A Year After My Transplant, It Looks Like Most Are Just Single Hairs

Hello Dr. Rassman,

I’m 29 years old and had a transplant exactly one year ago in Thailand. I had roughly 1000 grafts transplanted to my hairline and temples using the FUE method. After waiting the full year, I’ve got to say I’m somewhat disappointed in the results.

I purchased a digital microscope after reading many of your blogs. I’ve taken a good look at the recipient area and it appears that 90% of my grafts are just single hairs, as if the follicular units were transected during the operation. I’ve also noticed many colorless, short, thin hairs in that area. Are these the remnants of my native hairs that have miniturized? Would you say I can expect any more development in the transplant? Or is 12 months pretty much it? If I was a norwood 2 at 27, how far would you guess my balding will progress? My crown looks thin to the naked eye, but I believe it’s because of the cowlick and that I’m a blonde and the light penetrates through. With the microscope, I see no miniturized hairs in the crown. Thank you for your time

If you have 2-hair grafts placed and only a single hair grew from each, that could mean one of three things:

1. Close to half of what grew in each follicular unit died from the process you had done. Or…
2. You are Asian and have typical Asian hair densities, which means that there are equal one and two-hair follicular units growing in your native hair. Or…
3. The doctors just divided the 2-hair grafts to make singles to increase the graft count.

Even if you are Asian, you should have 50% one-hair grafts and 50% two-hair grafts (on average). Strict quality control is critical for all of the hairs in the follicular units to grow and if you had all two hair grafts (typical of Caucasians) the growth of only one-hair grafts reflect some damage. You should also count the grafts, as well as the hairs. Was it a bargain deal? Take a look at our recent post about cheap hair transplants.

The doctor could have separated all the grafts into single hair grafts (if the doctor was not honest and tried to push up the graft count if he charges by the graft). In any event, 1000 two-hair grafts should have yielded 2000 hairs (in a Caucasian) and 1500 hairs (50% each of one and two hairs in each graft). That is the bottom line. I always measure the density of the patients prior to surgery so I know what I expect to achieve in the harvested grafts as well as how many hairs are transplanted, the count of each graft with regard to the number of hairs they contain. Some clinics charge per HAIR and not per graft, so look at how the billing was made. Maybe you were charged for 1000 hairs and not 1000 grafts (not uncommon to find).