In 2012, former England footballer Michael Gray had hair transplant surgery – and the full seven-hour operation was streamed live on the Internet. In June 2015, he was back for more, sharing his experiences live online once again [click here to see video]. Inspired by the courage displayed by other high profile men such as Wayne Rooney in having hair transplants so publicly, Gray saw his surgery as an opportunity to educate and “open up discussions” on solutions for male pattern baldness. Certainly, with issues of confidence and self-esteem at play, it is not a problem to be brushed under the carpet. What Does A Hair Transplant Involve? There are two principal methods of hair transplant: FUT (follicular unit transplant) which is also known as the ‘strip’ method, and FUE (follicular unit extraction) which adopts a more random donation and implanting pattern, often giving a more natural look. Both entail the uprooting of healthy follicles from the back or sides of the head and grafting them, one at a time, into the bald parts of the head. The grafts are usually transplanted into the slot where hair has previously grown, allowing the results to follow previous (and therefore natural) angles and direction. It is a painstaking procedure – Michael Gray had 2,119 grafts to reverse his receding hairline – and it can take up to eight hours. Hair transplant patients describe the procedure as not painful, rather that it was uncomfortable and, frankly, “boring” in the words of Michael Gray. It takes about five days for the implants to graft and the redness to settle, and about 10 months before the final thickness can be judged – in most cases, there is a 90 per cent permanent ‘uptake’ of follicles. What Does Michael Gray's Hair Transplant Story Tell Us? While a hair transplant can produce some fantastic results – and results which allow you to feel real hair back on top of your head once again – there can be the occasional disappointment and the experience of Michael Gray and other leading sportsmen, particularly Wayne Rooney, sheds a light on this. There are a number of limitations to hair transplant surgery. Surgeons aim to take hair that is genetically resistant to hair loss – donor hair – and transplant it to the recipient area. On a man, hair that is genetically resistant to hair loss only grows in the limited bar of hair that runs around the back and sides of the hair. Any hair taken above this area is at risk of being lost as part of the natural progression of hair loss. What's also obvious when you look at much older balding men, is that the 'safe' area of hair is much smaller than the unsafe' area, i.e. the bald patch. Spreading the donor hair to cover the recipient area means hair density is compromised. A hair surgeon would hope to harvest anything from 2,000 to 4,000 hairs from the donor area, but if you've undergone significant hair loss, you may have already lost up to 50,000 hairs. Furthermore, hair transplants do not stop further hair thinning so you may require a repeat procedure as a top-up in the future. This is the case with Wayne Rooney who underwent his first hair transplant surgery at the relatively young age of 25. In fact, according to a recent census from the International Society of Hair Restoration Surgery (ISHRS), 64 per cent of men who'd undergone a hair transplant were disappointed with their hair density after their procedure. Hair Transplant Surgery And Pre-Planned SMP: The Perfect Solution? In the first months after a hair transplant you are likely to experience a loss of density until the follicles are fully established. Secondly, perhaps because of expectations not being managed, some patients are disappointed with the thickness of the results. A possible solution which is becoming increasingly popular is pre-planned scalp micropigmentation whereby pigment is delivered to the upper layer of the dermis, simulating hair follicles. This gives the illusion of thicker hair at the root level, and can therefore assist effectively with the appearance of the transplanted areas of the scalp. If you want more information on SMP in combination with hair transplant surgery or as a standalone procedure, then book your consultation at HisHair Clinic today.