Hair transplants explained: From grafts and hairlines to recovery and risks

A holiday package might begin innocently enough — wandering through historical landmarks, strolling along sunlit coastlines, and taking a few restorative days horizontal on a scenic Riviera. Increasingly, however, travellers are adding another dimension to their itineraries: medical procedures. Hair transplants have become one of the most common procedures sought overseas, with Türkiye, Thailand, India, and other destinations attracting patients worldwide due to competitive pricing, social media exposure, and the promise of fast, dramatic results.

The numbers can be persuasive. Hair transplants can go for as little as US$1 per graft — an irresistible offer for the price-sensitive, says Dr Joshua Chong, medical director at Terra Medical Clinic and a practising hair transplant surgeon.

“With Follicular Unit Extraction or FUE technology, where individual hair follicles are extracted from the donor area and then implanted into the recipient area that is thinning or balding, this skill requires less understanding of anatomy. Anyone can perform hair transplant surgery at cutthroat prices,” he says.

Dr Rachel Ho, medical director at LA Clinic, sees a familiar playbook. “Türkiye has built a reputation as a hub for cosmetic treatments, especially plastic surgery, especially among Europeans,” she notes. While cost plays a role, social media is the real engine. “I’ve seen on TikTok, mostly patients documenting and sharing their transformative overhauls like facelifts, rhinoplasties, and hair transplants. However, I also believe that there are patients who also seek more discreet tweaks.”

Still, she’s quick to point out that savings aren’t always as straightforward as they seem. “Most of the time, the recovery is uncomplicated, but if complications emerge and the patient requires continuity of care or corrective procedures, the costs may outweigh the initial savings.” Emotional and psychological stress, she adds, carries its own price tag — especially when expectations weren’t properly set in the first place.

Even injectables aren’t exempt. Botox, threads, and fillers may sound low-stakes, but Dr Ho points out that these, like every medical procedure, come with risks such as blindness, asymmetry, and infection. “And if these occur, is this overseas doctor or clinic prepared to manage the complication?”

The graft trap

Marketing rarely reflects that reality, particularly when it comes to hair transplants. “There are certain red flags to be aware of,” says Dr Chong, “not just from Türkiye but also Thailand, China, India and Pakistan. For example, unlimited grafts, no-scar hair transplant, and the list goes on.”

Unlimited grafts may sound generous, but the donor area has a finite supply of healthy follicles. Overharvesting can leave visible thinning that’s impossible to reverse. The promise of a no-scar transplant is equally misleading: while FUE avoids a single linear scar, it still creates hundreds of tiny dot scars where follicles are removed.

More importantly, Dr Chong stresses that hair loss is often mistaken for an isolated problem with a single fix. In reality, it’s usually a combination of genetic and epigenetic factors, including nutritional status, chronic inflammation, hormonal disorders, elevated stress, medication side effects, scalp microbiome shifts, and cellular ageing. In some cases, it’s a symptom of systemic disease, such as systemic lupus erythematosus or polycystic ovarian syndrome.

“These conditions require an experienced hair restoration professional to assess, diagnose and treat appropriately,” he says, “sometimes without the use of invasive techniques.”

Fringe benefits

Back in 2010, researchers at Procter & Gamble posed a simple question: how important was hair to starting the day on the right foot? For many respondents, it ranked above sex. What wasn’t energising were breakage, thinning, and fallout — hallmark symptoms of androgenetic alopecia.

Men still make up the majority of hair transplant patients. Dr Chong notes that 75 per cent of men show signs of pattern baldness by age 40, compared to 40 per cent of women. “That said, women are seeking hair transplants for indications other than androgenetic alopecia,” he says. These include lowering the hairline, eyebrow transplantation, scar repair, and congenital defects.

A natural-looking result should never announce itself. We’re now in what Dr Ho describes as an “undetectable era,” where enhancements are less about reinvention and more about quiet refinement.

That subtlety demands precision. Leonica Kei, principal trichologist and founder of Leonica K Trichology, notes that hairlines should avoid being overly neat or symmetrical. For men, where shorter hair exposes irregularities, design is especially critical. “The depth of one’s forehead also significantly influences facial proportions,” she adds.

Dr Chong emphasises the importance of experience with Asian hairlines, which typically feature lower density at the temples. Deviating from this can make results appear artificial.

The science of natural

FUE involves harvesting individual follicular units — natural groupings of one to four hairs — and implanting them into thinning areas. But it isn’t a simple pick-and-place procedure.

“The directionality of the hairs in the temples is crucial to a natural appearance,” says Dr Chong. “The position of the temporal hairline is necessary to ensure the face does not appear wide.”

The anterior cowlick, hair exit angles, hair calibre matching, and donor-to-recipient ratios all matter. A wrong move can result in overharvesting or unnatural density.

Full disclosure

A medical tourism package can make surgery seem deceptively simple: research, book, fly, return, reveal. But condensed timelines often lead to rushed decisions. Dr Ho flags this lack of diligence as a major risk, especially when complications arise after the patient has left the country.

Dr Chong observes that many women avoid hair transplants due to downtime, opting for alternatives better suited to early-stage hair loss. Leonica adds that scarring alopecia or severe recession may justify surgery — but only after understanding root causes.

“For women especially, testing ferritin, vitamin D, and hormone levels is often key to successful hair restoration,” she says.

Psychological readiness matters, too. Dr Ho stresses the importance of recognising body dysmorphia before operating. “It’s not always possible to achieve perfection,” she says, “and to expect ‘perfection’ from a single session may not be possible.”

A good surgeon prepares patients for the shedding phase before regrowth. Dr Chong shows patients timelines — one week, one month, four months, eight months, one year — to reinforce that shedding isn’t failure. It’s part of the process.

On paper, perfect

The International Society of Hair Restoration Surgery runs a global campaign against black-market clinics under Fight the FIGHT, of which Dr Chong is a participant. Syndicate-run clinics often rebrand and rotate names, making them hard to detect until patients arrive.

For those set on travelling, vetting is essential. Dr Ho advises checking for Joint Commission International accreditation, recognised medical degrees, and professional memberships. Dr Chong recommends consulting the ISHRS database or the American Board of Hair Restoration Surgery, though he cautions that no system is foolproof.

Virtual consultations, clear communication, and proper medical insurance are non-negotiable. If the offer feels rushed or too good to be true, Dr Ho’s advice is simple: don’t trust it.

Price and virality may be persuasive, but they’re rarely wise foundations for irreversible decisions. The smarter bet is understanding the limits of medicine — and choosing someone who knows where the scalpel ends and realism begins.