Hair loss affects approximately 50% of men over 40 years old. Beyond the physical aspect, alopecia can profoundly affect identity and self-image.
For androgenetic alopecia, hair transplantation has become the gold standard surgical solution. This procedure allows for the restoration of dense, natural-looking hair in a lasting manner. The principle is simple: harvest hair follicles from a hormone-resistant zone to transplant them into thinning areas.
Hair Transplant Indications: Who Can Benefit
Not being a candidate for a hair transplant is common and is not a failure. Exclusion criteria protect against procedures whose results would be compromised.
Androgenetic alopecia: the main indication
This is the most common form of baldness in both men and women. It is characterized by progressive hair miniaturization under the effect of a hormone, DHT.
Ideal candidates present:
- Stable hair loss with a defined pattern (Norwood-Hamilton classification for men, Ludwig for women)
- At least 50% density loss in one or more areas
- A healthy donor area with density typically between 60 and 85 follicular units per cm² (variable according to age, ethnicity and individual characteristics)
- A healthy scalp
- Realistic expectations
Note: a follicular unit (graft) contains 1 to 4 hairs. Density is measured in follicular units, not individual hairs.
Main contraindications:
- Generalized hair loss without stable donor area
- Active cicatricial alopecia (lichen planopilaris, etc.)
- Alopecia areata not stabilized for at least 2 years
- Progressive baldness in young patients
- Insufficient donor area (generally less than 40 follicular units per cm²)
- Psychological disorders (trichotillomania, body dysmorphic disorder)
- Medical conditions compromising healing
Hair transplantation can also correct scars, reconstruct eyebrows, beard, mustache.
Hair Transplant Techniques: FUT and FUE Explained
Strip Transplantation (FUT)
The surgeon removes a strip of scalp 1 to 1.5 cm wide from the back of the head. This strip is then dissected under a microscope to isolate follicular units one by one. Grafts are stored in a chilled solution before implantation. The wound is closed with sutures, leaving a linear scar that can be concealed by surrounding hair.
Advantages:
- High graft yield
- Optimal follicle protection
- Shorter operative time for large sessions
Disadvantages:
- Linear scar visible with short hair
- More marked postoperative pain
- Slightly longer recovery
Follicular Unit Extraction (FUE)
Follicular units are extracted one by one with micro-punches of 0.8 to 1.2 mm. The surgeon harvests in a dispersed manner to avoid a visibly thinned appearance in the donor area. No sutures needed, just practically invisible circular scars.
The risk of follicle transection depends on the surgeon's experience but also on the natural geometry of the follicle (curvature, implantation angle). An experienced practitioner achieves comparable transection rates between FUT and FUE.
Advantages:
- No linear scar
- Faster recovery
- Little pain
- Possibility of very short hair
Disadvantages:
- Longer operative time
- Potentially higher cost
- Cumulative scars if multiple sessions
The choice depends on the extent of baldness, donor area quality, your usual hairstyle and any existing scars.
Hair Transplant Procedure: From Consultation to Post-Operative Care
Preoperative consultation
The consultation does not commit you. It is a step of mutual evaluation and informed decision-making.
The surgeon examines your donor area, evaluates the degree of miniaturization (often by dermoscopy), discusses your expectations and designs a hairline adapted to your face. Excessive miniaturization can compromise long-term results.
For afro-textured hair, an adapted technique is essential because follicles have a natural C-shaped curvature.
Surgical procedure
The operation is performed in one day under local anesthesia, with possible sedation. A team works in a coordinated manner.
The steps:
- Local anesthesia
- Follicle harvesting (strip or individual extraction)
- Microscopic dissection if necessary
- Storage in chilled solution
- Creation of recipient sites
- Graft implantation
Most surgeons harvest only about 50% of donor density to preserve natural appearance. For large sessions, several thousand grafts can be transplanted.
Post-operative recovery
The first 48 hours may require mild analgesics. Many patients manage with paracetamol. Facial edema appears in 18 to 42% of patients according to clinical series in the 2-3 days following, variable according to technique and postoperative protocol. Redness and crusts form around the grafts.
To avoid the first week:
- Intense physical activities
- Too vigorous washing
Crusts disappear in 7 to 10 days. Follicle inflammation (folliculitis) may occur in approximately 23% of patients, mostly benign and transient. It rarely requires more than warm compresses.
Temporary shedding (effluvium)
Two distinct forms:
- Transplanted hair shedding: grafted hairs fall out in 2-4 weeks. This is normal and expected. Follicles remain viable under the skin.
- Surrounding native hair shedding (shock loss): non-transplanted hairs around the operated area can also temporarily fall out. More common in women and in cases of advanced miniaturization.
This phase is often the most psychologically challenging, although it is temporary and normal.
Hair Transplant Results: Timeline and Success Rates
Waiting naturally generates impatience. This is normal and shared by the majority of patients during the first months.
Regrowth timeline
Months 1-3 (resting phase):
- After shedding, follicles rest
- No visible growth
Months 3-4 (early regrowth):
- First fine, light hairs
- On average about 20-30% of final density
Months 4-6 (accelerated growth):
- Hairs thicken and darken
- At 6 months: on average 40-50% of final result
- Significant cosmetic benefit
Months 6-9 (maturation):
- On average about 75% of final result at 9 months
- Texture and diameter normalize
Months 9-12 (final result):
- Definitive result for most
- Natural appearance
Months 12-18 (complete maturation):
- For some patients, especially at the vertex
- Growth can continue up to 18 months
Graft survival rates
Variability between patients relates to biological and technical factors, not to non-compliance with instructions.
Under optimal conditions, studies report survival rates of 90 to 95%. A study using the KNU implanter documented 92% survival at 6 months, after an initial drop of about 50% in the first month. These data come from techniques developed in the 2000s; modern instruments may show slightly different results.
By donor area:
- Scalp: 89% survival at one year
- Beard: 95%
- Chest: 76%
These variations are explained by differences in caliber, depth and growth cycle.
For inactive cicatricial alopecias: significantly lower rates (82.7% at 7-12 months, then decrease to 58.4% at 25-36 months according to a 2025 systematic review).
Longevity
A 4-year follow-up study shows that 91% of patients present some reduction in density of transplanted hairs. These data suggest that the recipient site environment may influence long-term survival. Other studies with different protocols are needed to confirm these observations.
Hair Transplant Prices Belgium: Rates and Cost Factors 2025-2026
The financial weight deserves an informed assessment, without rush.
General range: €6,000 to €15,000
This is an order of magnitude for procedures performed in major Belgian clinics.
Factors determining price:
- Number of grafts (€2 to €5 per graft depending on clinics)
- Technique (FUE and DHI generally more expensive than FUT)
- Surgeon's reputation
- Location (Brussels and major cities often more expensive)
- Included services (consultations, examinations, follow-up, medications)
By baldness stage:
- Stage 2-3 (1,500-2,500 grafts): from €4,500 (clinics outside major cities) to €6,000
- Stage 4-5 (2,500-4,000 grafts): €7,500-€8,500
What is included (generally):
- Initial consultation
- Operative planning
What is not included (often):
- Accommodation
- Transportation
To verify in the quote:
- Number of grafts guaranteed
- Technique used
- Follow-up consultations
- Complication management
- Touch-up policy
No health insurance coverage (aesthetic procedure), except rare post-traumatic reconstruction.
Hair Transplant Complications: Risks and Frequency of Side Effects
Listing complications aims to inform, not to alarm.
The safety profile is generally favorable. Data comes from retrospective series and should be interpreted as indicative ranges.
Common complications (generally benign)
- Facial edema: 18-42% of patients, 2-3 days
- Sterile folliculitis: 23%, mostly benign and transient, resolution with warm compresses
- Bacterial folliculitis: 11%, antibiotics
- Itching: common
- Numbness: 11%, a few weeks to a few months
- Persistent hiccups: rare, 2-3 days
Rare but significant complications
- Severe infection: less than 1%, may require IV antibiotics
- Skin necrosis: donor area (excessive FUE harvesting) or recipient (sites too close together)
- Minor bleeding: common, simple compression
- Bleeding requiring surgical hemostasis: exceptional
- FUT wound dehiscence: infrequent
- Keloids: less than 1%
Aesthetic complications
- Unnatural hairline: major source of dissatisfaction
- Incorrect angulation: artificial appearance
- Enlarged FUT scar: 15%
- "Moth-eaten" donor area appearance: overly concentrated FUE harvesting
Late inflammatory complications
Lichen planopilaris, frontal fibrosing alopecia, erosive pustulosis: 0.08% of consultations according to some series. Hence the importance of preoperative dermoscopic examination.
Overall assessment
According to large published series, major complications threatening vital prognosis remain exceptional (< 1%). The rate of minor complications varies between 0.10 and 4.7% depending on studies and definitions used.
Hair Transplant Contraindications: When to Postpone or Decline
Postponing or declining may be the responsible choice. See the "Indications" section above for the complete list of contraindications.
Adjuvant Treatments: Complementary Options
These treatments are optional, not mandatory. Their use is based on individualized medical decision.
Topical minoxidil
Vasodilator applied locally. Can be used from one week after the procedure to stimulate growth. Studies show it can accelerate regrowth and improve graft survival.
Oral finasteride (1 mg/day)
Reduces testosterone to DHT conversion. Can be initiated 4 weeks before and continued after. A randomized controlled study shows it improves overall coverage and protects native hairs.
Possible side effects:
- Sexual dysfunction
- Mood disorders
Strictly contraindicated during pregnancy and breastfeeding due to teratogenic risk.
Platelet-rich plasma (PRP)
Contains growth factors that can stimulate regeneration. Current scientific data remains limited and its use is not standardized.
Autologous stem cells
Innovative approach with emerging data, not validated as standard of care. No official recommendations to date. A recent study shows promising results on scarred tissue, but confirmation needed in larger controlled trials.
Hair Transplant in Women: Specific Considerations
Female alopecia is subject to underdiagnosis and often delayed care. Women's concerns deserve the same clinical attention.
Characteristics of female alopecia
Diffuse thinning with preservation of the frontal hairline (Ludwig classification). May benefit from transplantation but rigorous evaluation necessary to ensure donor stability and exclude other causes (deficiencies, thyroid dysfunction, hyperandrogenism).
Specific features
- More conservative density goals (avoid artificial appearance)
- Frontal hairline preservation: diagnostic criterion and surgical advantage
- Slightly higher risk of temporary native hair shedding
- Oral finasteride contraindicated during pregnancy and breastfeeding
- Other hormonal options possible (spironolactone) with endocrinological monitoring
Frequently Asked Questions About Hair Transplant
