I’m 3.5 months out from hair replacement surgery. Everything seems to be going very well except approximately 10 percent of the hairs transplanted never shed. They are also not growing. Is this normal? Will they ever start to grow?
This question was posed by a hair loss sufferer 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.
You have to understand what is happening at the microscopic level under the skin after a hair transplant. After hair transplant surgery, approximately 95% of the hair follicles that have been moved to the recipient area are “shocked” into a 3-4 month telogen phase, during which the follicle structure “shrivels” up, shrinks, and takes a nap for a few months. While it does this, it totally disconnects from the little stub of hair above it, leaving it sitting in its little superficial hole. Often times, a shower, brushing, or rubbing your scalp will cause these to fall out of their tenuous hold in your scalp and cause panic. Don’t worry.
The hair follicles that don’t shock, which is usually a small percentage, but occasionally can be quite a few of them in some hair transplant patients, you can tell because the hair grows from the get-go and from week to week you can tell this is happening. In many cases, a lot of the short hair stubs will fall off along with the scab at the 1-2 week mark and cause alarm in hair restoration patients, thinking that they have lost the transplanted hair, when it is just a hair shedding of this detached hair, which is dead, just like a finger nail that has been separated from its bed but still sits in position at the end of your finger. Interestingly enough, when one uses multi-follicular unit grafts of 4-5 hairs each, almost all of the hair stubs DO fall off with the scab, whereas in areas where all follicular units are used, I find it common for the hair stubs to sit in place for many weeks as you have described. When the follicle finally comes out of its “slumber” and starts creating a new hair shaft, this new shaft quickly displaces the other one.
Mike Beehner, M.D.