I Had a Hair Transplant (12 month results shown)

A trivial thing to write about? Absolutely. Alas, here we are.

I’m writing this post for a few reasons.

Firstly, guys tend not to be so great at talking about insecurity when it comes to their looks in any capacity, let alone hair loss. I think in the grand scheme of things this probably hurts more than it helps.

Secondly, I think everyone has the right to do whatever they want with their bodies and not feel embarrassed about it. I admire men and women who are open about any cosmetic work they’ve had done, and I personally have benefited from reading and listening to their experiences. I’d feel like a hypocrite if I didn’t at least make some effort to be open in the same way.

Thirdly, I’m in the strange position where I’m now being watched on a semi-regular basis by a large audience online, many of whom are younger than me, so I feel somewhat obliged to be open about what parts of my appearance are artificial (not that I’d be delusional enough to think anyone is using me as a beauty standard, but still).

And fourthly, if I’m entirely honest, my motives are selfish. I find being open about my insecurities an oddly protective thing - I get to mock myself before anyone else does.

In a Nutshell

In February of 2021 I had a hair transplant.

I did this because my rapid hair loss seemingly halted when I fixed my health issues caused by my eating disorder and exercise addiction.

The word transplant can be misleading. I haven’t taken anyone else’s hair – I’ve simply relocated some of mine - from the back of my head to the front.

I had just under 2,000 follicles relocated, which restored my natural hairline. Hair Transplants range from 800 to as many as 12,000 follicle relocations.

The full results of the procedure usually take about a year to see. This is because when the follicles are relocated, they begin a new growth cycle, so you go through an odd dip where all the hairs you just implanted fall out, and you wait (and hope) for them to grow out once more.

I am writing this in April of 2022, and can confidently say that my results were pretty good.

I had my procedure done at the Harley Street Hair Clinic in London. I paid a sum that sits comfortably into the four figures for it (as you’d imagine, the price varies depending on the extent of the procedure).

This was not a ‘complete’ surgery – I still have areas at the top of my scalp where I’ve lost significant amounts of hair (though I am trying to fix this with minoxidil – more on this later).

The surgery covered about 1/2 to 2/3rds of the area which experienced significant hair loss. Often hair transplants are done in two parts – firstly to avoid excessive trauma to the scalp (there’s only so much you can heal from at once) and secondly to see if you respond well to the procedure in the first place. I will likely have another procedure at some point.

One year later (pictured with my much cooler sister)

I like my new look. I feel more confident in myself for the most part, however I definitely think more about my looks than I did before the procedure. This is mainly because prior to the procedure, when I shaved my head, I had mentally “opted out” of the beauty game, as it were.

If you’re losing your hair, or worried about losing it, the end of this post covers the basic science of hair loss, along with some suggested actions.

The rest of this post covers the long story.

It covers why I did this, given I was genuinely living quite happily with a fully shaved head for several years prior.

It covers the procedure itself, before during and after.

And it covers where I’m at now, and what I’m doing to try and look after my hair.

If you’re someone who has experienced, or is worried about hair loss, my hope is that you’ll find some part of this post useful – if not technically, then perhaps emotionally.

Why?

I shaved my head aged 23 in May of 2018. I wrote about it at the time here

I had been losing hair rapidly for a couple of years, and basically decided fuck it.

Shaving my head was an extremely positive experience. I rocked the bald look for several years without shame or insecurity. While yes, I did feel less attractive without hair, I never felt particularly attractive anyway prior to that, so it didn’t make much of a difference.

I went on lots of dates, performed improv comedy shows to hundreds of people, started a new job, made new friends, all without giving my new appearance any more thought than I had previously. I quickly thought of myself as “a bald person”. Life went on.

But then two things happened:

1. I was diagnosed with an eating disorder and exercise addiction

2. The pandemic.

1. Diagnosis

I was diagnosed with exercise-induced hypogonadism in June of 2019, when I was 25. I’ve written about my diagnosis, and subsequent recovery here and here - however, to give the story in brief:

In my early 20s I self-medicated against an increasingly worsening depression by engaging in an increasingly intense exercise regime (often up to twice a day, every day). Simultaneously I was practicing extreme fasting (often not eating for 40 hours at a time…while still exercising).

Obviously, from where I’m sitting now, this behaviour seems self-evidently destructive and unhealthy. But back then, I genuinely believed what I was doing was good for me – not only on a physical level (I had heavily bought into the hype around fasting) but also on a mental or even spiritual level.

Though I wouldn’t have articulated it in these terms at the time, I saw my excessive exercise regime, and self-imposed misery with hunger, as almost moralistic. I thought myself somehow better, tougher, than those around me. What I now see as a way of desperately exerting some level of control in a life where, in the grand scheme of things, I felt I had none, at the time I believed my actions to be serving me as a bulwark against suffering.

I now know there are better ways to approach such predicaments. But I digress.

When I was eventually diagnosed with these issues around exercise and food – and forced to accept them – I went into therapy, intentionally gained some weight, got healthier, and became much happier.

And, noticeably, my hair stopped falling out.

2. The Pandemic

While obviously the Pandemic was a worldwide horror which I hope never befalls humanity again, on an individual level it was undeniably good for me.

The job I had leading up to the pandemic was extremely travel intensive. I would typically fly to several different European countries in any given week. Monday in Estonia, Tuesday in Finland, Wednesday in Germany, Thursday in the Netherlands… and so it goes.

On one particularly busy Tuesday, I visited four countries in the space of 24 hours for various meetings.

This is too many countries.

So while I had gained weight and had found a better - if somewhat necessarily chaotic - regime for exercise, my sleep was wildly inconsistent. I was extremely stressed most of the time. Life was good, but manic and stressful.

Then the pandemic happened, and as you know, all travel stopped.

Suddenly, my life was radically simplified. I was no longer waking up at 5am worried about a flight I had to catch that day, or constantly being tugged to-and-fro by a waxing and waning 2 hour time difference. I finally had consistency. My circadian rhythm had an actual chance - I went to sleep in the same bed every night, at the same time, in the same time zone. I could cook and control all of my meals, and eat when I needed to.

My days became dull and predictable, and that was wonderful for me.

Furthermore, the industry I was working in – cyber security – was one of the few that saw a huge surge in business during the pandemic. So, while I was often spending days glued to a laptop screen, doing hours of calls each day back-to-back, I had no anxiety about work, losing my job, or money.

I spent my newly-acquired consistent downtime gently exercising in the garden, playing videogames, catching up on sleep and basically processing everything that had happened in the previous years. Not seeing people for a span was also something I didn’t know how badly I needed.

During this time, I decided to grow out my hair again in an act of grim curiosity. While it didn’t look great, it wasn’t nearly as bad as I thought it might be. I also found, to my delight, I was finally able to grow facial hair.

Turns out chronic stress might not be good for you or your hormones - who knew.

Towards the end of 2020, when spending some time with friends, a photo was taken of me whereby my head happened to be angled the same way towards the camera as another photo taken 18 months prior. It struck me that my hairline had not noticeably changed since the efforts I made to get healthy.

I wondered if, perhaps, my lifestyle choices had accelerated whatever natural hair loss would have inevitably happened to me with age.

I knew I had the gene for male pattern baldness, however, this matters less than you might think.

Lots of men have that gene, but often it only fully expresses its effects later in life. My male relatives - my father, my uncles and grandfathers on both sides of the family - didn’t really experience any significant hair loss until they were at least in their 50s, and even then it has been gradual. Inevitably, some of them must possess the same gene I do.

I had up until this point, never seriously considered a hair transplant, mainly because the rate at which I lost hair from the age of 21-23 I figured would render my head as smooth as a bowling ball by the time I was in my late 20s, and it simply was not an actual option.

But now my hair loss had seemingly halted, and, therefore, it seemed like something that could be fixed.

Procedure

I visited the Harley Street Hair Clinic for two reasons.

1. It was recommended by a friend, and

2. It was the Pandemic, and I couldn’t exactly fly to Turkey (which, for those of you who don’t know, is the hair transplant capital of the world – procedures are so cheap that even factoring in flight, hotel and procedure costs, the total sum often comes to barely a quarter of what the same work would cost in London).

After speaking with the clinic, I was thoroughly sold, and went for it. I booked the procedure for February of 2021, hoping that I’d still be working remotely, and so would have the ability to shut my camera off during video calls for the first two weeks post-surgery where my head would be red and covered in scabs, and generally extremely unappealing to look at.

February rolls around, I take roughly a week off work. The procedure takes two days. Each day is split into the morning whereby they extract follicles from the back and sides of my head, and the afternoon where they insert them.

For context, there are two main types of hair transplant procedure:

Follicular Unit Extraction (FUE) – hair follicles are extracted and transplanted one-by-one.
Follicular Unit Transplantation (FUT) – a patch of skin, containing lots of follicles, is lifted and shifted to transplant the heir.

Both have pros and cons, but there doesn’t seem to be much in it. I had FUE.

Local anaesthetic is used for the procedure. Besides the initial insertion of the first few needles needed to make your skin numb, it’s fairly painless - if somewhat uncomfortable. I passed the time making small talk with the operating staff, watching Netflix (where I finally watched Stranger Things) all while bleeding absolutely everywhere.

After the two days of procedures I was given some antibiotics along with a salt spray to apply onto my scalp every 2 hours or so in order to prevent infection. I was also given some medication to prevent excess swelling.

I’m not sure how effective this medication was. My swelling was so bad that I got two black eyes simply from the fluid draining from my head. Given I have no control to test this against, perhaps had I not taken the medication my head would have simply exploded. For a good week I looked like I had been in a serious car crash or had been beaten to a pulp by the roadside.

Sleep at first was difficult, as you need to avoid putting any pressure on the transplanted area. For me this meant sleeping like Dracula for a week or so. All part of the fun.

Eventually my face returned to its normal shape. You’re only allowed to exercise, and basically resume normal life, 10 days after the procedure (and it shows how not-quite-recovered I was, that it was this abstinence from physical activity which was genuinely the thing I was most worried about with this whole ordeal).

I went back to exercising, appearing on video during calls, and eventually making videos. Life went on.

Results

I think it’s pretty self-evident that the procedure worked.

The Harley Street Hair Clinic take all the credit - they were absolutely amazing throughout.

While I have no regrets, it is worth mentioning the following:

For the first 12 months, I was examining my hair all the time. I was for a short time more self-conscious than I had been when my head was shaven.

And secondly, when my hair really started to grow out, I felt odd about receiving compliments about it. Particularly if the person in question didn’t know me beforehand. Compliments like this on a date made me feel a bit like I was doing some false. Yes, it is my hair but really, it’s kind of a more elaborate wig isn’t it? Or am I overthinking? And while - on the one hand - every time I received a compliment it added to my confidence that it was a good decision, it did quietly also add to my growing, almost retro-active, anxiety about how bad I looked before.

This was epitomised when, in the space of a week, two completely separate people in my life who I interact with semi regularly by way of weekly errands and so on, told me that they thought that when I had gone bald, I must have had leukaemia or something, given how pale and washed out I looked.

Best not to analyse.

Did people notice?

Obviously people noticed I suddenly had hair again, but I really don’t know how many people noticed I had work done.

Naturally, my closest male friends noticed immediately (in your late 20s you become acutely able to detect hair loss in yourself and others) and they were savagely, yet lovingly, open about letting me know they knew. I imagine others with whom I was less close may have noticed, but probably didn’t say anything to me about it, politely being discreet.

What did surprise me was how many people I was close with, who – when I did eventually tell (long after the results of the transplant were more than apparent) – genuinely had no idea. Most figured I had just let my hair grow out again, or that it looked better now that I was healthy.

It goes to show how few people, at least consciously, register these things.

Furthermore, in all of the hundreds of thousands of comments I’ve received on my tiktok videos, many of which I’ve read, I can only recall about 5 or 6 that noted they could tell I had work done. Whether this speaks to the quality of the work, or the perception of the viewers, I do not know, but it felt worth noting.

Conclusion – Should you get a hair transplant?

It depends.

Firstly, it’s very much a last resort. Had I known ten years ago what I now know about hair loss and the various preventative measures one can take, I would likely never have needed one (see the science section).

Secondly, they don’t always work – a lot of it will depend on why you’re losing your hair (again, see the science section).

Thirdly, you have to ask – Is it worth it?

Even doing the cheap option of flying to Turkey, a hair transplant is going to cost at least £1k. Assuming you can afford it (which is a big assumption, that’s no small sum) for some, this might still be a steal in to feel better about their appearance. Hell, it might even be necessary for their careers – if you’re an actor, a presenter, or in a job where youth/having a specific look matters a great deal. For others, it might not be.

But fourthly, and most importantly, does it matter?

Lets be real here – looks do matter. There’s a wealth of psychological literature documenting that we’re nicer to people we consider to be more beautiful, we give them status, credence, and trust. Beauty is a currency, and being wealthy opens doors. We all know this.

Certainly, it’s not all upside – but I think for anyone you cared for, you would want them to look better, rather than not, on any particular day.

But what I think we can hopefully do, is separate the practical advantages to being attractive, with what it can do for our self-esteem.

Not to be morbid, but everyone will contend with their looks fading at some point.

If your self-worth is solely dependent on your looks, that’s probably not a great long-term strategy.

I am perhaps in the odd position of having made peace with losing my hair - shaving it fully for a few years – and only then going for a transplant.

I didn’t need it.

I wanted it to work – sure, it would be nice, but it was a luxury, not a necessity. Shaving my head meant that by the time I had the hair transplant, I had already divorced my self-worth from that aspect of my appearance. As such, I can enjoy the results without anxiety. Should they fade, while practically I will acknowledge I probably will look worse, it doesn’t mean anything about me.

In the same way that you perhaps logically know that if you were better looking or taller or smarter, this would make your life easier in many ways. But a secure person doesn’t grieve the fact that they are not. You’ve got to accept who you are, love it, and work with it.

And there’s no contradiction in enjoying making improvements to yourself in any regard (whether that’s aesthetically or otherwise) while simultaneously not making them the fulcrum of all your positive opinions you hold about yourself.

Think of it this way - you probably enjoy getting dressed up for a night out right? You also (hopefully) pause to admire how good you look in the mirror before you head out to see your friends. This is all normal and healthy and great.

But what you don’t do, is lament that you don’t – and can’t - look like that all the time. It’s a fun temporary thing, that you can enjoy, that reaps tangible benefits, that means nothing about you.

This is where I’ve arrived at emotionally regarding my hair transplant. It’s an extra night out – a temporary party look - and I’m going to enjoy it while it lasts.

The Science of Hair Loss

*caveat with this section. I am not a doctor, a biochemist, or anything of that nature. Below is a summary of what I believe to be true at this time given what I’ve read on this subject. If someone authoritative makes a different claim, go with their view, and do your own research.

Hair loss, or alopecia, can be caused by a wide variety of things. These include stress, certain drugs, chemotherapy, infections, pregnancy, autoimmune diseases, obesity, age, genetics and hormone changes.

Most people have roughly 100,000 to 150,000 hairs on their head at any one time, typically shedding 100 a day. A hair is only lost when the follicle producing that hair dies, or is removed. Most people, just because of the natural passage of time causing cell death and degradation, will experience some level of hair loss as they age due to some follicles dying without being regenerated. This much is guaranteed.

Beyond that, it varies.

While both men and women have to contend with the genetic lottery when it comes to hair, men are far more susceptible - due to their average hormonal profile - to a kind of hair loss called androgenic alopecia.

‘Androgens’ is the catch all word for male sex hormones (testosterone being one well known example). While women also possess androgens, it’s less common that they have them in quantities to cause hair loss, but it can happen. Confusingly enough, ‘androgenic alopecia’ is also sometimes called ‘androgenetic alopecia’, and it is also often interchangeable with ‘male-pattern-baldness’ and ‘female pattern hair loss’.

The long and short of it is that androgens can mess with hair follicles, causing hair loss.

Most commonly, the culprit is the androgen Dihydrotestosterone (DHT). DHT is formed out of good old regular Testosterone by the enzyme 5α-reductase, and as an androgen, is five times more potent. This is why high testosterone is associated with hair loss. High testosterone correlates with high DHT, as DHT is created out of testosterone.

High DHT/androgen levels can shorten the growth cycles of hair follicles, basically meaning that each time they grow a new hair, they have less time to do so, leading to thinner and thinner hairs, with more time in-between new growth cycles, until the follicle is gone.

High DHT levels in particular are associated with a bunch of other symptoms. These can range from acne, to (more specifically to men) an increased risk in prostate cancer later in life.

And of course, precisely none of this explains my rapid hair loss in my early twenties. The issue I had then was low testosterone, among other things, due to my eating disorder. My best guess therefore for why I lost so much hair so rapidly is simply due to compromised health and excessive stress.

In a way I’m glad that I didn’t have this information when I was going through my eating disorder. I likely would have taken medication to reduce my DHT without actually getting my DHT levels checked, and would have further messed up my hormones.

My most recent blood test showed testosterone on the top end of the range, while also showcasing high DHT. As a general protective measure, I’ve taken a supplement which is meant to slightly attenuate DHT levels. It is entirely possible that from bouncing from a state of terrible to perfectly good health, I have moved from one cause of hair loss to another. Only time will tell.

What to do if you think you’re losing your hair

Read the science section before proceeding on to this.

*Again, I am not a doctor, a biochemist, or anything of that nature. Below is a summary of what I believe to be true at this time given what I’ve read on this subject. That being said, this subject seems to be a bit contentious. Do your own research.

I should say, regretfully, this section is mostly aimed towards men – as that’s the issue I researched most heavily.

OK, so you think you’re going bald, or you’ve seen your hairline recede a bit, or you’re just generally wary of your family history.

The good news is this – unless you have atrocious genetics, you have many effective options.

Plus, the earlier you tackle this the better, an ounce of prevention is worth a pound of cure

There are two kinds of medication you can take – things that promote hair growth and things that prevent hair loss. These are radically different. Your best bet is to prevent hair loss. Lets start with that:

Prevent hair loss

If you read the science section, you may have inferred that logically, if high DHT typically causes hair loss, all you’d need to do is to take a medication which reduces DHT to prevent it.

And you’d be correct. However, there are side effects.

DHT is reduced usually by inhibiting the enzyme 5α-reductase which creates DHT out of testosterone. The most common medication which does this is called Finasteride (which is notably, is also prescribed for some prostate issues).

Finasteride is no joke. DO NOT TAKE THIS ON A WHIM.

Do a google search and you’ll find a plethora of horror stories – that this medication can cause depression, destruction of libido, steal your wallet, sometimes permanently.

The stats that are available show that this is rare – something like 1/1000 cases. What causes this?

You see Finasteride actually increases testosterone, as less of it can be converted into DHT. Which you’d think would aid libido, however what this also means is you also increase the amount of Estradiol (E2) - a kind of oestrogen - you have, as this is also created out of testosterone. This increased E2 can throw the ratio of hormones out of whack in men, thus creating issues with libido, creating depression etc.

There are also indications that finasteride can directly interfere with neurological activity in some cases, which might also cause depression.

I am currently not on finasteride. I tried it, and it was awful. I did all my homework – I got all my hormones checked, DHT, Testosterone, E2 and so on. I had high DHT and my ratio was solid, so I was fairly sure taking finasteride would be something I could tolerate. I took 0.5mg daily for 5 days in a row and felt bleaker than I had done in years. I ceased taking it immediately, and within a few days I felt fine.

Since, I have started taking 3-6mg of Saw Palmetto daily, which also acts as a 5α-reductase inhibitor, and I have not noted any side effects.

My advice – if you can, get your hormones checked. DHT, Testosterone, E2 etc. Do this after getting your health in check. After you clear it with a Doctor, if your DHT is high, perhaps try finasteride. Statistically, it works perfectly well without side effects for the vast majority of people. I truly thought that would be me, but for whatever reason it wasn’t. Personally, I’m never touching finasteride again, but others use it without issue at all. Don’t give yourself a placebo effect.

Take photos at semi-regular intervals, maybe every month or so. And notice if there are any follicles you pull out while brushing your hair/see if they appear in the drain after the shower.

Promoting hair growth

The main medication for this is topical Minoxidil, often known under the brand name Rogaine. This stimulates hair growth by promoting blood flow to the skin its applied to (it can also help grow a beard, if you’re interested!) I’ve been using Minoxidil, along with micro needling, for a few months. It takes a full 9 months to see ‘full results’ and so far my usage might indicate I’m a non-responder – what I’ve read seems to indicate this medication only effectively works for around 40% of men. I’ll update this post at some point with the full results 9 months on.

There are also side effects associated with Minoxidil, though less catastrophic ones than what you read about with Finasteride. As always, do your own research.

One of the best resources on this I found are the videos/blog posts by biochemist meathead Derek from More Plates More Dates.

Go nuclear?

Here’s a potentially terrible bit of advice to leave you with.

If you’re really worried about it, try shaving your head.

I can tell you, first hand, that being bald is not the end of the world. Women still found me attractive (and some men too, though sadly I don’t swing that way). Life went on. Don’t sweat it. It’s a huge thing until it happens and then it’s forgotten.

Shaving your head prepares you for the ‘worst case scenario’. And who knows, you might even like it.

At the very least, your anxieties will likely be reduced. Plus, if you ever did have a hair transplant, you would need to shave your head anyway (usually).

I’m having another run with hair while I can, but I know one day I will inevitably rock the bald look again.

And that’s OK.

Jack LawrenceApril 25, 20228 Comments