Hair Transplant Graft Survival – Do They All Grow?

Mon 29 Mar 2010

This question was posed  by a hair loss sufferer seeking hair loss  help  on our hair restoration forum  and answered by  Dr. Michael Beehner  of Saratoga Springs, NY who is one of our recommended hair restoration physicians. His professional answer is below.

My understanding is that it is normal to have shafts of transplanted hair fall out within weeks or a month, and that they will (hopefully) grow back after 3 to 4 months after the hair transplant procedure.   I realize that not all heads are created equal but, on average, if there is such a thing, what is the percent of transplanted grafts that will continue to grow after transplanting without falling out first?   Maybe it would better ask if it is common to have hair grow without falling out, or is it completely unheard of?

Your impression is correct, in that the great majority of the hairs that are transplanted (most of which are only 1/8th inch long) are shed during the first few months, before the “real” hairs appear 3-4 months post-operatively. They usually shed in one of two ways: some fall off with the scab at the 6-10 day point, while others just “sit in place” in the skin, even though down deep in the skin they are literally disconnected from the follicle (the living part of hair), which shrivels up and hibernates for that time period. These short stubs then can sit there for weeks or they can fall off at anytime. The best way to tell a “disconnected,” non-growing one from one that is going to grow is to simply look at it a couple of weeks later. If it is longer, then it is growing. It’s as simple as that.

I find that around 5% of hairs keep on growing from the day of the hair restoration procedure, and in some patients, this percentage is even much higher, but they are definitely the exceptions.

The other issue you alluded to was what percentage of the hairs that are transplanted actually survive and grow. Many studies have been done to look at this, some with tiny boxes out in the middle of bald skin, and others deep in the center of a thousand other sites, and the averages are somewhere around 90% survival for all follicular units (FUs), and around 99% for multi-follicular units (MFU) grafts (DFU’s and TFU’s). The FU studies range from the high 70’s to even higher than 100% (due to hidden telogen stage hairs that later grow). The percentage you receive from your doctor will depend on the skill of him/her and the staff more than anything. In two research studies I conducted, 1-hair FU’s did not survive as well as 2-hair FU’s. Again, the probable reason for this is the same as for why MFU grafts survive better – namely, because of the extra protection and buffering against the elements of drying and trauma that the extra tissue between the follicles provides.

Mike Beehner, M.D.

Bill Seemiller
Managing Publisher of the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum
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6 Comments so far:

  1. Jonathan F says:

    Hi Dr. Beehner,
    Thank you for that very informative answer. Regarding what you wrote about the transplanted hairs that just “sit there” and not fall off with the scabs… I am 8 weeks post HT, and I noticed several of these hairs. When i gave them the slightest pull, they just “slipped” out completely out of the scalp. Interestingly, most of their length was actually “hidden” inside the scalp.
    Now I’m afraid that I somehow ruined these grafts, even though these hairs weren’t growing at all, and I felt nothing when pulling them out (no bleeding or anything), or maybe now that I removed them then the new hair that will grow won’t be able to “find its way” out.
    Have I done damage?
    thank you very much!

  2. Jonathan,

    At 8 weeks post-operative, all grafts are anchored and you aren’t going to “ruin or damage” any grafts by touching them at this point. In most cases, the initial grafts shed and begin regrowing around month 3. However, in certain cases the grafts stay anchored (and grow) or don’t shed until a later date. My guess is that these grafts either shed later or had already shed (meaning the follicle was producing a new hair), but simply hadn’t fallen out of the scalp.

    I hope this helps.

    Blake (Future_HT_Doc)
    Editorial Assistant

  3. Jonathan F says:

    Hey Future Doc, it did help to ease my concerns, so thank you for that :]

  4. adriano says:

    after hair transplant surgery by 3 or 4 days when i was taking shower i saw 1 graft came out . im so worry if the others came out too without noticed it . so how can i make sure if they still in . and by the way im now at 6 months after surgery

  5. David aka - TakingthePlunge says:


    The loss of a graft or two in the first few days after hair transplant surgery is not uncommon and is normally accompanied by bleeding. Do you recall seeing any bleeding during that time?

    This small loss of grafts should not affect your final results. However, the only way to know at this point how many of your grafts survived is to wait at least six more months for your final result.

    I also recommend discussing your concerns with your hair transplant surgeon immediately if you have not yet done so. Your doctor should stand behind his or her work in the event that your results are less than optimal.

    David (TakingThePlunge)

  6. Hekmat says:

    Hi, I have done my FUE transplant. after post op day 4 I see some crack in scabs.
    I m very worried, I some one can help

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