting at our Portsmouth clinic, our patient advisor and doctor will listen to you and take the time to understand your particular situation and your goals.

We’ll give you clear guidance on all of the options available to you, the pros and cons of each and the costs involved. We’ll also give you full information about the kind of result you can realistically expect to achieve.

Before recommending any particular course of treatment, we’ll take into account your age, your medical history and your general health and wellbeing. You can enter our surgery safe in the knowledge that you are receiving not just the best possible hair restoration treatment, but the best possible medical care.

If you are having a hair restoration procedure, your treatment day will take place at our state-of-the-art clinic discreetly located a short drive or train journey from London on the south coast. We can even arrange transport and accommodation for you to ensure maximum convenience and comfort.

Before surgery you’ll have a meeting with your doctor, who will talk you through the procedure and will assess you to make sure you are in the right condition to receive your procedure.

Although our treatments are medical operations conducted in a theatre, we have made every effort provide an environment that is comfortable and pleasant. All of our procedures are conducted using local anaesthetic, which is very like an injection at the dentist and is the only discomfort you will feel throughout the process.

You will be awake but relaxed throughout the day, and able to watch a movie or use an iPad while the procedure is taking place. We have made a treatment at The Maitland Clinic as much like a spa day as possible – and more than one patient has even said that their day with us was the most enjoyable ‘me time’ they’d had in years.

When the procedure is complete we will again assess you to ensure you are in full health and able to leave the clinic. We’ll provide you with everything you need to take care of your scalp, and full information on how to look after your new hair roots in the coming days and weeks.

2) Who will I meet at my consultation?

Your initial consultation will be with David Anderson, Senior Patient Advisor, who will collect information about your hair loss history, take detailed global and trichoscopic photographs for our doctor to assess, and inform you of the general principles of hair restoration. If considering surgery, you will also need to see Dr Edward Ball who will assess your hair loss, make a diagnosis and explore treatment options with you. There tends to be a longer waiting list to see Dr Ball on the same day as your initial consultation with David Anderson, which is why we offer the more readily available initial consultations with David if you are keen to make a start on your hair restoration journey.

3) Why do I need to see Dr Ball for a consultation before I can book a hair transplant?

Hair restoration surgery is a surgical procedure intended to treat medical conditions such as androgenic alopecia, traction alopecia and certain scars. A full medical assessment is needed to review your general health and the health of your scalp and hair before establishing a diagnosis. Only then can a safe and personalised treatment plan be explored with you.

4) Is my GP informed about my hair loss consultation and treatment?

The Maitland Clinic is fully compliant with GDPR and your confidentiality is always respected. We hand you a GP letter summarising Dr Ball’s assessment at the end of your consultation. We ask that you hand this to your GP if you are comfortable with sharing this information.

5) Why is there such a long waiting list to see Dr Ball for a consultation?

We differ from many hair transplant clinics in that, when operating, Dr Ball likes to commit 100% of his attention to his surgical patient. As a result, he doesn’t pop in and out of theatre to carry out consultations while he is carrying out the surgical aspects of a hair transplant. This means that you get to enjoy Dr Ball’s undivided attention during your surgery but there may be a slightly longer wait for your initial consultation with him.

6) How much is a consultation?

A consultation in Portsmouth with David Anderson is £50 and a consultation to meet with David and Dr Edward Ball is £150. 

7) How long is my consultation?

Every patient has different needs and questions, but a typical consultation will last around 45 minutes.

8) Where can I been seen for a consultation?

Consultations are available in our surgical venue just outside Portsmouth.

9) What happens during a hair transplant consultation?

There is lots to discuss during the consultation and it includes a detailed assessment of your hair and scalp. Please read our blog for more information.

10) If I meet with David Anderson, will I need to see Dr Ball before surgery?

David provides general advice and education based on over 10 years of experience helping hair loss patients and his own personal journey. He will take detailed global and trichoscopic photographs of your hair and scalp and gather information to assist Dr Ball in formulating a personalised treatment plan for you. If considering surgery, you will also need to see Dr Ball who will assess your hair loss, make a diagnosis and explore treatment options with you.

11) What is the difference between a consultation with David and Dr Ball?

In short, David Anderson offers a service which provides you with a wealth of information, and a way to avoid the longer waiting times to see Dr Ball.  Any consultation with Dr Ball will also be with David. However, David also offers consultations alone in order to gather information and provide general education about hair restoration options. This can help you avoid the longer waiting times to see Dr Ball, whilst making a highly constructive start on your hair restoration journey. If considering surgery, you will ultimately need to see Dr Ball for an analysis of your hair and scalp, in order to establish a diagnosis and to facilitate a discussion about your own specific treatment options.  

 

We recommend that anyone travelling some distance arranges to meet Dr Ball at their initial consultation.

12) Is there free parking at the clinic?

There is ample free parking at our Portsmouth clinic.

13) How quickly can I book a hair transplant procedure?

We require you to have at least two weeks reflection (a “cooling-off” period) between your medical consultation and the date of any surgical procedure. Any deposit or payment for treatment is fully refundable during this time. 

Results of hair transplant procedure

1) What is the success rate of hair transplant procedures?

Hair transplants are very successful at replacing significant amounts of hair loss but the final results will be dependent upon many personal factors such as:

  • hair characteristics – coarse, curly hair will appear thicker than fine, straight hair
  • contrast between hair and skin colour – for patients with pale skin and dark hair the skin will be more visible through the hair, making it appear thinner
  • extent of hair loss – this will affect the ratio of donor area to recipient area
  • skin laxity – this will determine how much tissue can be taken in a FUT strip
  • size of head – in larger heads it is possible to harvest more grafts
  • donor area density – dense hair in the donor area will provide a greater supply of follicular units
  • donor follicular unit groupings – donor supply with lots of 3 and 4 hair follicular units will create more ‘thickness’ than one consisting mainly of 1 and 2 hair follicular units.

No treatment can guarantee a level of transplanted hair thickness that is inconsistent with the thickness and characteristics of your existing hair.

Before you opt for surgery, The Maitland Clinic team will give you a honest and realistic idea of the kind of result you can expect to achieve given your particular characteristics and circumstances – so you go into your procedure fully informed, safe in the knowledge that we can give you the best chance of achieving your goals.

2) How long will it take for the results of the procedure to show?

New hairs will begin to grow through in the treated areas of the scalp about four months after surgery, continuing to thicken over the first 10 to 15 months. These hairs will continue to grow in the same way as those in the donor area, creating a natural, fuller head of hair.

3) Will I be left with bruising or scarring from a hair transplant?

Follicular Unit Transplantation will leave a small linear scar where the donor strip is taken from the scalp. This is usually at the back of the head and is covered by the patient’s hair.

Follicular unit extraction only leaves tiny dotted scars where individual follicular units have been taken from the scalp so is preferable for people with very short hair.

4) How long will the results last?

This will vary hugely according to the patient’s age, type of hair, lifestyle and more. In some patients a hair transplant can offer a lifetime of healthy hair but no treatment can guarantee a level of transplanted hair thickness that is inconsistent with the thickness, characteristics and lifespan of a patient’s existing hair.

5) Will I need another procedure?

It is not uncommon to undergo more than one hair transplant procedure during your hair restoration journey. This may be in order to add density to a previously transplanted area, address a new area or transplant hair to areas of ongoing hair loss. Taking hair loss medication (such as finasteride and/or minoxidil) can stabilise ongoing hair loss and help to reduce the need for further surgery.

Unfortunately, some of the patients we see at The Maitland Clinic have had a hair transplant procedure elsewhere but found the result unsatisfactory. This might be because they have undergone a procedure that is now out of date, or often they have been let down by what seemed a low-cost option, or by an advertisement, perhaps in a country where there is less regulation of the hair restoration industry.

If you wish to discuss having corrective surgery for a previous hair restoration procedure, Dr Ball will be able to examine you, identify how the current hair design can be improved or corrected, and provide a realistic idea of the kind of result you can expect.

6) What will the clinic do if the transplant does not work?

If our hair transplant procedures are not likely to help a patient, usually because they do not have enough healthy hair to harvest, we will advise against surgery during the consultation phase.

To ensure the best possible long term results, the Maitland Clinic provides comprehensive aftercare to all its patients. We see our patients as lifelong beneficiaries of our hair care service. You’ll be able to stay in contact with us for ongoing support and help on monitoring your hair growth progress, looking after your scalp, and preventing any potential problems.

You’ll be able to return to us for check-ups and maintenance procedures, giving you a lifetime of professional hair care.

7) Why do hair transplants not work for everyone?

No treatment can guarantee a level of transplanted hair thickness that is inconsistent with the thickness and characteristics of your existing hair. A patient whose donor hair is very fine, straight or sparse will not be able to achieve the same results as someone with course, curly, dense donor hair.

8) What are the risks and potential complications?

There are minimal risks with hair transplant surgery if it is performed correctly. Some patients might experience ingrown hairs or folliculitis. Others may experience temporary shedding or “shock loss” of their original native hair in the recipient or donor areas. Infection is always possible with any surgical procedure, but we find this to be very rare. A significant risk is poor surgical technique and planning. For example, a low, straight hairline might look ok for a few years, but will look unnatural as the patient ages or loses more hair in the future.

9) Will I suffer shock loss after a hair transplant?

Shock hair loss (or shedding) usually happens between two and eight weeks after an FUT or FUE hair transplant, when your new hair grafts enter a resting phase and the hairs are shed. This is a perfectly normal and natural process and is nothing to worry about. Your new, healthy hairs will soon begin to grow in their place. However, the term shock loss can also refer to the shedding of existing hairs in and around an area of your scalp where new grafts are placed or within your donor area. Please read our blog on the subject here.

Treatment costs

1) How much does a hair transplant cost?

It depends from patient to patient and an in-person consultation is needed to determine suitability for a procedure and the estimated price.  As a guide, at The Maitland Clinic the average cost of a procedure is between £6000-£7000, with prices starting at £3500.

2) Why are some hair transplants clinics cheaper than others?

Prices will vary from clinic to clinic and country to country, usually depending on the number of patients a day that are treated and the quality of the service. Other factors will be the level of involvement of the doctor during the procedure and the experience of the staff. There are, of course, many other factors which are discussed here.

Aftercare

1) Can I drive home on the evening of surgery?

You will not be able to drive yourself home on the evening of surgery as you will usually have been given diazepam during the procedure. It is fine to drive home the following morning.

 

2) Do I need to return to the clinic the day after surgery?

Although you are always welcome to pop in for a check-up, most patients tend to head straight home the day after surgery. We do not suggest a hair wash on the first post-operative day, so there is usually no intervention required. We like to see photographs of your scalp as it heals and encourage you to keep in touch during the healing period. 

3) How soon after a hair transplant can I wear a hat?

You can wear a hat the same day as the procedure, however you have to be very careful in the first 6 days post op. If you wear a hat you must ensure that the material of the hat does not touch the grafted area. Immediately after a hair transplant, a loose hooded top can be worn over a layer of cling-film to protect the grafts. Later in the week, a loose-fitting baseball cap or similar is preferable to a beanie hat. At 6 days post op you can wear most hats without damaging the grafts. You can read more here.

4) What is the average healing time after an FUT hair transplant?

In most cases, there are minimal signs of surgery (other than the new graft stubble) after 10-14 days post op. With FUT, the stitches need to be removed 10-14 days after surgery. More information about the post op period following an FUT procedure can be found here.

5) How long will it take to recover after an FUE hair transplant?

10 days after an FUE procedure most patients are free of scabs and display little or no signs that surgery has taken place (other than the new graft stubble). Our blog on FUE and recovery can be found here.

6) I am having a hair transplant to my temple corners (frontotemporal angles). Do you have to shave all my head, or can I leave the hair longer behind to cover?

The hair in the area that we are placing grafts needs to be shaved in most cases for the best results. If this is a small area, then it is possible to grow your hair longer behind this area to brush forward and cover the grafts following surgery.

7) How long will the post-op redness last after a FUE or FUT procedure?

This does vary from patient to patient but most patients do not have redness in their scalp after day 10-14 post-op. Patients with fair skin types can retain skin redness for longer. 

8) Does FUE leave scarring?

Any surgery will leave scars and the FUE technique leaves small dot scars throughout the donor area. However, this method of extraction usually leaves very subtle scarring that can be concealed by a grade 1-2 hair length. More information can be found here.

 

9) When does the transplanted hair start to grow?

The newly transplanted hairs will typically shed 2-4 weeks post-op and there will be a period of waiting for the new hairs to re-appear. In most cases, some of the transplanted hair will start to appear 3-5 months after a hair transplant.

10) When will I see my final results?

Most patients see their full results around one year after a hair transplant. In some cases, patients can be a “slow/late grower”. These patients may have to wait 18 months to see full maturation of the transplanted hairs.

11) How long after a hair transplant can I return to exercise?

This does vary depending on your procedure but, in most cases, light exercise can be restarted 6 days after surgery and full exercise can be restarted at day 10 post op. We tend to suggest waiting up to 14 days after FUT surgery. For more information please read our detailed blog.

12) Has The Maitland Clinic been assessed by CQC (Care Quality Commission)?

Yes, the clinic and staff were inspected in September 2018 and the report can be read here.

 

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