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.
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.
- Spencer Stevenson (aka Spencer) has had 13 hair transplant procedures in his lifetime. You can watch him on The Bald Truth UK show.
- Joe Tillman (formerly Jotronic) has had 9 hair transplants. He now has an almost daily hair loss show called “The Mane Event“. I have a nagging suspicion that sooner or later Joe will have his 10th.
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.
- Well known UK actor James Nesbitt also had his sixth hair transplant in 2019. I covered him in 2014 when he was stuck on two.
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.
Joe Buck! Never knew.
I thought Joe had his tenth surgery a few years ago?
Thanks Nc2023. I should check up with him as I used an old number that I have never updated. On Joe’s site (linked in the post), he does not list all 9 or 10.
Edit: Did you mean Joe Tillman or Joe Buck?! Looks like Buck had his 9th in 2021 after a 10-year gap. I updated that part of the post.
No, I’m pretty sure he had 10. I think he mentioned that on a recent episode of the bald truth.
I think it all comes down to choosing the right surgeon and staying on meds. I think the difference comes down to the surgeon. I think even the rich people like celebrities and athletes aren’t even as educated about who to go to and then get mediocre results and have to keep touching up. An example is a lot of athletes and celebrities go to Leonard. In my opinion his results are mediocre at best. I think some surgeons can make less grafts go way further than other surgeons. In my opinion the most important factor of hair loss and what makes me the most self conscious is the hairline. In my opinion if you have a solid frontal 3rd through transplants you have it made. This is what frames your face. If you have a strong frontal third and then transition into a thinning mid and crown you will look good. This is very age appropriate when you reach your late 30s and so on. Will you ever have the density of your adolescent hair? No, but having a solid hairline in my opinion is what it’s about and that is 100% achievable with the right surgeon. If you look at older dudes that are diffuse thinners but still have a solid hairline to frame their face they look solid compared to those that have no hairline. Thin hair with a hairline is way better than no hair up front. Just my opinion
Hey, if you have the donor hair, and spread out those surgeries over the course of a decade or more, why not get eight? You’re only limited by money at that point. Most people don’t have 8 surgeries worth or donor hair, though – depending on the size of each surgery. Heck, if I had donor hair I’d get another one right now.
I’m one of the “two” people but my doc said something that stuck. He said sure we can do it all at once but it’s best to do some, see how it turns out and then follow up with another (often smaller) surgery (they’ll sometimes give you a deal on the second if you use the same surgeon). I like the idea of two because you can reassess and say, okay, you know what? Let’s thicken or do this or that instead this time. It’s like a second chance to change things based on results from the first.
But I think it also comes down to when you do the surgery. Earlier the better (less loss to try and cover) – and as Ty said, stay on the meds. That’s key.
Great comments James1 and Ty.
Interesting comments all around. I’m due for my first surgery this November with the Muresanus.
It’s taken me almost 2 years to save the full amount, and I’m fearful of future dissatisfaction / further surgeries needed – but I suppose this simply comes with the territory.
I have scarring alopecia so I’m in a tough position. I have hair loss in spots along my hairline. Styling my hair is a nightmare. If I sweat, the 1-2 hours I put in styling my hair will become undone in a matter of minutes. If there is ever a cure, you guys will have your hair back before me.
I’m worried about the shock loss of a transplant. The sides of my hair have been thin since Dec of ’99 when I left some relaxer on it for too long. If the sides go due to shock loss, it’s not coming back.
I know it happens to some but I didn’t have any shock loss. Legit concern though, I get it. Sounds like you’re in a tough situation. I feel for you. It’s really impossible to say how successful any HT will be (for anyone) because we’re all unique and you can’t really say how your body will respond. Best we can do is research so we’re making an educated decision (and picking a good surgeon).
I’ve always said that HTs would be the ultimate cure if you could just clone hairs. It’s wild how fast your sides can thin when you start taking thousands of grafts from them (surprisingly fast). If I could clone mine, I’d definitely get at least one or two more HTs. But I know we’re decades away from that being possible and the cost would be insane (HTs are expensive enough as it is).
51 years old today, I started losing my hair with 20. 31 years ago I would have bet everything in favor of a permanent cure for baldness within 10 or 20 years, apparently I would have lost everything and not just my hair. 31 years and still nothing… very sad.
Please guys, at least let me complain.
Happy Birthday Larry, keep hope alive, may your next decade bring a better treatment that works to improve your hair.
Happy birthday Lorence! I can fully empathize.
Very interesting post. I do not understand how one can get more than 4 lifetime hair transplants with today’s larger better quality individual sessions. FUE or Strip.
Hi guys, I lost track … which company is working on microRNA to treat hair loss?