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What are hair plugs and who should get them?

A patient undergoes a hair transplant - Getty Images Europe
A patient undergoes a hair transplant - Getty Images Europe

When I ask hair loss expert Spencer Stevenson who should consider getting hair plugs, his reply is both swift and emphatic: "Nobody." 

"Plugs are an outdated term for an outdated and fairly barbaric type of hair transplant that was popular back in the 1980s," he continues. "The results were often very unnatural and unsightly, with the overall appearance of doll's hair."

With plugs, the procedure involved using a ‘punching tool’ to remove rows of tiny round patches of tissues, each containing roughly twenty hairs, from the back of the head. The surgeon would then create similar sized holes in balding areas and the hairs would be transplanted into the holes and either left to ‘bed in’ or be stitched up.

Spencer Stevenson
Hair loss expert Spencer Stevenson

However, results were often obvious and unnatural; "The results would be a red flag that you’d had a hair transplant," says Spencer. "The transplanted hair would grow bunched together in unnatural looking groups, spaced unnaturally apart, rather than blending in with your remaining hair.

"The procedure was also tough on the ‘donor area’ – in other words, the back or sides of your head where hair still remained. This donor area is precious and needs to be utilised efficiently to get the most out of any future hair transplants. Plugs were an inappropriate way of dealing with the finite donor area and the patient was often left with circular scars."

Hair plugs looked unnatural

So, says Spencer, plugs have fallen out of favour in the last decade due to a new generation of hair transplants. "As the years passed, surgeons have refined their procedures. The results are now less doll's hair, and more natural looking and replicate hair growth in the way Mother Nature intended, right down to the spacing and direction of growth.

"A well done hair transplant should blend in seamlessly with your remaining hair. Even my hairdresser can’t tell I’ve had a hair transplant."

The cost of a hair transplant depends on the work required

Spencer Stevenson

Two of the newer and most popular transplants that have overtaken plugs in popularity are known as Follicular Unit Extension (FUE) and Follicular Unit Transplantation (FUT).

"FUE is the most popular – it's the one Wayne Rooney had," says Spencer. "It’s more expensive and takes longer, but it’s minimally invasive and doesn’t leave a scar."

FUE and FUT have replaced hair plugs

In FUE, individual hair follicles from a hair-covered part of the head are removed with a tiny specialised cutting machine. Using fine blades, tiny ‘sites’ are then created and the follicles are inserted into them. "Local anesthetic numbs the area and it takes the best part of a working day, depending on how much treatment is required," says Spencer. "Wayne wears his hair very short and you can’t see any scarring, so it’s good for very short or shaved hair.

"The cost depends on the work required, but is usually in the range of £5,000 and £12,000.

Wayne Rooney - Credit: Twitter
Wayne Rooney just after his FUE hair transplant Credit: Twitter

"With FUT, local anesthetic is used and a strip of hair is removed from the back or sides of your head where hair still remains. Under a microscope, your surgeon then divides the hair follicles into individual or small groups and inserts them into bald patches the same way they do with FUE. With FUT, however, your surgeon can harvest and move thousands of hair follicles in one go. You’re moving twice as much hair for half the price. On the flip side it’s more invasive and leaves a scar, but this can usually be hidden under your remaining hair.

"Downtime is similar to FUE, although there’s a little more discomfort from the scar and a four week healing process.

"Like FUE, results begin to show around four months and take a year to fully appear. Similarly, the price depends on the work required but it usually costs between £5,000 and £8,000."

Can hair plugs be removed?

Old hair plugs can be surgically removed and a number of men have had this procedure, either opting to have them replaced with FUE/FUT or simply to go naturally bald, rather than have the unnatural-looking plugs in place. 

Your hair transplant at an affordable price | Qunomedical
Your hair transplant at an affordable price | Qunomedical