Explaining Hair Replacement (Non-Surgical) by Graham Wake MSc BSc MTTS


With current alopecia medications severely limited in their success at arresting certain forms of alopecia, technological advancements within the non surgical hair replacement field make it a realistic option for those requiring significant hair restoration.

Hair transplantation is a proven technique for redistributing hair. There are limitations and the procedure is not always viable.


Non surgical hair replacement procedures attach a thin transparent layer of polyurethane to the scalp, forming a tight membrane which acts as ‘a second layer of skin’. The hair replacement membrane will have previously been implanted with human hair, customised to create a near as possible match with the patients existing hair characteristics. These detailed design specifications include a site specific colour match, density selection, direction of implant, hair wave, as well as crown and parting breaks amongst other features.

Following the initial design stage a good hair replacement system will take up to eight weeks to produce with hairs individually knotted, or injected, into the base membrane.

The most undetectable, lightweight and revolutionary hair replacement systems provide a fine layer of skin that literally becomes an extension to the epidermis. The transparent polyurethane membrane, known as liquid skin, allows the patients underlying scalp skin to be visible, providing a natural appearance at the crown and partings. Undoubtedly the strength of modern non surgical hair replacement is its non-intrusive attachment, enabling the user to participate in sporting and water activities with complete comfort and confidence. Non surgical hair replacement procedures are the choice of a number of celebrities and sportsmen.

Continued technological advancements have culminated in modern hair replacement systems that supersede the infamous hair pieces of yesteryear. Users of hair replacement systems find traditional terminology such as hair piece, toupee and wig derogatory to the quality and concept of modern hair replacement systems. The non surgical hair replacement procedure is after all a far superior and more advanced version of the original hair piece.

Construction of the membrane involves creating a template, or mould, of the patients scalp. Producing an identical replication of the scalps contours forms an imprint that is utilised for the construction of the transparent polyurethane layer. This ensures a perfect fit with the area of scalp requiring hair replacement. Customised scalp templates enable hair replacement in only the scalp area subject to hair loss. Thus, patients can successfully restore bi-lateral temporal recession, crown (vertex) thinning, and in more advanced cases enable the gradual restoration of a full head of hair.

Off-the-Shelf membranes are available at a cheaper cost, though these standard sized bases provide rather an inadequate integration where accuracy of fit with the area of hair replacement needs to be extremely precise.

Modern hair replacement techniques bond the hair replacement system to the scalp with a translucent, hypoallergenic medical adhesive. This provides a skin-tight adhesion with the perimeter of healthy terminal hairs, shaven to 2mm, surrounding the area requiring replacement. The procedure is painless, non-intrusive and the adhesive is resilient to sweat and water. A porous membrane allows the epidermis to breath and aids cleanliness.

The bonding procedure involves shaving the perimeter of the area requiring hair replacement. Following the application of medical glue to the hair replacement systems perimeter and the corresponding area of the scalp a steadfast bond is formed upon contact.

Hair replacement systems need to be detached, cleaned and reattached approximately every four weeks.

Following reattachment of the system, the existing scalp hair needs to be re-blended to ensure a perfect integration. An alternative to perimeter attachment is full head bonding which enables the hair replacement system to be attached to the scalp.

The most technologically advanced membranes presently available are polyurethane, monofilament and lace. Any prospective hair replacement patient should ensure that the membrane is one of the aforementioned base types. In summary, Polyurethane provides a transparent, super-thin layer and is optimal in terms of undetectability to both touch and sight. Monofilament is a porous material preferable for those that require the skin to breath and benefit from additional cleanliness.

Lace will form the front hair line in the most sophisticated hair replacement systems softening the front hair line and giving the appearance of hair growing from the skin when brushed away from the temples and forehead.

Human hair is the preferred choice when selecting hair fibre though it is more expensive than the synthetic alternatives. Human hair is natural and compatible with all products and grooming procedures acceptable to real hair. Synthetic hair can burn or melt when subject to straightening and curling irons and is susceptible to matting if mistreated or subject to hot water and harsh detergents. Once educated in care and treatment, synthetic fibre is suitable for patients seeking a cheaper hair replacement system. A human and synthetic fibre mix is often a good compromise.

Whilst modern technology has enabled the creation of the most fully realistic, undetectable hair replacement systems to date, one should not underestimate the importance attached to the creative skill of those performing the procedure. Specific training and hairdressing excellence is required to perform the procedure of designing, cutting and blending a hair replacement system with the patients own existing hair.

An experienced stylist will accurately design the directional implantation to accurately integrate with the existing hair. Detailed attention should be given to the membrane design and hair characteristics.

A specialist stylist will achieve an undetectable finish by adding a life cycle to the hair by skilled thinning, tapering and cutting-in frontal baby hairs. Some temporal recession and crown thinning may be necessary to perfect the overall realism.

Non surgical hair replacement is not a single procedure that will last for life. Individual hair replacement systems have a life span of up to one year and future hair replacement systems will be required with new templates to take account of any further hair loss. A less frequent replacement of membranes will compromise the hair replacement systems undetectable appearance due to the occurrence of discolouration, weathering and shedding over time. One should consider the long term cost implications and arrange a sensible financing plan where necessary.

As a guide, one should not expect to pay more than around £650 (GBP) for the latest non surgical hair replacement procedures consisting of a fine polyurethane membrane and real human hair.

This price should include design and styling by a recognised hair replacement professional.

Non surgical hair replacement is a suitable technique for a number of alopecia conditions including androgenetic, or hereditary hairloss, totalis and universalis amongst others.

Where the alopecia condition has caused total scalp hair loss a template enables a perfect mould to be constructed of the scalp and nape area.

© 2007 – G Wake MTTS


UK patients requiring further information regarding wigs, bandanas and non-surgical hair replacement products could contact:

The following TTS members who offer these products 


Hair Development
Mr S Levy MTTS,  Ms J Levy MTTS,  Mr M Burns MTTS
247 Mile End Road, London E1 4BJ
telephone: 0207 790 4567/3996



Cotswold Trichology Centre, Evesham, Worcestershire
Mrs S-A Tarver LTTS




Bloomsbury Wigs (Mr Graham Wake)
London Studio WC1N
0207 4046040,



© The Trichological Society.