Just over a year ago I woke up to a massive surprise. As I went to make my morning coffee, I caught a glimpse of myself in the hallway mirror and froze in total shock. In what seemed like overnight, I’d developed a bald patch revealing a scar that I’d developed post-stitches, some 30 odd years ago as a child.

Though I’d noticed changes such as thinning and sparseness to my hairline over the years, I was still shocked that the scar that was once totally hidden by my hair, was now on full display. Especially since I’d spent years testing out hair health treatments like LED light therapy, platelet rich plasma injections (PRP), scalp microneedling, hair growth supplements and more.

I wondered what had caused such a noticeable amount of hair loss, and hot footed it to a dermatologist who specialises in hair to find out. I soon discovered that I had developed traction alopecia. “It’s a form of alopecia caused by repetitive tension, and it presents as thinning or complete loss of hair generally on the hairline and temples (edges), but can affect anywhere on the scalp, where pulling occurs,” shares Consultant Dermatologist and Doctor Sharon Belmo.

The diagnosis came as a surprise–I never really considered my go to hairstyles as overly tight. I don’t braid my hair, wear wigs, or tight ponytails, but I did professionally blow dry my tight curls straight two to four times a month, and regularly wore my hair in a bun when my curls needed a refresh and I didn’t have the time (curly hair is gorgeous but high maintenance).

Turns out over time this tension can lead to a loss of hair, and while it’s a reversible condition, if you catch it early and are prepared to change your styling habits, “it can’t be reversed after long term tension, as this leads to scarring alopecia which is when there is a permanent ‘death’ of follicles and hair is no longer able to grow back,” explains Belmo.

I ditched blow drying my hair straight, and any other style that created tension at my hairline. I restarted PRP, and popped handfuls of growth-boosting supplements a day, but try as I might, I couldn’t coax back my hair. As time went on I became increasingly self-conscious about my bald spot, and every time an old friend would ask me how I got this seemingly new scar, I was reminded just how visible my alopecia was.

With few other options left to explore, I decided on hair transplant surgery with Dr Christopher D’Souza, Founder of The D’Souza Clinic in London, and famed for his natural-looking hair restoration skills.

Who makes a good candidate?

On my first consultation with Dr D’Souza I discovered that, “generally speaking, when it comes to hair transplant surgery the most compatible forms of hair loss are androgenetic alopecia (a genetic disorder), and irreversible traction alopecia.”

Thankfully I fit the bill, but for those who don’t there are other methods of treatment from topical and oral treatments like minoxidil and finasteride, to supplements and hormone therapy. What will work best for you depends on what form of alopecia you’re experiencing, so it’s wise to see a dermatologist for a diagnosis.

Does hair type matter?

I wondered whether having curly hair would put me at a disadvantage when it came to having a hair transplant, but Dr D’Souza assured me that all hair types are suitable for surgery. However, “In the UK your surgeon should be a member of the British Association for Hair Restoration Surgeons (BAHRS) and International Society for Hair Restoration Surgeons (ISHRS),” he shares.

These memberships should signal that your surgeon knows what they are doing, and if they aren’t the right person for the job they will point you in the direction of a surgeon who is, because when it comes to extracting a curly or textured hair follicle, things can be tricky. These hair types tend to not only curl above the scalp but also underneath the scalp, making it imperative that your surgeon knows what they’re doing.

Having a suitable surgeon for your hair type isn’t the only concern–it’s also important to seek out a surgeon who has plenty of experience performing female hair transplants, and who can create pleasing, yet realistic hairlines.

What does the surgery entail?

On the day of my surgery Dr D’Souza reexplained what I could expect and reconfirmed my chosen method. We’d opted for the Follicular Unit Transplantation (FUT), which is where a thin strip of the scalp is removed, and the hairs are harvested from said strip. FUT tends to yield more hair follicles in one sitting and is a safer option for those with curly or Afro textured hair, plus it’s more discreet than the Follicular Unit Excision (FUE), "where the donor area is shaved down and each hair graft–a tiny piece of scalp that contains anything from 1 to 3 hairs–is removed using a small punching device,” explained Dr D'Souza.

Shaving a large area of my scalp down wasn’t an option as I have very long hair, plus when it comes to FUE surgery, it’s imperative that your surgeon uses the punching device at the right angle to ensure they don’t damage your follicles which tend to be more angled in curly, kinky hair. Knowing all this, FUT was the best option for me.

Dr D’Souza began by shaving down my hair along the thin strip of skin on the lower part of my scalp he would soon remove. He then numbed my head with local anaesthetic (the only slightly uncomfortable element of the process) and removed the strip. He then sewed me back up and moved to my recipient area, aka my hairline, where he made tiny incisions that his team of technicians would later place my grafts into.

It’s worth noting that it’s normal for a hair transplant surgeon to have a team of technicians working with them. However, what isn’t allowed is for non-medical personnel to perform the medical steps of the transplant surgery, like removing donor hair or making incisions in the scalp. This is a practice that is becoming more prevalent, both in other countries where people flock for cheaper procedures, and even here in the UK at blackmarket clinics.

“When performed correctly, hair transplant surgery is very safe and there are very few issues post-op. However, in the wrong hands there’s lots that can go wrong,” warns Dr D’Souza. Excessive bleeding, infection, scarring, over-harvesting of the donor area, skin tissue death, shoddy hairline design, and poor growth are just some of the problems that can arise. This makes it wise to make sure you ask what elements of the surgery your chosen doctor will be performing before you sign on the dotted line.

How long do results take?

For someone who has very little patience I’ve had to channel the saints. On the day of surgery, my hairline was cut very short so that Dr D’Souza could add donor hair to my bald patch as well as the areas along my hairline that had become sparse over time. This meant that after the two-week follicle implantation mark when the implanted hairs fell out (which is normal), I was not only left once again with my scar on display but with super short hairs along my hairline.

Three to four months later, new hairs started to appear and more began to steadily sprout as the months rolled on. “Initial hairs can be weak and flimsy, and 90 per cent of the result is usually apparent by 12 months post op, while the quality and thickness can improve up to 18 months post op,” Dr D’Souza warned me.

Eight months in and I’m impressed with the results, my hairline has been restored and I’m encouraged by the hair growth I’ve seen so far. I’m doing my best to be patient and see what my hairline looks like by month 18, before I decide whether to go for round two.

“Density with a single hair transplant can never match the existing density of the rest of the hair on the head,” warns Dr D’Souza. So if I want my scar to be as hidden as it once was, a second round might be the final chapter in my hair restoration story.