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Home arrow Basics arrow Hair transplants
Hair transplants: Basic Principles and how it is done
The principle of hair transplant is simple. It has been proven during the first half of the 20th century, that in a given person transplanted hair follicles further produce hair in its new location (refer to Historical development of HT).

Besides it has been observed, that these transplanted hair follicles grow even on bald areas of the head and produce in these new locations normal and strong hair. The reason behind this phenomenon is the fact that each hair follicle contains its own genetic information. Aside from this, it takes with it this genetic information during transplantation. Thus, it can even produce new hair in the new place it has been tranplanted to. Putting it in a more casual manner, a healthy hair follicle does not care at all whether it has been transplanted into a hairy or bald area of the scalp. 

This genetic autonomy of each single hair follicle opens many possibilities. Cosmetically annoying hairless scars resulting from burns or ruptured wounds of the eyebrows can, for example, be repaired. And, of course the bald scalp areas encountered in men with male pattern baldness (medical term: androgenetic alopecia) may have new hair again.

In the following lines, we shall consider the latter case. W shall explain to you the principle of hair transplant in the treatment of androgenetic alopecia:

Nature has pointed out that in men a part of scalp hair does not atrophy or loss. Instead they live a long life through, for they are accordingly resistent against hair loss. These resistent hair follicles are located in a somewhat horseshoe- shaped region (posterior and lateral parts of the head). You must have already noticed that it is on these spots of the head where a man, who has been bald for decades, has still full hair.

These areas serve as donor region, from where genetically resistent hair follicles are taken and eventually transplanted to the bald areas. In these bald areas, the hair follicles fall out during the following 2- 5 weeks due to the so- called "transplantation stress" only to reappear after a lapse of around 3- 6 months after undergoing a rest phase. After this rest period, the hair follicles have regenerated enough to begin producing new healthy hair. Thus, on the once bald areas of the head new healthy and strong hair begins to grow. And this, a whole life long!

The disadvantage in this lies in the fact that in hair transplant no new hair is produced. What takes place here is a mere new distribution of already existing hair. In this particular case, there is no reaching of hair thickness reminiscent of teenager days.  However, it is not necessary. A general rule says that one loses first around 50% of his original hair thickness before the process of thinning out of the hair becomes visible. In other words, it means that a 50 % density of natural hair can also produce absolutely satisfactory results!

Nevertheless, the attainable density and the possible position of the future hairline also depend on the number of donor hair follicles of the donor region.

International Norwood- Hamilton scale:
 Norwood- Hamilton Skala

The Norwood-Hamilton scale was introduced to classify androgenetic alopecia. For example a person classified to have Norwood 5 (NW5) or higher has relatively advanced baldness. After a hair transplant he can have no deep hairline typical of a teenager and at the same time have a high density of hair distributed over the whole upper head.  Should an acceptable density be reached in this case, then it is only possible when the future hairline is placed accordingly higher. The lateral sides of the frontal hairline should not be closed fully. It should not be forgotten that a conservative- looking high hairline, which represents the starting stage of the androgenetic alopecia, looks specially very good and natural for older men.

You must have already noticed that a compromise must be found between the wishes and the existing possibilities.

For men with only a few donor hairs from the scalp but lots of body hair on the chest, there exists the option of using the latter for implantation into the bald head. If these chest hairs possess an adequate length, thickness, structure and colour, they can be even used for thickening the scalp hair. Obviously, the use of body grafts is only possible through the use of the gentle FUE extraction technique since the donor region remains free of long scars.

The widely- practiced strip method is not applicable in body hair transplant surgery on account of the scalpel cuts and the long scars it produce. On the one hand, chest hair is almost always too light to cover the resulting long scar. On the other hand, an indescribably big strip of skin in the breast has to be cut in order to collect enough donor hair.

After each hair transplant, the transplanted grafts lose their hair shafts during the first 2- 5 weeks after transplant procedure due to "stress" (Shedding). But they remain alive. They have simply entered a so- called rest period lasting around 3- 6 months. After this period, the grafts recover well and start producing new healthy and strong hair shafts. You can even watch how "new" hair begins to grow!
Get more information from our website concerning the details and different techniques applied in hair transplant surgery (see hair transplant in detail / FUE in our practice ).