How To Determine Patients Are Not Suitable Hair Transplant Candidates – A Clinical Perspective From My Hair UK Sheffield

At My Hair UK, patient selection plays a critical role in achieving safe and meaningful hair transplant outcomes. Not all individuals experiencing hair loss are suitable for surgical intervention, and recognising medical, psychological, and anatomical contraindications early is essential. This process requires a full clinical assessment carried out by a qualified hair restoration doctor, with a structured approach grounded in both current evidence and practical surgical experience. Suitability is never assumed based on patient desire alone. We do not simply assess hair loss. We assess you as a whole.

Hair transplantation, specifically via Follicular Unit Extraction (FUE), requires a healthy donor area with sufficient density, a scalp environment capable of sustaining grafts, and a body that can heal post-operatively without excessive inflammation, bleeding, or risk of infection. Certain groups are repeatedly found to have a higher risk of poor outcomes. Among them are patients with active dermatological scalp conditions, individuals with unstable or advanced pattern hair loss, and those with systemic illnesses or medications that impair wound healing or promote ongoing shedding. Common examples include lichen planopilaris, frontal fibrosing alopecia, uncontrolled thyroid disease, and poorly managed diabetes. When present, these factors must be addressed before surgery can be considered.

One particularly important yet under-recognised group are young men under the age of 25 presenting with early-stage male pattern hair loss (MPHL). In these cases, the full pattern of future loss is unpredictable. If surgery is performed too early without concurrent medical management – typically with a DHT-blocking agent – it can result in an unnatural look as surrounding native hair continues to thin while the transplanted grafts remain. Current medical literature strongly supports medical therapy prior to surgery in this group. A study published in the Journal of Clinical and Aesthetic Dermatology (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6380979/) highlights the importance of stabilising MPHL with oral finasteride before considering surgical intervention.

In our practice, we also encounter patients whose expectations are misaligned with achievable outcomes. Hair transplantation does not restore the density of youth. The average scalp contains around 100,000 hairs, while even a large FUE procedure (e.g. 3,000 grafts) provides around 6,000 hairs. This is suitable for creating the illusion of fullness, particularly in the frontal third. But it cannot match natural density, especially if hair loss continues in other areas post-procedure. Where this mismatch exists and cannot be resolved through discussion, surgery should be postponed or declined.

Another critical factor is donor capacity. If the occipital and parietal scalp zones lack sufficient density – either due to diffuse unpatterned alopecia or previous surgery – then harvesting may compromise the appearance of the donor area. We assess this during consultation using magnification, manual hair counts, and clinical judgment. There is no automated substitute for trained eyes and experienced decision-making.

We also refer all patients back to their GP before surgery for a general health check. A complete blood count, fasting glucose, and thyroid panel can reveal underlying issues that may not be visible during consultation. For those in Sheffield, we recommend contacting one of the following GP surgeries to arrange a general check-up:

• The Avenue Medical Practice, 7 Reney Ave, Greenhill, Sheffield S8 7FH

• Walkley House Medical Centre, 23 Greenhow St, Sheffield S6 3TN

• Steel City General Practice, 251 Shoreham St, Highfield, Sheffield S1 4SS

Referrals and electronic summary printouts from these practices help ensure safe planning and continuity of care.

Psychological readiness is equally important. We look for signs of body dysmorphic disorder, depression, or anxiety. Where present, we advise referral to a mental health professional. Surgery cannot treat psychological distress about appearance – and may even exacerbate it. Inappropriate selection in these cases can lead to long-term dissatisfaction regardless of technical success.

The cost of hair transplantation in Sheffield at My Hair UK is fixed and transparent. For example, a 1000 graft FUE procedure (approximately 2000 hairs) costs £2,899. Larger cases – up to 3000 grafts (around 6000 hairs) – cost £4,499. These prices include consultation, anaesthetic, the full-day surgical session, aftercare products, and follow-up. What they do not include is the assumption of suitability. Each patient undergoes a rigorous evaluation, and we only proceed when the likelihood of benefit clearly outweighs the risk.

Patients with autoimmune conditions, bleeding disorders, poorly controlled cardiovascular disease, or on long-term immunosuppressants are often not suitable for surgery. In such cases, we liaise with GPs and consultants when appropriate. Hair transplantation should not be carried out in a silo, and it is not a cosmetic procedure in the casual sense. It is a form of minor surgery with real physiological demands.

As a clinic, we remain committed to ethical decision-making. Saying no is sometimes the best form of care. We invite prospective patients to attend a consultation at My Hair UK Sheffield with an open mind, prepared for a thorough assessment – and a truthful response. If surgery is not the right option, we will explain why and help guide next steps.

If you’re considering a hair transplant, ask yourself:

• Are you medically fit?
• Is your hair loss stable?
• Are your expectations realistic?

If the answer to any of these is unclear, your first appointment should be with your GP, not your surgeon.