24 Year Old Female Hair Transplant - How Long Do I Have To Wait To See The Full Results?

Written by Raymond J. Konior, MD on January 28, 2009

I got a hair transplant 6 1/2 months ago and I am not seeing too much results, is that normal? Is it at 12 months that I will see the full effect or longer? Do grafts sometimes not grow? I also had a lot of shock loss. By the way, I am a 24 years old female with PCOS. Thanks! – Melissa
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It is normal for hair-bearing grafts to enter a resting phase following surgical hair restoration. The typical resting phase following a hair transplant lasts 3-4 months. During this time the follicle does not produce any hair as it is resting and recovering from the stressful events relating to the surgical process. Although hair begins its regrowth cycle at this 3-4 month mark, it takes several more months for full density to be achieved. During this period the follicle recovers its ability to produce a thick and fully mature hair shaft.

Although the majority of patients begin their regrowth cycle around the 3-4 month mark, there are some patients who are fortunate to see earlier growth and there are those who see a much latter regrowth. These variations are simply related to the normal variations of all human characteristics such as height, weight, IQ, etc. Extremes which deviate from the average are much less common, but they do occur. The longest resting phase following hair transplantation I have witnessed occurred in a man who decided to enter a tanning booth 2 weeks after surgery. It took 6 months for any evidence of regrowth in the transplanted follicles. Needless to say, both he and I were nervous during the prolonged wait, but he went on to grow some of the thickest, high caliber hair I have ever seen. Ten years later he still looks great.

Based on this information, you should be seeing some evidence of regrowth at this time. However, assuming that you are a late sprouter, you will have to wait for one full year to pass judgment on the success of your surgery. If at that time you continue to have negligible growth, then one would have to assume that your surgery was unsuccessful. It is true that grafts may not grow; however, this scenario is very uncommon. The most common reasons for grafts failing to grow are technical in nature. Surgical results vary tremendously depending on the quality and integrity of the surgical team. Consistently great results depend on many factors which include: 1) meticulous donor harvesting; 2) careful graft dissection under high power magnification; 3) precise graft insertion site preparation; 4) continuous hydration of the grafts throughout the procedure; and 5) gentle handling of grafts during dissection and insertion. Lack of care and attention to detail at any point in the operation can result in poor growth. There are some patient-related factors that can adversely affect graft growth, such as preexisting scar tissue in recipient site, but the vast majority of patients with a healthy, previously non-operated scalp should expect consistent regrowth.

Shock loss is an unfortunate occurrence when one grafts into an area with thinning hair. The surgeon has a responsibility to educate the patient on the nature of shock loss so that any sudden deterioration in recipient site density is not a fully unexpected event. Many factors contribute to shock loss. These include: 1) anesthetic technique; 2) size of the insertion sites; 3) graft density within the recipient area; 4) meticulousness of the insertion site preparation; 5) current state of the hair quality in the transplant zone (i.e. severity of miniaturization); and 6) nature of the hair loss disorder. Assuming that you had a quality team performing your transplant, shock loss of any healthy hair should be temporary. Healthy hair that has been shocked should begin to recover around the same time your grafts begin their regrowth phase. On the other hand, healthy hair follicles that were injured during the surgical procedure may never recover. Weak hairs, such as those which were miniaturized prior to surgery, may also never recover. Many surgeons recommend the use of Rogaine postoperatively to help maintain vitality in the miniaturized hair population and to facilitate regrowth of any shocked hairs.

It is very important for you to visit your operating surgeon at the one year mark so that your transplant zone can be compared to your preoperative photographs. At that time you should have a full assessment as to whether or not the procedure was successful. Good luck.

Raymond J. Konior, M.D.
Member, International Alliance of Hair Restoration Surgeons
Member, American Hair Loss Association

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