Hair transplant: 5 questions to understand the procedure

Demand for hair restoration surgery—a procedure that uses the patient's own follicles to fill bald patches—has been growing in Brazil and worldwide. According to the most recent census by the International Society of Hair Restoration Surgery (ISHRS), released in 2025, the percentage of men interested in transplants increased from 13% to 18% in the last three years.

Approximately 6,000 hair transplants are performed annually in Brazil, and doctors report a 20% increase in the number of patients, according to the latest census by the Brazilian Association of Hair Restoration Surgery (ABCRC), conducted in 2023. The trend isn't limited to the scalp: beard and mustache procedures already account for about 5% of cases. According to the survey, 12% of women seeking the procedure intend to improve the appearance of their eyebrows.

The demand is driven by various reasons. Many patients report a desire to feel more attractive, while others claim to want to look younger to remain "competitive" in the job market. "There are several factors behind the increased demand, including the increased popularity of this seemingly simple, less invasive technique, without cuts or sutures. This has led to a proliferation of clinics with more attractive prices," says plastic surgeon Henrique Radwanski, a member of the Brazilian Society of Plastic Surgery and former president of ABCRC.

In Brazil, any doctor can perform the procedure. However, the association recommends that it be performed by dermatologists or specialized plastic surgeons. "The problem is performing it with non-doctors, in places without a surgical center, anesthesiologist, or adequate infrastructure," warns Radwanski.

Below, learn more about the indications, techniques and care after the procedure:

1. Who seeks transplantation?

More than 80% of patients who undergo hair transplants are men with androgenetic alopecia — a hereditary and progressive condition responsible for hair loss in about half of men over the age of 50.

Although more common among men, the technique is also sought after by women. Among the main reasons are to correct a high forehead or thinning hair due to hormonal changes, medication use, or nutritional imbalances.

Transplantation may also be indicated in specific situations, such as after-effects of trauma, burns, or surgery, to correct gaps left by cosmetic procedures like facelifts, where the hairline has shifted, or to correct visible scars that cause embarrassment. "In general, people resort to transplantation when clinical treatments are no longer sufficient to restore areas of hair loss," says dermatologist Barbara Miguel of Einstein Hospital Israelita.

2. In which cases is it recommended?

Hair transplantation is indicated when there is permanent loss of hair follicles—that is, when there is no longer any potential for natural hair growth—or when available treatments fail to restore the desired hair density. The main indications include:

• Androgenetic alopecia (male or female pattern baldness), when thinning is already advanced; • Scars resulting from trauma, burns, surgeries or other conditions that prevent hair growth in the region; • Congenital or acquired defects, such as the so-called “high forehead” or areas with no hair since birth;

• Stable scarring alopecias, in which the inflammatory process has already been controlled and the condition is under medical monitoring.

Before referral, a thorough dermatological evaluation is essential, which involves confirming the diagnosis, ruling out active scalp diseases, and analyzing the viability of the donor area—the region from which the follicles will be harvested for implantation. "In many cases, the transplant is also combined with complementary therapies, such as topical and oral medications, to enhance the results and prolong their durability," notes the Einstein physician.

3. What is the procedure?

Hair transplantation is a meticulous surgical procedure that involves removing hair follicles from areas where hair is genetically more resistant to hair loss—usually the sides and back of the scalp—and implanting them in areas where hair is thin or missing.

There are two main techniques: the oldest, known as FUT, involves removing a strip of scalp from which follicles are extracted prior to implantation. Although it allows for faster harvesting, this method has fallen into disuse because it leaves scars that can be visible and cause greater postoperative discomfort.

The most widely used technique today is FUE (Follicular Unit Extraction), which eliminates the need for scalpels and sutures. In this technique, follicles are removed individually through small punctures, typically between 2,000 and 2,500 units, which must be carefully handled to preserve the hair bulb.

They are then implanted one by one in the recipient area, respecting the natural direction of hair growth. The surgery usually lasts eight to ten hours, performed under sedation and local anesthesia, and has a high success rate—generally, over 90% of implanted follicles develop normally.

When the goal is to restore eyebrows or other delicate areas, the process requires even more precision, as the hairs—also taken from the scalp—need to be positioned with special attention to angle and density. When properly performed by a specialized team, the procedure has a low risk of complications.

4. What is the post-operative period like and what precautions should be taken?

The post-operative period of a hair transplant is usually uneventful, but it requires attention to certain recommendations to ensure proper healing and a successful procedure. Immediately after surgery, the implanted roots enter a resting phase—known as the telogen phase—and only begin producing new hairs about three months later. After about six months, about half of the final hair coverage is visible, while full results usually appear between 10 and 12 months.

In the first few days, healing occurs quickly, usually between 24 and 48 hours, but some care is essential: it is important to maintain proper scalp hygiene to prevent infections, washing your hair as directed by your doctor.

It's also essential to avoid trauma to the transplanted area, as well as to avoid intense physical activity, contact sports, swimming in the sea or pool, and direct sunlight for at least a month. Following these recommendations correctly helps ensure the follicles are firmly established and optimize new hair growth.

5. What to expect from the transplant?

Despite advances in techniques and the natural results that can be achieved, it's crucial to have realistic expectations regarding hair transplantation. The procedure significantly improves hair density and appearance, but it can't restore the exact volume a person had in their youth. "We have to manage expectations. You won't get back the hair you had in your 20s, and it's important that the doctor avoids making promises and explains that surgery isn't for everyone," warns Radwanski.

Furthermore, the transplant does not eliminate the need for ongoing care. "Even after the transplant, the patient must continue dermatological follow-up and clinical treatment for alopecia, which is essential to preserve the results and prevent disease progression in non-transplanted areas," adds Barbara Miguel.

Source: Einstein Agency

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