If TikTok is anything to go by, the hair transplant is gaining traction among twentysomethings, with top Harley Street surgeon (and president of the British Association of Hair Restoration Surgery) Dr Christopher D’Souza noticing a younger demographic in his clinic. However, unless you’re experiencing severe, early onset male pattern baldness, it’s worth exploring treatments such as finasteride and minoxidil before you turn to more extreme measures. “The worst candidates are guys in their twenties who are losing their hair, not keen on medication and just going straight to transplant,” D’Souza says. “You can only graft where there’s space to graft, so if they lose more hair, they’ll end up with an unnatural pattern pretty quickly.”

As for the perfect candidate? That would be fellow aesthetics expert Dr David Jack, who, aged 39, turned to his friend Dr D’Souza for treatment earlier this year. Having noticed thinning in the past few years, he’d already started on the medication to slow down the hair loss, plus tried a few rounds of platelet-rich plasma (PRP) to help with shedding. All this meant he could go from deliberation to consultation to surgical chair within the short space of a couple weeks.

Micrografting is considered to be the gold-standard alternative to transplants – and a more suitable choice for those at the earlier stages of hair loss or who don’t want the downtime of transplant. “We call it a lunchtime treatment because people can come in, get it done and go back to work,” says Dr Daniel Hunt, who performs the procedure at aesthetics super-clinic Ouronyx in London. “The only sign you’ve had anything done is a little plaster.”

As for results, expect thicker, fuller strands by the six-month mark – and depending on results, you’ll only need to repeat treatment every two to three years. But do manage your expectations if you’re on the balder side.

“[With male patients], I think the biggest thing you’ve got to explain to people is that if hair’s not there, it won’t bring it back,” Hunt says. “If you’ve got a bald patch or real area of thinning, a hair transplant is your best bet.”

Still, the two aren’t mutually exclusive and can give optimal results in conjunction. “Before a hair transplant, it can help thicken up the hair you’ve got and improve scalp health. And after a hair transplant, it can help with longevity.”

As D’Souza explains, there are two hair transplant techniques: follicular unit transplantation (FUT) and follicular unit extraction (FUE). The former is the more old-school method. It involves a “linear strip excision [from the scalp] – about 1.2, 1.3cm of width,” D’Souza says. This is dissected into individual follicles, which are then implanted. “This way, you don’t have to shave your head at all, but you do end up with a thin linear scar at the back of your head,” D’Souza says.

Nowadays, though, FUE makes up about 90 per cent of D’Souza’s practice. “This is where you’re punching out each graft individually. The main advantage is no linear scar, so you can wear your hair shorter. But you usually have to shave the back and sides down to zero.”

How do they compare? “FUE gives the most flexibility. If it’s a younger patient and you’re not sure what’s going to happen in the future, FUE is the best technique because, if worse comes to worst, you can just shave it all quite short and be done with it. FUT is really good for cases where you have extensive hair loss, and you can’t get the number of grafts required with FUE. If you wanted as many grafts as possible, that’s the way to get them.”

The secret to a natural-looking transplant is all in the hairline. Typically, the shape will be agreed upon during the consultation stage – ensuring some natural recession in the temples as is common to most men – and then drawn on again just before surgery.

“You have to make sure that you do something which is going to be in keeping as they get older,” D’Souza says. “There are a lot of younger patients that want a very flat, low hairline. It can look quite oppressive to begin with anyway, but especially when they age and they have a wodge of thick hair [at the front] and then thinner hair behind it.”

To avoid this, top surgeons such as D’Souza will divide hairs into one, two and three hair follicles, using the finest grafts around the hairline to mimic natural growth. “With the single-hair follicles] along the front, it shouldn’t be a flat line – it should be nice and tethered, with the twos and threes behind it, so really you get that irregularity and that asymmetry.”

Yes… and no. While transplants can technically be performed on all hair types, those with Afro hair would do best to seek out a specialist – and in these cases, Dr D’Souza typically refers patients to Dr Christian Bisanga, who is based out in Belgium, but runs consultations in the US and UK.

“Afro hair itself is often dryer due to the amount of cuticle layers present, and the hair tends to be thicker and tightly curled,” Bisanga says. “The curvature of the hair extends below the scalp, often to the extent that the follicle when removed is in the shape of a letter C, meaning that it is essential to have a surgeon who has knowledge and experience of working with Afro hair.” He also notes proneness to keloid scarring among Black patients, meaning that “some may be more suited to FUE [than to FUT]”.

As for the actual procedure? “The placement is harder due to the follicle shape and so the whole process from harvesting, extraction and placing of the follicle presents more challenges,” Bisanga says. “Recipient site cutting also needs to reflect these differences with angles and density that is particular to Afro hair.”

In a nutshell, be sure to put your hair in the hands of someone with significant experience in your specific texture. “Failure to do so can result in over-harvested donors in the attempt to get [a certain] number of grafts, poor healing of the skin with possible keloid formations, and poor and patchy growth.”

An FUE transplant is a nine-or-so-hour procedure, with Dr D’Souza dedicating an entire day to each case. Patients are awake the entire time and are free to pop to the bathroom, use their phone and even have their lunch in theatre. “I was going to do some work – but I just couldn’t get my laptop to the right angle, so I just watched Netflix,” Jack says.

If the patient hasn’t done so already, their head will be shaved before D’Souza goes in and marks the hairline out with them in the mirror. And when the time comes for him to make the incisions, the ouch factor is relatively low. “You have local anaesthetic injections all the way around, so I was numb the entire time,” Jack says. “The whole process was relatively pain-free.”

From there, D’Souza carefully harvests the hair follicles from the back of the head using an extraction device, while two or three technicians on either side inspect each of them under the microscope and divide them up into ones, two and threes, before they are finally inserted into the new sites.

Expect to leave with a bandaged head, a pocket full of antibiotics, and a saline spray to keep the wounds clean. And for the first five days, “you want to be at home looking after your grafts,” D’Souza says. “Nothing’s keeping them in place apart from the skin healing over.”

By day six, you’re welcome to wear a loose-fitting hat, although swimming, the gym and the sauna should be avoided for two weeks. Generally, D’Souza’s advice is to book a week off work, but as Jack explains: “I had [my transplant] on the Friday, and I came back to work on the Monday, and nobody noticed that I’d had anything done.”

After about three weeks, the new hairs will start to fall out and then from month three to six, you can expect them to start regrowing again. And granted you’ve followed the aftercare advice, recovery should be pretty smooth sailing.

“The only pain I had was about day seven at the donor site at the back, where they take a biopsy,” Jack says. “It was a bit achy while it was healing and a bit scabby, but not anything that paracetamol couldn’t treat.”

With FUE, the wounds at the back of the head are miniscule and so tend shrink down and heal up quickly. For strip surgery, however, it’s back to the doctor around day 12 to 14 to have the stitches taken out.

“By six months, there’s maybe 50 per cent of the result,” D’Souza says. “The new hair will have come through, but it may be a little weak and flimsy, and it can be a little bit frizzy. By 12 months, it’s around 90 per cent, and the final result is 18 months.

“Generally speaking, there’s very few complications with surgery that’s done correctly,” he adds. That said, expect to return periodically for check-ups with your surgeon to ensure all’s ticking over as planned.

Given all goes to plan, “you generally get 85, 90 per cent take of the grafts,” D’Souza says. And though your hair won’t realistically be as thick as it was when you were 15, “it can change people’s overall face shape dramatically.”

Finally, for those who’ve spent years grappling with hair loss, a well-performed hair transplant can be both a confidence booster and stress reliever. “One of the best things is when people say they don’t really think about their hair any more at all.”