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Can You Have a Hair Transplant With Long Hair?
Dr Lucy Glancey (MRCS)
Medically reviewed by
Dr Lucy Glancey (MRCS)
Updated on May 20, 2023

If you are considering a hair transplant but have long hair and are worried about either shaving your head or letting people know you have had a hair transplant, then good news – there are many options at your disposal at the Wimpole Clinic.

It’s certainly possible to have a hair transplant if you have long hair. In most cases, this is no different from a normal FUT or FUE procedure. Lots of people with long hair choose an FUT procedure, as their hair lengths will cover up any hair transplant scarring.

But there are other hair transplant techniques for people with long hair.

In this article, we will explore your options with an array of procedures, benefits, and risks associated with long hair transplants.

Table of Contents

Types of long hair transplant

As well as standard FUT and FUE methods, there are other techniques that may be used for those with longer hair. These include:

  • Long hair transplant — the hair shafts are kept intact when the grafts are removed and transplanted
  • Unshaven FUE (UFUE) — the recipient area is left mostly or completely unshaved when the grafts are implanted, helping to keep your hair transplant under wraps.

Let’s explore how each technique is different, and what to expect from each.

How do long hair transplants work?

For patients with long hair, a traditional FUT or FUE is often a viable option to cover bald spots, lower receding hairlines and increase density if hair has become so thin your scalp can be seen. In standard hair transplants, the hairs can be extracted at their full length, but the recipient area is usually shaved so the grafts can be transplanted with ease.

Standard FUE long hair after graft harvesting
Standard FUE long hair after graft harvesting
Unshaven FUE technique

Extracting long hair grafts

A long hair transplant involves extracting the follicle and then trimming the hair shaft to a length of 2 – 8 cm (rather than the 2 mm of a traditional FUE procedure) before inserting it back into the scalp.

As pictured above, an assistant holds the hair aside using upward traction or a narrow sterile stick, while the surgeon punches the follicle with their right hand and moves the hair with the forceps in their left hand.

These transplanted hairs are long enough to disguise the areas of implantation, which will scab over in the days following the procedure.

Before and after long hair transplant
Patient’s desired hairline marked prior to a long hair transplant [left], patient’s appearance immediately following long hair transplant surgery [right]

Implanting long hair grafts

After extraction, the long hair graft is trimmed to around 3-4cm (or 1cm for eyebrow transplants) and collected for implantation.

Long hair transplant grafts vs tradiitonally shaved hair transplant grafts
Long hair transplant grafts after trimming (left), traditional shaved hair transplant grafts (right)

The surgeon then inserts each graft into the scalp. With unshaven FUE, approximately 2500 grafts can be extracted and implanted per day, with surgeons reporting the procedure is “time consuming, demands high concentration, and is physically exhausting.”

Can You Have a Hair Transplant With Long Hair?, Wimpole Clinic
Long hair transplant seven days after the procedure (left), traditional transplant 12 days after the procedure (right)

Advantages of long hair transplants

So, what are the advantages of a long hair transplant over a traditional transplant? 

Hidden transplant

Many people are put off from a hair transplant by the obvious visual signs of the procedure, such as a shaven scalp and scabbing. The primary advantage of a long hair transplant is that these signs are minimised and can be often completely hidden.

Hair is either entirely unshaven, or only shaven in small patches, which are easily obscured with styling. Patients often return to work and everyday activities within days. 

Hair transplant preparation for female patient with long hair
Clips are used to expose the scalp in preparation for hair transplant surgery in a female patient with long hair.

Immediate results

If you choose an unshaven hair transplant, you may be able to  return to everyday tasks within days without anyone knowing you have undergone the procedure. Redness and scabbing can be obscured under your hair, and you can maintain your original hair style.  

It usually takes around 6 months to a year to see the final results of standard FUE. With a long hair transplant, patients can get an immediate impression of their final results, equivalent to approximately 1 year post transplant.

In one study of 10 long hair transplant patients, 8 patients stated that their immediate result was 80% accurate with their 6-month result [1]. Patients also appreciated the early clarity on the results of the procedure, allowing them to plan for further treatment if necessary. 

Can You Have a Hair Transplant With Long Hair?, Wimpole Clinic
Long hair transplant patient, A: before the operation, B: immediately after the operation, C: 6 months after the operation

The study also noted that postoperative scabs lasted longer with an unshaven FUE than traditional FUE, but patients returned to social activities quicker as the scabbing and redness could be easily concealed. 

While the unshaven FUE procedure offers definite advantages regarding the immediate appearance of a patient, it’s important to note that long hair transplant patients are still at risk of shock loss

Shock loss refers to temporary postoperative shedding experienced by many patients, also known as telogen effluvium. The trauma of the procedure causes both the newly transplanted hairs and those nearby to fall out, leaving the follicle root safely embedded in the scalp. In the following weeks and months, those hairs will regrow. 

For long hair transplant patients, if their newly transplanted hairs do shed, patients will have to allow time for these hairs to regrow just like those undergoing a traditional transplant. This gentle shedding can affect patients’ ability to disguise their affected areas, although the impact on appearance is limited: by the time shock-loss occurs, most of the scabbing and redness should have healed, leaving hairlines close to their pre-transplant state. 

The chance of shock loss, furthermore, however, can be mitigated by use of Minoxidil after your hair transplant. Minoxidil is an FDA-approved hair loss medication that works as a vasodilator, widening blood vessels in the scalp.

Better follicle selection and placement

For areas where hair curl and weight are vital for seamless transplantation, such as for beards, sideburns, or eyebrows, long hair transplants help the surgeons select the best follicles to match the area as effectively as possible. 

Surgeons are also much less likely to implant follicles in the wrong direction, which results in odd hairs growing away from the main body of hair. This can also cause skin cysts and benign spots linked to inflammation.

Lower risk of overharvesting

Some reviews have suggested that there is a lower risk of overharvesting follicles from the donor area as the surgeon is better able to see the hair loss in this area [2]. However, this is only considered relevant in cases where patients have previously suffered severe overharvesting, or when the donor area is very small in cases of advanced hair loss. Standard qualified hair transplant surgeons are trained to work with a shaven donor area. 

Disadvantages of long hair transplants

While long hair transplants are becoming an increasingly popular option, there are several drawbacks to the more complex unshaven FUE procedure that can deter some patients.  

Procedure difficulty

The long hair transplant procedure is considerably more difficult than the traditional transplant. The unshaven long hairs can tangle and knot, making extracting the follicle much harder as the strands get stuck together. This is compounded by blood from the punch holes which quickly clots in the long hair.

The number of doctors qualified to perform the procedure are limited, making it harder for patients to find the right clinic for them. 

Long hair transplant recovery

As with a traditional transplant, in the immediate days following the procedure patients may experience minor symptoms like tenderness, swelling, or redness. These are only temporary and resolve in the days after the procedure. In order to keep these symptoms under control, your doctor may prescribe anti-inflammatories or painkillers. You can also discuss specific post-transplant medications that your doctor may recommend, such as minoxidil

Immediately following the procedure, patients usually wear bandages for a day but are able to return to day-to-day life within 1-2 days. Hats and hoods should be avoided until given the all-clear by their surgeon, while patients should resist scratching the donor and transplant sites at all costs. 

As the transplanted hairs are longer, they are at greater risk of tangling and therefore being dislodged from the transplant site, so as much care should be taken as possible. Steps to protect your hair transplant at night include: 

  • Elevating the head
  • Investing in a silk pillowcase
  • Supporting the head with a travel pillow or similar to avoid turning in the night
  • Avoiding tight hairstyles

Hair transplanted grafts are expected to secure themselves into the scalp in a process known as anchoring within 5-9 days. Your doctor will give advice regarding washing your hair (saline solution is often recommended for the first wash) to reduce trauma to the transplant, while firm brushing should be avoided for 3-4 weeks. 

Is a long hair transplant right for you?

Studies have shown that the final result of a hair transplant is not affected by the type of procedure [3]. Standard hair transplants, unshaven FUE, and long hair transplants can result in the same final visual, and so patients can make the right choice for them without worrying about the end result. 

If you are considering a long hair transplant, it is essential to consult with a qualified hair restoration surgeon to determine if the procedure is right for you. Your surgeon will evaluate your hair loss, medical history, and overall health to determine if you are a good candidate for the procedure. They will also discuss the benefits and risks associated with long hair transplants and answer any questions you may have.

Unsure of what to ask? Check out our list of questions to ask before your hair transplant to help you get the best out of your free consultation. Book a free consultation at the Wimpole Clinic to find out more.

Dr Lucy Glancey (MRCS)
Medically reviewed by Dr Lucy Glancey (MRCS)Updated on May 20, 2023
The Wimpole Clinic offers FUE Hair, Beard & Eyebrow Transplants & Trichology.
Talk to a specialist ☎ 020 7935 1861.
Dr Lucy Glancey (MRCS)
Medically reviewed by
Dr Lucy Glancey (MRCS)
Updated on May 20, 2023

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