Patients using medications as a means of hair restoration (e.g., minoxidil, finasteride) will need to apply the product daily as recommended by their physician to ensure the best possible results. Medications may or may not be successful in stopping hair loss and/or stimulating hair regrowth. When effective, improvement in appearance is generally noticeable within several months.

Hair restoration surgeries are performed on an outpatient basis, usually under local anesthesia while the patient is awake. The patient may be placed under general anesthesia (asleep during the procedure) during more extensive surgeries. Patients under anesthesia will be insensitive to pain, although those under local anesthesia may feel pressure or a tugging sensation during the procedure.

Hair transplantation involves the removal of small pieces of hair-growing scalp (grafts) from a donor site (usually the back or sides of the head) and implanting them in a bald or balding area. It is the most popular surgical hair restoration method.

At the beginning of the surgery, the hair at the donor site will be trimmed short to facilitate easy access and removal of the skin. Both the recipient and donor sites are sterilized to help prevent infection. Different tools may be used depending on the size of the graft and where it is to be relocated. An average donor site rarely produces more than 100 follicles (tiny, tubular structures in the skin through which hair grows) per square centimeter. The size of the total area removed depends on hair density at the donor site.

After grafts are removed from the donor site, they are then separated into smaller sections and transplanted into small holes or slits prepared in the scalp. Grafts are placed about one-eighth of an inch (approximately 30 millimeters) apart to maintain healthy circulation. Subsequent treatments with additional grafts may later be required to fill in any open spaces that remain or have since appeared. During the procedure, a saline (salt water) solution may be periodically injected into the scalp to help keep the skin strong and resilient. The donor site is then stitched shut, leaving a small scar that is usually covered by surrounding hair. The total process typically takes from five to 12 hours depending on the number of grafts taken and the number of staff required.  

Some differences in the technique may be incorporated for women who undergo hair transplantation. The use of minoxidil 2 percent may be advised for two weeks immediately before surgery and resumed five to seven days following the procedure. Larger grafts may be necessary behind the hairline to give a natural appearance.  

During a tissue expansion procedure, a balloon-shaped object called a tissue expander is placed beneath hair-growing scalp that borders a bald area. The tissue expander is then gradually inflated with salt water over a several week period during which time the patient can perform normal duties. This causes hair-growing skin to stretch and produce new hair-growing skin cells. When the tissue expander has stretched the skin sufficiently, an incision is made by a physician and the hair-growing scalp is stretched over the adjoining bald area and stitched closed.

During a flap surgery, a section of bald scalp is first cut out. Then a section of adjoining, hair-growing scalp is lifted off the surface while it is still attached at one end. The hair-growing scalp is then stretched and sewn into place where the bald scalp was removed while remaining connected to its original blood supply at the other end. The size of the flap needed and the way it is placed will depend largely on the needs and expectations of the patient.

During a scalp reduction, a portion of the scalp is removed. The skin surrounding the removed area is then loosened and sewn together with stitches. Scalp reductions provide coverage of bald areas at the top and back of the scalp. However, they are not effective for coverage of the frontal hairline. The size of incision may vary according to the extent of the procedure. Scalp may be removed in the shape of an inverted Y, U, pointed oval or other figure depending on the amount of coverage needed.