If you’re completely bald, you may assume a hair transplant isn’t possible. This is because, in order to perform a full hair transplant on the scalp, a surgeon will need to harvest groups of healthy hair follicles from a donor area. According to the ISHRS, 93% of donor hair sites are situated on the back of the scalp [1].
However, in cases of total baldness, there are no hair follicles available to harvest from the scalp, meaning a hair transplant usually can’t be performed on a totally bald head. Fortunately, in some cases, it’s possible for people with extensive hair loss to have hair restoration surgery.
Wondering whether a hair transplant is possible if you’re completely bald? You’ve come to the right place. In this article, we discuss whether it’s possible, how completely bald hair transplants work, and who may be a good candidate.
We also explore which is the best donor area, what recovery is like, and complementary therapies that may help you get the results you want.
Key takeaways
In some cases, it may be possible to get a hair transplant if you’re completely bald. Nonsurgical treatments such as PRP and hair loss medications like minoxidil may activate dormant follicles on the scalp [2-3], providing a sufficient donor area for a hair transplant.
This patient used a combination of finasteride, minoxidil and derma rolling for hair growth to prepare his scalp for hair transplant surgery. Once his density had improved, he went on to have a 4,345 graft follicular unit extraction (FUE) hair transplant.
Although this patient was not completely bald, the image demonstrates the potential of nonsurgical treatments to improve hair growth sufficiently to get a hair transplant.
Surgeons may also use donor hair from other areas of the body, such as the beard, chest, or other areas. However, body hair transplants may not look as natural and there is usually not enough hair for full coverage on the scalp.
If you’re completely bald, you will not likely be able to get a sweeping mane of hair from your surgery. You may, however, be able to at least have a natural-looking hairline restored.
This Wimpole Clinic patient had a 4,500 graft combined FUE and follicular unit transplantation (FUT) hair transplant. She is a transgender woman who used minoxidil and finasteride before her surgeries to maintain hair growth, as well as hormone medication to help with her transition. She was in her early 50s at the time of the transplants.
She had significant hair loss before her hair transplant; around stage 6 to stage 7 on the Norwood scale. She went on to have a further two hair transplants at the Wimpole Clinic with successful results.
This patient also had extensive hair loss and received a 4,500 graft hair transplant at the Wimpole Clinic. She had also undergone brow lift surgery, raising her original hairline.
Our team successfully created a feminine hairline and significant coverage, despite these challenges. Although there are still areas of the scalp visible through her hair, the overall appearance is much improved.
In the future, it may be possible to improve these areas with treatments like PRP, low-level laser therapy, minoxidil, and possibly a second hair transplant if she has sufficient donor hair.
This patient was almost completely bald on top at Norwood stage 6-7. He had a 2,800 graft FUT hair transplant at the Wimpole Clinic, with excellent results.
While he doesn’t have a sweeping mane of hair post-transplant, his results look very natural and are a definite improvement. He’s now around stage 3 to stage 4 on the Norwood scale.
There are two main methods of hair transplantation: FUE and FUT. Both hair transplant procedures rely on removing healthy hair follicles from a donor site elsewhere on your body.
Learn more here about the differences between FUE and FUT hair transplants.
The scalp may not be a viable donor site if you’re completely bald with no existing hair present. Hair donation from other people isn’t usually possible for hair transplants. However, it may sometimes be possible to use other areas of your own body as the donor area.
Not all people are candidates for a body hair transplant, as the success rate of any hair transplant first relies on donor supply. In these cases, you may need to consider other types of hair restoration.
If it’s viable to use a different area of the body as a hair transplant donor area, FUE surgery will most likely be the best option, as this leaves minimal scarring in noticeable places. Some research suggests FUE hair transplant surgery is the only appropriate method for harvesting body hair [4].
If you have an autoimmune hair loss condition such as alopecia areata or alopecia universalis (where the immune system attacks hair follicles), you are not usually a good candidate for a hair transplant. Transplants in these cases almost always fail because the new grafts are vulnerable to the same immune response.
Other people who may not be good candidates include those with insufficient donor hair, unstable or rapidly progressing hair loss, or serious health issues that make surgery unsafe. You’ll need a specialist consultation to confirm whether surgery is safe and appropriate for you.
In general, the best donor area for a hair transplant is the back or sides of the scalp. Opting for an alternative donor site to the scalp means that the look and feel of the transplanted hair will likely be different in coarseness and colour.
After the scalp, the second most common donor area is the beard, as beard hair continues to grow despite the presence of DHT (dihydrotestosterone) in the body [5] In fact, beard hair growth is stimulated by DHT.
Beard hair is coarse and may be slightly different in colour compared to the head. However, it can provide good coverage to the crown area if you’re considering a crown hair transplant.
When body hair is moved to the scalp, it retains its natural growth cycle. This means the density can fluctuate more over time than with transplanted scalp hair [6].
Body hair extraction (especially the beard and chest) is more time-consuming, technically demanding, and can result in higher graft transection rates and a lower total yield than scalp hair [7]. The follicles are more fragile and require careful handling.
It’s also unlikely that you’ll have enough body hair for a high coverage hair transplant. A hair transplant surgeon will assess whether you can achieve a natural-looking hair transplant with body hair.
If your scalp is completely bald, using chest and abdomen hair along with beard hair on the scalp may create good coverage, as well as a natural-looking hairline. It all depends on how much body hair you have available.
The level of hair loss that men experience is usually measured against the Norwood Scale, which shows the 7 progressive stages of male pattern baldness (the female pattern baldness equivalent being the Ludwig Scale). Your Norwood stage can determine the possibility of a hair transplant, as most transplants rely on a donor area from the scalp.
At Norwood stage 7, which is the most advanced level of hair loss, you will typically have a single band of hair around the back and sides of your head, and be bald across your crown. Norwood stage 6 can also appear as almost total baldness on top.
Dr Thomas shares,
“Norwood stage 6 patients have been happy with their outcome from 2 FUE procedures. The success depends on their opinion.”
“If the patient is keen for a transplant after discussion it may be in their best interests to consider FUT procedures first to maximise the yield from the donor area, being conservative with hairline design, and potentially improving their starting position with medication first (if miniaturised hairs are present).”
Some men with aggressive hair loss begin to lose hair in the safe donor area. This is known as retrograde alopecia. Those who are completely bald are at a more advanced level than any stage of the Norwood scale and have an atypical type of pattern hair loss.
This does not mean that a hair transplant is impossible. Even if you are totally bald, you may have a healthy supply of viable hair follicles in other donor areas.
However, Dr Thomas advises that if you are completely bald and are expecting a full coverage look with good density, a hair transplant may not be the best way to achieve that. He suggests scalp micropigmentation and hair systems as potential alternatives.
Throughout the process of a hair transplant, surgeons must keep the safe donor area in mind. This establishes a safe number of hair grafts that a surgeon can extract from the donor area to avoid overharvesting the follicles. Therefore, even if you have some hair present on your scalp, it may not be usable if you’re at risk of hair transplant overharvesting.
In most cases of male pattern baldness, your stage on the Norwood Scale would determine the number of grafts you would need for a hair transplant. However, complete baldness is not a stage on the scale and therefore differs.
Using a graft calculator, you can work out how many grafts you need. At the most advanced stage of male pattern baldness, Norwood stage 7, zones 1-6 would all need transplanted grafts.
However, that would total around 7,650 grafts for full coverage. The average number of grafts that can be harvested from the safe donor area in a lifetime ranges from 4,000 to 6,500 [8], which is why full coverage transplants at Norwood stage 7 are generally not possible. But transplants that restore partial coverage and a natural-looking hairline are often a viable option.
It’s difficult to successfully transplant large numbers of grafts in a single session. For patients with extensive hair loss, surgeons often plan multiple sessions to safely achieve the maximum number of usable grafts.
Dr Thomas shares his insights on this topic:
“Ideally a patient would need 4000+ grafts to get good coverage and density. It is subjective on what a ‘meaningful result’ is, therefore an honest discussion with the patient is needed.”
“They would need to accept limitations with their donor area (such as low density, fine hair, a small head and a small safe donor area), and think about whether they should target specific areas (e.g. the frontal half) for a better cosmetic outcome. Talking about hair transplants as multiple procedures can help patients think about getting improvements initially and then reassessing to try and enhance further.”
Even if you’re completely bald, recovery should follow the same stages as other hair transplant patients. However, larger transplants may take slightly longer to heal, and multiple sessions will extend your overall hair transplant recovery time compared to a single session.
In the first 1-2 weeks post-op, hair transplant scabs and redness are common as the scalp heals, and these usually settle by the end of week two. In the first few days to weeks [9], most transplanted hairs fall out in a process called shock loss.
This is completely normal and doesn’t mean the grafts have failed. It usually resolves around month 3-4 [9], which is when new hair growth begins coming through. These new hairs gradually thicken and gain density over the following months.
By 12-18 months, the final results are usually visible. But if you’re starting from complete baldness, it’s important to remember that transplanted density is limited by the donor area. While a natural hairline and significant coverage can be achieved, full youthful density across the entire scalp is rarely possible.
If you have very limited donor hair, complementary therapies can make a big difference to the final outcome. Scalp micropigmentation can create the look of natural stubble or added density, helping camouflage areas where full coverage isn’t possible [10].
PRP injections given during the hair transplant procedure can help improve results by [2]:
Medications like finasteride and minoxidil help stabilise ongoing hair loss and improve the quality of existing hair. This gives you better overall results and can reduce the need for repeat procedures.
When choosing a clinic, safety and credentials should come first. Look for surgeons who are properly licensed and experienced in performing the type of hair transplant they’re offering you. Reputable clinics are transparent about their team, surgical methods, and aftercare, and will show you genuine before and after photos of patients with similar hair loss.
Want to see the results we get at the Wimpole Clinic? Check out our extensive gallery of hair transplant before and after photos here.
Be cautious of clinics, especially overseas, that advertise very high graft numbers at low prices. This is a known tactic for Turkish hair transplant clinics to create perceived value — learn more here about Turkish clinic red flags.
Overharvesting can leave permanent thinning in the donor area, and procedures performed by unqualified technicians increase your risk of increased hair transplant scarring, hair transplant infection, and poor results. A good clinic will give you a realistic treatment plan, explain the risks, and never pressure you into surgery.
If baldness or hair loss is having a negative impact on your life, the Wimpole Clinic is here to help. Our expert trichology team can help you explore hair restoration treatments, which may include discussing hair transplant options or considering hair loss medications to fight against further hair loss.
The Wimpole Clinic has been awarded best hair transplant clinic for four years running) and we’ve been providing expert hair restoration services for more than 50 years. We offer a range of services, including FUE and FUT hair transplants for extensive hair loss.
Book your free consultation at your nearest clinic location to find out more. Learn about the questions you really want to ask before hair transplant surgery to get the most out of your consultation.
People with autoimmune conditions like alopecia areata or alopecia universalis, those with very limited donor hair, unstable or rapidly progressing hair loss, or serious health problems are usually not good candidates. Speak to a hair doctor or hair transplant surgeon to learn whether a hair transplant may be an option for you.
The average price per graft in Turkey is £0.55, according to our Turkish hair transplant cost analysis. This means that a 5,000 graft hair transplant costs on average around £2,750, though prices vary by clinic, technique, and surgeon experience.
Prices are generally lower than in the UK, but beware of clinics offering unnecessarily high graft numbers for your procedure. It’s not always possible to tell if a Turkish hair transplant clinic is legitimate unless you get there, as some clinics offer fake reviews and photos online.
Hair transplants are performed under local anaesthesia, so you should only feel only mild discomfort during the procedure. Afterwards, you may have scalp tenderness or tightness for a few days. Hair transplant pain is typically managed with over-the-counter medication, and most people describe the experience as uncomfortable rather than painful.
Hair transplants are generally permanent because transplanted follicles come from the safe donor zone, which is resistant to balding. Results usually last a lifetime, though natural ageing and ongoing hair loss can affect your transplant’s appearance. Some people may need future treatments or medications to maintain coverage and preserve their results long-term.
Wimpole Clinic Services:
Hair Transplants, Beard Transplants & Eyebrow Transplants.
Talk to a specialist
Dr Peter Thomas (GMC 7554440) specialises in FUE (Follicular Unit Extraction) hair transplants and has trained with our internationally recognised surgeons at the Wimpole and Mayfair Hair Clinic. His strong artistic background and breadth of surgical experience enable Dr Thomas to excel in combining a keen sense of aesthetics with meticulous attention to detail.
After graduating from St George’s University of London with a Bachelor of Medicine and Surgery, and also earning a Bachelor’s degree in Biological Sciences, Dr Thomas continued his career as a general practitioner. He is a member of the Royal College of General Practitioners, General Medical Council, and an associate member of the International Society of Hair Restoration Surgery (ISHRS). Dr Thomas gained valuable surgical experience in the NHS, working across general surgery and trauma and orthopaedics. His experience in general practice also provides expertise in women’s health and dermatology.
Focused on achieving natural results, Dr Thomas strives for harmonious designs that complement his patients’ facial features and age. He uses a sapphire blade to create closely packed and precise incisions, achieving high-density, and seamless hair direction and angulation. Additionally, he practices non-surgical hair restoration techniques including platelet-rich plasma (PRP) therapy.
Dr Thomas understands the significant impact of hair loss on an individual’s self-confidence and well-being, taking the time to listen to his patients’ concerns and aesthetic goals. He is one of the lead surgeons at our prestigious Birmingham clinic and contributes his expertise and experience to the benefit of Wimpole clientele.
