Category Archives: Hair Transplant

Getting Addicted to Hair Transplants

Medications have enabled me to hang on to a large portion of my hair. However, the follicles are incapable of growing long due to a short anagen phase cycle throughout the scalp. The area above my ears cannot even grow one inch in length before dying or shriveling up. And some areas of my scalp are sparser than others.

How Many Hair Transplants do you Need?

Eventually, I will have to choose between shaving it all off or getting a hair transplant. Unless a greatly improved hair loss treatment comes along. I do not like the messy dishevelled look, nor a combover. I also do not like the idea of shaving my head every week in case I go for the barren look. I know I will shave weekly due to having some obsessive compulsive disorder (OCD) and body dysmorphic disorder (BDD) tendencies.

One of the reasons that I am wary about getting a hair transplant is because I am certain that I will need more than one procedure. I feel like the vast majority of patients need two procedures. Moreover, if you are unlucky, even your “permanent” donor hair at the back of the scalp can thin out before old age. Meaning that over the years you may lose some of it after it is transplanted to the front, and then require a second hair transplant. My mother’s father lost most of his “permanent” donor hair before he hit his 70s, although he never took any hair loss medications.

Having said all of the above, according to the ISHRS 2022 practice census hair transplant statistics:

“Two-thirds (68.2%) of members reported performing an average of one procedure to achieve the desired hair restoration result. The average number of procedures needed to achieve the desired hair restoration result was 1.4.”

I would still go with my guess of 2.0 rather than 1.4. If the ISHRS were to follow these one-and-done patients for 20 years, I bet that the majority do end up getting a second hair transplant in the long run. Or at least wanting a second one, but not going through with it for various reasons.

Edit: Joe and Spencer on the July 28th Bald Truth show raised a great point that some of the patients who go for a second hair transplant with a different surgeon might not get counted as “two”. An accurate survey would poll the patients rather than the surgeons.

In the ISHRS census chart, only 28.6% of patients needed two procedures, and just 3.3% of patients needed three procedures.

Number of Hair Transplants
Number of hair transplants needed. Source: 2022 ISHRS Practice Census.

Obviously these statistics are impacted by many factors including:

  • The size of each procedure. FUE procedures tend to be smaller than FUT/Strip procedures. See my post on FUE versus FUT.
  • The need for any separate repair or scar revision surgeries.
  • Whether someone has a small body hair transplant (BHT) filler procedure.
  • Donor hair graft quantity and quality.
  • Scalp laxity when it comes to extraction.
  • Patient preference for a small versus large session.
  • Surgeon comfort level in performing larger one time megasessions (or even gigasessions).

It is extremely rare to hear of anyone who has had more than four hair transplants in their lifetime. Most people seem to get two and are done. However, some do go crazy.

Hair Transplant Addiction

On this site, I have covered the two most prolific hair transplant recipients in the world (Spex and Joe) many times.

Obviously, some of these procedures were very small and entailed repair work or scar revision. Joe had some initial surgeries to repair prior bad work. He also had a small body hair transplant procedure. I do not know much about most of Spex’s various procedures.

Both these major hair loss world influencers have access to their choice of leading surgeon. Moreover, I am assuming that they can get free procedures from any quality surgeon nowadays if they document the work in return.

I thought that no-one would ever come close to ever matching Joe and Spex when it comes to this crazy statistic. Besides the significant cost of a single hair transplant procedure, no-one I know likes to go under the knife on a regular basis. Then I read something crazy last week, and further research led to finding yet more anomalies.

Christopher Maloney had 8 Hair Transplants

Singer Christopher Maloney became a viral hit on the UK X Factor show in 2012. His major nervousness as well as stellar voice garnered him a lot of fans. Including 87 million views of the below video:

Last month, the Daily Mail covered the now 45-year old Mr. Maloney’s obsession with plastic surgery. He has “uncontrollable body dysmorphia”.

“My body dysmorphia, my anxiety and depression has taken over my life. In the past 12 months it’s gone into overdrive.”

One fact in the article struck me more than anything else:

Mr. Maloney has had 8 hair transplants (and 7 nose jobs)!

He seems to go to Poland for most of his procedures. In general, people who suffer from BDD will never be willing to get covered in the media. I have to give kudos to Mr. Maloney for sharing his story so publicly. And for having the courage to sing in front of the world.

Interestingly, in the Daily Mail article, Mr. Maloney blames stress for causing his initial hair loss. i.e. telogen effluvium. But that usually reverses itself after a while. In my opinion, he always had thin hair and likely suffers from androgenetic alopecia (AGA). Chris’s new hair looked good the last time he updated his Instagram a few months ago.

Joe Buck had 9 Hair Restoration Procedures

Well known US sports announcer Joe Buck had his eighth hair transplant in 2011. His story makes for a very interesting read. For a long time he lied to people about a surgery related side effect on his vocal cords in order to avoid discussing his “hair plug addiction”.

He had his first ever procedure in 1993 in New York at the age of 24.

“As a young man, one of Buck’s overwhelming fears was losing his hair, and the possibility soon consumed him.”

Edit: It looks like he had his 9th procedure in 2021 and discusses his results here.

Calum Best and James Nesbitt: 6 Each

  • Also of note, UK reality TV star Calum Best had his sixth hair transplant several months ago. It involved moving beard hair grafts (including from just beneath his neck) to his scalp. In his own words:

“I feel so much better about myself. If science can sort out a problem, why not use it if it is going to improve your mental health and put a smile on your face?”

Calum does not want to take medications such as Finasteride due to any potential side effects. So his hair loss has continued at a faster pace than that of hair restoration patients who are on hair loss drugs.

Cheyenne Jackson: 5 Hair Transplants in 14 Years

American actor Cheyenne Jackson has had five hair transplant procedures across 14 years. He calls his significant strip procedure scar “gnarly”. He had his first surgery at the age of 28. Both his hair loss and scar caused him anxiety and shame.

Fake Hair Transplant Before and After Photos Using AI

Hair Transplant Front Before After AI Photo
Hair transplant in the front (two separate photos). Generated by AI using Bing Image Creator and DALL-E.

Artificial Intelligence (AI) is all the rage in 2023. This is entirely due to the release of the ChatGPT (Chat Generative Pre-trained Transformer) chatbot from OpenAI in November 2022. Most people seem to already be impressed with this technology in its first iteration.

At the time of release, ChatGPT was based on OpenAI’s GPT-3.5 language model and only included information and data through 2021. This was since supplemented with the latest GPT-4 language model that was released on March 14, 2023.

Moreover, after Microsoft Bing added ChatGPT into its new search engine (only available on the Edge browser), the chatbot’s data includes the latest information from 2023. When used inside Bing, the chatbot also cites sources and references that it finds from the Bing search engine.

As the AI chatbot plus search engine battle accelerates, Alphabet (via Google) launched its own new Bard chatbot and Baidu (China) launched Ernie. Google is being more cautious with Bard in comparison to Microsoft with ChatGPT. It would be ironic if the global dangers of AI (and personal data collection) are ultimately in the hands of the Bing, Google and Baidu search engines.

Everything is moving at breakneck speed, although I am not one to trust AI content without detailed verification on my part. On a related note, check out my 2021 post on Alphabet-owned DeepMind’s Alphafold protein database; and my 2022 post on artificial intelligence and drug discovery.

Bing Image Creator Just Launched

I was initially planning to write a post on ChatGPT and how it responds to questions related to hair loss. However, then something even more interesting happened:

On March 21, 2023 Bing launched the groundbreaking Bing Image Creator. It is powered by DALL-E, also from OpenAI.

The old adage is now updated:

“A (fake AI-created) picture is worth a thousand words.”

As Deepfake voice and video artificial intelligence technology continues improving, perhaps someone will create a new adage:

“A (fake AI-created) video is worth a thousand pictures.”

Fake AI Generated Hair Transplant Before and After Photos

Over the years, I have seen numerous examples of hair transplant clinics using before and after patient photos from other clinics as their own. It is an epidemic according to some surgeons. Even when it comes to my own site, I regularly find other spammy sites plagiarizing and scraping my photos, logos, images and content.

But now we have Bing Image Creator that is free to use. No need to plagiarize photos from other people anymore. Moreover, other AI image creation software products (not free) such as Midjourney and Stable Diffusion already became popular in 2022.

The quality of these images is still subpar on some occasions. e.g., the below are two of the four images I got generated for “hair transplant before and after“. It seems like the AI prefers hair transplant results on the rear of the head for some reason! And it often puts the after result first, followed by the before.

Hair Transplant Before After AI Image
Hair transplant before after AI image using Bing Image Creator.

However, I have no doubt whatsoever that it is only a short time before these fake AI generated images become undetectable from the real thing. All of these technologies are constantly learning and self-improving from user feedback.

Moreover, if you vary the query in Bing Image Creator, the photos can become at least somewhat believable. At the very top of this post is one with the query “hair transplant in the front.”

Below are two results for the query “FUE hair transplant.”

FUE Hair Transplant AI Image
FUE hair transplant artificial intelligence Images.

To me, both of the above images seem like they are of real human scalps. Quite amazing if you are someone who is older than 30 years old in my opinion. Google was only founded in 1998, and the internet only started to became popular in the mid-1990s. Smartphones and faster speed internet access are yet more recent.

Inevitably, we will see numerous hair transplant surgeons and hair loss product developers use such “fake” photos. It will become impossible to discern truth from fiction. I would not be surprised if even some clinical trial before and after photos turn out to be doctored ones in the future.

Buyer beware (Caveat Emptor) is truer then ever before.