My question is regarding post operative transplant shedding. For a little background, I’m a 26 year old male on Propecia for 2 years and exactly 8 months out of a 2000 graft hair transplant all in the frontal part of the scalp. At 5 months, my results were excellent, a very dense, even result with a natural looking appearance and texture. Since that time, however, I have noticed an increased thinning in my hairline; leaving a more see-through appearance. This has been coupled with a more “pluggy” texture. Furthermore, at 6 months, I noticed an increase in shedding but it has slowed down in the last 6 weeks.

My 8 month result is still great but there’s a visible difference in the last three months. Is this merely a part of the natural process for some patients and can’t be judge too quickly in my first year growth? Any help would be greatly appreciated! Also, let me know if you need extra information to answer my question.

Why don’t you follow up with your doctor with these issues? A pluggy texture is not good. Thinning may be related to continued (normal) genetic hair loss that may have happened without surgery. Shock loss is generally seen in the first month or two after the surgery.

In general, results of a hair transplant surgery can be seen in as early as the 2nd month all the way up to 12 months. Most see results in about 6-8 months. I couldn’t tell you why your results looked better at 5 months than they do at 8 months, though.

I am 2.5 weeks post-op, and already seem to be shedding transplanted hairs in the recipient area. This seems quick to me. Are transplanted hairs shed quicker if there is no or minimal crusting post-op ?

Transplanted hairs shed in 19 out of 20 patients and they usually start shedding at 10 days or so, unless the crusts remain (which will hold onto the hair inside the crusting). I prefer having no crusts, as these grafts are more secure in their recipient sites.

One patient out of 20 will grow out their hair without shedding the transplant hair (no dormant phase), and these remarkable patients have 2 inch long hairs at 4 months post-procedure… and great joy from beating the odds

Hi Dr. Rassman,

I find your blog to be incredibly informative and helpful to those with concerns after their hair transplants. I decided to undergo a transplant exactly 5 months ago as preventative maintenance. 1,700 grafts to fill-in the thinning top portion of my head. I still have hair on my head, but under direct light you could visibly see through to my scalp. I followed my doctor’s instructions and had no major issues after the surgery.

At 5 months, the incision scar is still pink and I have occasional pimples on the top of my head (with what seems to be a noticeable increase in grease on my head). Also, after the surgery I had shock fallout. But it seems that ever since my surgery for the last five months my shedding has been consistently increased. Not just from the top of my head, but all over (sides and back). I have yet to see any growth from the grafts. But I have noticed white streaks in my hair. I have pitch black hair, and there are now random strips of white developing throughout my hair (I had never had white hair before the surgery). Is it possible that the shock of surgery would cause some of my hairs to begin to turn white?

And I’m also concerned at this point that my grafts will not grow in and that I will continue to get thinner and thinner since my fallout has increased. Thank you for your input and advice.

In my practice, we never recommend a hair transplant surgery for “preventive maintenance”, mainly because most patients would not likely see much of a result as they continue to bald and run the risk of being worse off. There is also a good possibility that the surgically induced hair loss might make it look worse, something we call “shock loss”.

If you are really losing hair on the sides, maybe something else is going on like diffuse unpatterned alopecia (DUPA). Shock loss doesn’t usually cause hair to fall out from the back and sides of the head. White hair does appear with stress on some people, but I really do not understand the cause. It sounds like you need a good doctor to talk with and be examined by. Perhaps the surgeon that did your transplant would be a place to start.

In general it takes about 6 to 8 months before you can see results and I tell my patients that most people can see 80% of the impact from a hair transplant in 8 months. You should notice growth beginning about now and see improvement in the next 3 months. If you are young and had the transplant without taking the drug finasteride, and assuming that your preventive hair transplants were not really needed, then you will most likely not have as much hair as you did before the transplant (based upon what you are saying here). Hopefully though, over the next 3 months you’ll see some gains.

A year after a successful transplant I can still feel some grafts on my head that never shed a year later.

Hello doctor, it is about 12 months since my FUT procedure of 2350 grafts. I and all concerned are very pleased with the results. As expected by this stage, almost all of the grafts are grown out and have matured for quite some time now. However, I find it strange that in one or two areas of my head I can still feel some of the short shaved implanted hairs that never shed or started to grow in the whole 12 month period. Now this number is very small, im talking maybe only 10 to 15 hairs over my entire scalp, most of which are in the hairline region.

I discussed this with the transplant surgeon at my 12 month review, and he told me that it was acceptable that even after 12 months there may still be very small number of grafts still in the dormant phase, and that these would eventually grow out in time.

I was just wondering if you had ever come across this before and if it was normal? Perhaps my growth is just a little slower than average as I noticed my real thickening happened around month 9/10 as opposed to the normal month 6 that one usually reads about. I also have been on finasteride for the past 5 years.

Thank you and I appreciate any response you may have for me on this.

Kind regards

You may also have the hair from the original transplant that just never shed and is just stuck in there (without shedding or growing). You can test this hypothesis by finding this “stubble” and gently tugging on it. If it slides right out, it may have been the original hair in the grafts from a year ago. Imagine a splinter stuck in your scalp. In this case, the splinter would be your inert hair.

Otherwise, your guess and your surgeon’s guess is as good as mine. I have no idea what you may actually be experiencing without an examination.