Throughout his career, John Cleese has been ahead of the game - and yesterday, the star of Fawlty Towers gave hope to many follicularly-challenged males when he told Richard Madeley and Judy Finnegan that he'd not only had a hip transplant but a hair transplant.
The explanation he gave was typical Cleese: "Because I've got a very strange shaped skull, very pointy and I don't like wearing wigs."
Treatments for male pattern baldness have come a long way from Hippocrates' times - he applied a mixture of pigeon droppings, horse-radish, cumin and beetroot to his head. Cow saliva, bats milk, deer marrow, spiders' webs, horses teeth and coffee are other remedies that men throughout the ages have turned to in an increasingly desperate attempt to turn the tide of hairlessness (the term 'snake oil' originally comes from a tonic hawked in 19th century America as a baldness therapy).
However in the 21st century there have been steps forward for the man mourning his hair loss. There are medicines that have been proven in some cases to encourage new hair growth and stop the rate of hair loss (Minoxidil and Finesteride); and there are human trials currently taking place to see if hair follicle cells grown in the lab will grow in the head once replanted .
Most importantly, if you have a spare £5-8,000, hair transplantation has improved – and is continuing to improve - beyond the dreams of its early practitioners. Cleese lives in America now, but there are surgeons who are looking at this in the UK.
Greg Williams is the consultant in charge of the burns unit at London's Chelsea and Westminster hospital. He is one of a handful of surgeons in the UK who are pioneering new techniques for hair transplantation, and treats those who have lost hair, eyelashes and eyebrows due to burns, cancer treatment and male pattern baldness, though the latter is not available on the NHS.
Male pattern baldness (also known as genetic hair loss or alopecia androgenetica) is the most common form of hair loss in men. It usually develops gradually, typically involving the appearance of a bald spot on the crown of the scalp accompanied by thinning at the temples. The condition will affect half of all British men by the time they are 50 (almost a third are appreciably bald by the age of 30).
It occurs when hair follicles, the tiny sacs in the scalp from which hair grows, become sensitized to the hormone dihydrotestosterone, or DHT, which stimulates the growth of facial and body hair. The follicles shrink, so the hair becomes thinner and grows for less time than normal. The condition runs in the family, and the strongest influence is on the mother's side: if your maternal grandfather went bald, that's probably a better indicator than if your father's father lost his hair.
Put simply, hair transplantation works by taking hair from the areas that are not affected by hair loss and transplanting them to the areas that are. According to Mr Williams the results are "very good", though the take of grafts is less reliable in scar tissue than in healthy normal tissue (75–80 per cent for scar tissue compared to 95-98 per cent in normal tissue).
"Any man with male pattern baldness will have a horseshoe of hair remaining around the back and sides of his head," says Mr Williams, and it is from here that a strip of skin will be taken under local anaesthetic. The hairs from this section of skin will retain their own characteristics (ie they grow) rather than acquiring those of the place to which they are transferred (where hair does not grow). Dissecting the hairs from this strip of skin into their follicular units is painstaking work ("you have to have OCD to do this job", says Williams) and performed by a team of three or four technicians. Filling in a patient's temples alone, say, could require 500 hairs.
Old fashioned 'plugs' – the ones that gave hair transplants a bad name - would implant 12-15 hairs at one go. The modern ones use 1-3 hairs, inserted in incisions ranging from .75mm to 1.5 mm in diameter. "I normally aim to use single hair follicular units in the most important aesthetic areas, like eyebrows, eyelashes or the front hairline," says Mr Williams. "Further back I use larger groups of hairs." On average, the surgery takes around five to six hours.
It takes around 6-9 months to see the effect, but by then the hair should be growing as it did in its old home (patients who have had eyebrows or eyelashes done need to be aware of this, and the fact that they will now have to trim them every 5 -7 days). Although all patients are made aware that more work may be needed in the future , as male pattern baldness is progressive, the process can be life-changing.
"I had a patient who used to wear his hair over his eyes all the time because his eyebrow had been burnt off," says Williams. "Now he wears it off his face and that's made a big difference. There's another man who I'm about to operate on who can't go for job interviews because he feels he has to wear a hat all the time. It can be crippling."
Indeed. A recent survey of five European countries found that British men are unhappier about being bald than most of their European counterparts, but are too embarrassed to do anything about it. More than half said going bald made them feel old and less attractive.
Two years ago, LibDem MP Mark Oaten blamed his midlife crisis and ensuing sex scandal on losing his hair. It's unfortunate then that skilled hair transplantation is still so rare - the British Association of Hair Restoration Surgeons of which Williams is a member numbers only 11 members, and he is only one of two surgeons in the country who transplants eyelashes.
But he remains upbeat. "The reason it's not so popular in the UK is that the training is almost non-existent and people have memories of the bad transplants in the past," he says. "Cosmetic surgery in the UK lags behind America by about 10 years but as we are seeing more and more men having plastic surgery and botox I'm sure there are more who will be interested in hair transplantation."
And with Cleese speaking out with enthusiasm for such operations, Williams is likely to be right.