Having to shave parts of your scalp can be a problem if you’re trying to get a hair transplant without anyone knowing. Moreover, having visible hair transplant side effects, such as scabs and redness on their scalp, has deterred many people with alopecia from getting much-needed hair restoration surgery [1][2]. It has also led some to wonder: Can you have a hair transplant with long hair?
The short answer is yes – if you are eligible for this surgery, you can get a hair transplant without shaving your head. There are currently two procedures that can achieve this, called long hair follicular unit extraction (LH-FUE) and unshaven follicular unit extraction (UFUE). However, only the former preserves your graft hair length during harvesting and reimplantation. Find out all you need to know about this procedure.
This article will tell you all you need to know about getting a hair transplant while preserving your long hair. It reveals how this type of surgical restoration is performed, who can benefit from it and who may want to choose a more suitable option. Then, it explores the main advantages and disadvantages of getting a long hair transplant and breaks down the main factors that influence surgery costs. Finally, it lets you know what to expect during your recovery period and provides helpful tips and tricks for short-term safe healing and long-term hair transplant care and upkeep.
Key takeaways
Yes, some hair transplant clinics offer surgical techniques that don’t require shaving your donor area. Moreover, you can now even have long hair grafts implanted in your transplant area, so you can get an instant preview of your probable final hair transplant results.
However, you should know that long hair transplants are not performed by every surgeon or even in every clinic. This process is more painstaking and requires specific skill, experience and a different tool set than the traditional FUE.
Normally, before getting FUE surgery, the donor area at the back of your head is shaved, so the surgeon can extract the grafts more easily, without hair getting in the way. Sometimes, the recipient area is shaved as well, for visibility, convenience and uniformity. However, there are two main ways of getting a hair transplant without shaving any of your hair off:
UFUE involves harvesting healthy, pre-trimmed hair grafts from your safe donor area, while keeping the rest of the hair intact. The surgeon divides this area into smaller sections, using clips to secure the long hair around each section they are working on, so it doesn’t get in the way [3]. The surgical team will then trim only the hairs growing out of the follicles they are about to harvest, leaving the surrounding ones long. The rest of the hair will cover the areas where the grafts were extracted, making them inconspicuous.
However, UFUE only maintains the length of the non-harvested hair in your donor area. The grafts that are to be transplanted are still trimmed short (about 1-3 mm). It does not involve implanting long hair as well [3].
LH-FUE involves both harvesting and re-implanting your grafts without trimming the hair short. Specialised equipment (e.g. open punches or the Trivellini long hair punch [1]) is used to extract the grafts without slicing the hair shafts growing out of them or getting them tangled around the surgical instruments [4]. This makes the procedure far more laborious, complex and time-consuming than a regular FUE or FUT surgery. But in the end, the transplant area is covered entirely with long hair, so the patient can immediately get a good idea of what their final results should look like.
However, keep in mind that “long hair” does not mean any length. The optimal shaft size for this procedure is between 3 and 10 cm [1]. Any longer than that and the surgery would become too time-consuming and technically challenging to perform.
If you opt for a long hair FUE, during the first 7 days post-hair transplant, you will still notice the visual side effects that are normal for any kind of surgical hair restoration: scalp redness and swelling, as well as scabbing around the graft roots. However, the long hair growing out of your grafts will obscure some of these symptoms, making them significantly less conspicuous than they would have been had your transplant area been shaven [4].
However, immediately after surgery, you should get a pretty good idea of what your final results will look like. Of course, this is provided that the surgery was well-performed and you follow your hair transplant aftercare instructions closely, leading to a high graft survival rate.
When it comes to your final results, they are no different from the ones you would have achieved with traditional FUE. The length of the hair growing from the grafts does not directly influence their survival rate. However, you may need fewer grafts to achieve the same coverage provided by regular FUE (to be discussed).
Normally, the following categories of patients are ideal candidates for long hair FUE [1]:
However, the only way to find out for sure whether a long hair transplant would be the best option for you is to ask a specialist. Fortunately, all you need to do is book a free, no-strings-attached consultation with one of our exceptional surgeons. They will make a thorough, personalised assessment of your hair and scalp characteristics and offer expert recommendations, tailored to your specific needs and result expectations.
While some patients can benefit from a hair transplant with long hair, there are also situations where this type of procedure may not be a good idea. These include:
Opting for LH-FUE can provide numerous advantages when it comes to both aesthetics and hair transplant recovery, compared to traditional hair restoration methods. Here are some of the most important [5][4][6]:
Since no part of your scalp is shaved, there is no tell-tale scarring, and your long hair masks most of the scalp redness and scabbing, it will be much easier to maintain discretion over your procedure. That means you may be able to resume your daily activities sooner than you would have if you had to hide the give-aways of a traditional FUT or FUE procedure.
However, you should know that you are very likely to experience hair transplant shedding starting about 2 weeks post-op. So if you want to avoid raised eyebrows around your hair fullness ebbs and flows, you may want to plan ahead for this phase of your recovery. Getting some nice hats, caps, or bandanas can keep you looking fresh and stylish for the 3-4 months it will take for the hair to grow back in your transplant area.
If you get a traditional hair transplant, all you can see immediately after your surgery is an outline of your future results. However, when getting long hair FUE, as soon as your procedure is completed, you can get a clear picture of what your final results will probably look like [5]. You will be able to get a significantly better idea of the coverage you can expect, as your hair length and texture play an important role in creating the appearance of fullness.
However, please be aware that your post-op results are not always identical to your final outcome. Your graft survival rate can be influenced by several factors, such as surgeon skill, any complications you may experience, as well as the quality of your aftercare.
Long hair FUE allows the surgeon to see the texture and curvature of your hair shafts clearly when implanting the grafts. They can also view the coverage they produce in real time.This means they can give you a more natural-looking hair transplant, since they have better control over where each graft needs to be placed and how it needs to be positioned for an optimal visual effect.
Research [6] suggests that LH-FUE may be especially useful in enhancing the cosmetic results of hairline transplants. That is because the hairline is a complex area of the scalp, marked by micro and macro-irregularities. So, allowing the surgeon to see the long hair shafts can help them handpick the perfect ones to create a life-like result.
Certain hair textures (especially curly hair types) can create a much better illusion of density than others. And long hair FUE allows surgeons to optimise coverage by choosing the most suitable grafts and relying on their natural qualities. One study [7] found that 24% fewer grafts were used, on average, to achieve the same coverage when performing LH-FUE compared to the regular kind. This allows them to spare more of the hair follicles in your donor area, in case you may need a second hair transplant later in life.
During long hair FUE, the surgeon can see exactly what your donor area will look like post-op. This means they can easily tell when to stop extracting grafts from a certain section, to avoid making it look thin or patchy. With traditional FUE, with a shaved donor area, it is harder to tell what each scalp section will look like once your hair has grown back in and mistakes can happen, especially if the surgeon is not highly experienced. This can sometimes lead to hair transplant overharvesting.
However, long hair FUE also carries some well-known downsides which prevent it from becoming more widely used. These are some of its main disadvantages [7]:
Long hair grafts take significantly longer to harvest and reimplant than those with short hair. That is because the surgical team needs to be very careful not to get the shafts tangled around the equipment (or while handling the grafts), not to cut the hair while extracting the follicle and to implant them with the curvature in the perfect position. The long hair can also get in the way and obscure the view if not held back by a surgical assistant. It is a painstaking process, and research shows it can take almost twice as long to complete as traditional FUE [7].
Not every hair transplant surgeon can perform a long hair FUE surgery. It takes specific training and experience, as well as proficiency in using a particular kind of harvesting equipment, not normally used in other hair restoration surgeries. The steep learning curve for mastering LH-FUE makes it more difficult to find surgeons willing and able to perform this technique.
Nowadays, FUE hair transplant costs have become lower than FUT. However, this is not the case for long hair FUE. This technique requires more surgical staff assisting during the procedure, extremely skilled and experienced surgeons, and it is much more painstaking than the traditional method. All this can significantly increase surgery costs, making it one of the more expensive types of hair restoration surgery.
While long hair FUE patients experience the same post-op side effects as traditional FUE, the long hair can make the recovery period more risky. That is because it can tangle or catch on clothing, increasing the risk of graft dislodgement. It also makes the first few times washing your hair after your hair transplant more difficult, which is why some surgeons recommend coming into the office to have it professionally washed [4]. Longer hair can also collect dust and bacteria more easily, making patients more prone to a hair transplant infection (e.g. hair transplant folliculitis).
The average cost for an approximately 1500-graft FUE hair transplant in the UK is, as per our research, £4,820. However, this does not account for the extra expenses brought on by the significantly more demanding long hair FUE.
Normally, the price of your hair restoration surgery is determined by factors such as:
However, while long hair FUE may require fewer grafts, its costs are still increased by the following:
The best way to get a realistic quote for your long hair FUE procedure is to contact your clinic of choice and book a consultation with a surgeon specialised in this type of procedure. After your specific hair transplant needs and preferences have been expertly assessed, you will get a personalised cost estimation.
While the recovery period is mostly similar for long hair FUE as for the regular kind, there are a few differences that need to be kept in mind, especially during the healing period. Here is everything you need to know:
During the first days post-transplant, you will likely experience common surgical side-effects:
Most discomfort can be managed with over-the-counter medication and will subside naturally over the first 3 days post-op. However, since your transplant area is covered with long hair, it can be more difficult to protect your grafts from accidental dislodgement before they have a chance to become securely attached. Here is some long-hair FUE-specific advice to get you through the first week safely:
Pro Tip: Try using a silk pillowcase to minimise friction and tangling.
Pro Tip: Very gently move tufts of your grafts a little to the side to expose the scalp, then hold the spray bottle a little closer than you normally would (about 7 cm away) to spray the hair roots.
Pro Tip: Avoid wearing accessories such as large earrings or chokers that your hair may get caught in. Keep your nails trimmed to prevent hangnails that can snag the shafts as you touch your head. And avoid large or elaborate sleeve buttons that can catch your hair as you gesture around your hair or face.
Pro Tip: Avoid going out in warm or windy weather during the first week after your hair transplant, and if you want to take a short walk, choose a spot in nature, away from construction sites or high-traffic streets. Spray your grafts well upon returning home, to remove dirt particles. If more than 4 days have passed since your procedure, you can even wash your hair gently.
ProTip: If possible, ask to go into your clinic and have your hair professionally washed or purchase a hair transplant package that includes home visits where a nurse will wash your hair. For example, the Wimpole Clinic Premium and Platinum packages both include this service, alongside other amazing amenities and treatments (e.g. a 5-star hotel stay arranged by concierge, free scalp massages for hair growth, platelet-rich plasma therapy sessions, red light therapy sessions and a several-month supply of hair growth medications – contact us for more information)
Pro Tip: If you absolutely have to comb your hair, grab a small section firmly at mid-shaft, hold on to it with one hand and very gently and patiently work out the tangles at the ends with the other. Never use a comb or brush to pull on your hair without firmly holding its root in place, as the risk of graft dislodgement is very high.
Pro Tip: Once a day, go in front of your mirror and shine a light directly on your transplant area. Very gently move your grafts so you can see the scalp underneath. Check carefully for any of the symptoms listed above and let your surgeon know if you notice anything concerning.
After the first week of healing, most of your unpleasant and unsightly hair transplant side effects should have subsided, and your scalp should look as good as new (however, in some cases, some redness may persist for a few more days or even weeks). By day 10 after your hair transplant, your grafts should have become securely attached, and you can finally rest easily, without the fear of imminent dislodgement. And once you have reached the 14-day mark, you can safely resume most of your normal daily activities (unless they involve strenuous physical effort).
However, just as you thought you could finally relax and enjoy your wonderful new hair, you wake up one morning, about 14 days after your hair transplant, to find it falling out in clumps. This can be frightening and disheartening, but rest assured that it’s a perfectly normal and temporary part of your recovery. This phenomenon is called hair transplant shedding, and it happens to almost all patients, regardless of the type of procedure they opt for. Fortunately, it should only last for about 3-4 months, when you will start to see new, permanent hair growth.
After your transplanted hair starts growing back 3-4 months post-surgery, you will still need to wait patiently until 12-18 months post-op to see your final results. Ideally, after they have been achieved, your hair will look a lot like it did in the first couple of weeks after your transplant. However, at this point, it will be strong and resilient, and you will be free to style it any way you please.
Once the first couple of weeks post-op have passed, long hair FUE hair transplant maintenance is the same as it is for any surgical hair restoration. Here are the most important things you need to do to make sure you will still have a great-looking hair transplant after 10 years or more:
If you are considering a long hair transplant, it is essential to consult with a qualified hair restoration surgeon to determine if this procedure is the best option for you. Someone whom you can fully trust to openly discuss the benefits and risks associated with this procedure and answer any questions you may have.
The Wimpole Clinic’s 50-year legacy of hair transplant excellence and our 4-year running Hair Transplant Clinic of the Year Award (2021-2024) recommend us as a second-to-none authority in the hair restoration field. Book a hair transplant consultation with one of our exceptional surgeons and rest assured that your hair is in the most competent hands.
If you still have questions about getting a hair transplant with long hair, feel free to peruse the answers to the common queries below:
No, you cannot get a long hair transplant using the FUT technique. That is because it involves harvesting an entire strip of skin from your donor area and then slicing it up into individual grafts under a microscope. It would be too challenging to make a clean, straight incision, keep the area sterile and suture the wound during the harvesting phase if the surgical site were covered in hair. Moreover, slicing the grafts apart with long hair growing on them would also be very difficult, with long hair shafts getting in the way.
Yes, you can resume topical Minoxidil treatment, as long as at least a week has passed since your procedure. However, you need to be careful while applying it, to make sure the solution reaches all the way down to your scalp and doesn’t get caught in your hair instead. Carefully part your hair with your fingers to expose the skin underneath, then apply the medication directly to it. Then, very gently, rub the area in a circular motion with the flat part of your fingers to work it in. Be sure to wash your hair regularly to clean off any excess Minoxidil that could cause it to tangle.
Yes, long hair FUE is available to women as well as to men. And since a shaved head is significantly less common among women than men, it is one of the best ways they can get an inconspicuous hair restoration surgery. However, if you are looking for a female hair transplant that can preserve your full hair length, be advised that your long grafts cannot exceed 7-10 cm.
Yes, since long hair tends to tangle and snag, there is a higher risk of accidental graft dislodgement with long hair FUE. However, handling your hair carefully and remembering not to run your fingers through it, brush or comb it until your grafts become securely attached (7-10 days after your hair transplant) can reduce this risk. As can following your surgeon’s recommendation to wait at least 10 days before wearing a hat after your hair transplant.
Yes, if you choose an experienced surgeon, you can absolutely get as good results from long hair FUE as you can get from the traditional, shaven variety. In fact, the results may be even better, as the surgeon can see exactly what the hair from the harvested grafts looks like, so they can optimise graft placement and positioning for better coverage and a more natural appearance.
Wimpole Clinic Services:
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Talk to a specialist
Dr Ahmad Moussa is an experienced surgeon. His qualifications include a Master of Science degree in General Surgery, Membership of the Royal College of Surgeons of England, Doctorate degree in Neurosurgery and Fellowship of the Royal College of Surgeons in Neurosurgery. He is a member of the British Medical Association and the Society of British Neurological Surgeons. Dr Moussa has over 15 years’ experience working in neurosurgery and is a GMC and Royal College of Surgeons certified Neurosurgeon.
His training and subsequent work as a consultant neurosurgeon in the NHS has included performing intricate brain surgery while patients are fully awake to be able to safely resect complex brain tumours. This level of skill, expertise and familiarity with the scalp has allowed Dr Moussa to successfully step into the rewarding world of hair transplant surgery.
Dr Moussa is trained in FUT and FUE hair transplant techniques including combining the two techniques together when required to achieve the appropriate number of grafts without overharvesting. He successfully carries out hair transplant surgery for both scalp and beard hair loss. Registered Number: 6065705
