• Shruti GOCHHWAL

Stages Of A Hair Transplant

Following hair transplantation, new hair growth may not happen all of a sudden. Learn the procedure involved in hair transplantation and the stages of the hair transplant.

What Is Hair Transplantation?

Hair transplantation is a procedure in which hair units are removed from the donor site (back of the scalp or elsewhere from the same person) and transplanted into the recipient site. It is a surgical replacement procedure that has been around since the 1950s. Modern hair transplantation was introduced in the 1950s by Dr. Orentreich. Due to the advent of technology, there have been lots of advances in the procedures.

Methods Involved In Hair Transplantation

Hair transplantation can be performed by Follicular Unit Transplantation (FUT (strip procedure)) or Follicular Unit Extraction (FUE).

Follicular Unit Transplantation(FUT)

Hair transplantation

Hair follicle, Credits: pixabay


This is a hair restoration technique and also known as the strip procedure. Here the patient’s hair is transplanted in naturally occurring groups of 1 to 4 hairs, called follicular units.Follicular units contain sebaceous (oil) glands, nerves, a small muscle, and occasional fine vellus hairs.

This procedure allows the surgeon to transplant 1000s of grafts in a single session. This method is an advanced option compared to older hair transplantation procedures which used larger grafts that resulted in a pluggy and unnatural look.

The hair growth that is restored this way mimics an original hair with hair replacement systems and does not look like a hair transplant.

Follicular Unit Extraction (FUE)

FUE is another procedure for hair restoration. Not all candidates will be suitable for this method, and a FOX test is done to determine eligibility.

In the FOX test, the surgeon takes out a few (about 100) grafts from the donor area and then evaluates how many complete/incomplete follicular units are extracted.

If the surgeon can extract complete units, he may carry the FUE procedure or shift to the strip technique.

In FUE, only the method of extraction varies, but the implantation procedure is the same as FUT. This is a sutureless method of hair restoration. Here the hair follicles are extracted from the back of the head under local anesthesia with the help of special micropunches and implanted in the bald area.

The grafts are extracted from the donor area with micropunches. Follicles extraction is done under 2.5 – 5× magnification. The procedure is as follows.

Step 1

With the sharp side of the micro punch, the scoring of the scalp skin containing the follicular unit is done.

Step 2

Then the dull side of the punch is introduced in the same area and is twisted to loosen the follicular unit. At the same time, the assistant applies counter traction to facilitate the penetration of the punch inside the dermis.

Step 3

The graft is taken out with the help of forceps. The extracted grafts are preserved in saline solution.

The extracted graft may consist of 1 to 4 or rarely even 5 or 6 hairs. The extraction part is considered to be the time consuming and tedious procedure. Once the extraction is over, the grafts are implanted in a similar way as in the rest of FUT.

Advantages of FUE Method

Hair transplantation

Equipment, Credits: pixabay


  1. This method requires less manpower.

  2. The procedure is less traumatic and no surgical experience is required.

  3. Graft preparation is minimal and only minimum equipment is required.

  4. The post-operative recovery time is very short.

  5. The scars are almost invisible.

Limitations

  1. From a surgeon’s perspective, this is a tedious procedure.

  2. The protocol is a bit long and the patient needs to lie in a prone position for a long time which may cause discomfort.

  3. The cost is about 3 times more than a FUT.

What to Expect After a Hair Transplant?

  1. Pain and discomfort in the area. A gentle scalp massage can help lessen the discomfort.

  2. Bleeding at the sites of transplant is common. Applying gentle pressure with a moistened, clean cloth for 5 – 10 minutes can help reduce the bleeding.

  3. Scalp and face swelling. Apply an ice pack to the area of facial swelling.

Hair Transplant Growth Stages

It takes time for the scalp to heal and new hair to grow and develop normally. Here is a timeline that gives you the details of the post-transplant hair growth stages.

Days 1 to 5

During the first few days, patients experience swelling of the forehead and at the back of the head. At the place where tiny incisions were made, the skin appears dark. The redness diminishes after the first week or 2.

Days 6 to 10

The swelling and redness may go off. For each follicular unit transplanted, a “crust” will form in which the attached skin layer is drying out. By day 10, the crusting disappears, and the transplanted hairs appear like a “crew-cut” haircut.

Weeks 2 to 3

The transplanted hair shed and by the end of 3rd to 4th week, most will be gone. This is a part of the healing process and there is nothing to worry about. The actual follicular unit and bulb remain intact and a new hair shaft begins to grow.

Month 1 to 2

The hair follicles enter into a resting stage. Patients appear how they were before the surgery.

Months 2 to 4

Hair transplantation

New hair, Credits: pixabay


The new hair starts emerging out. The growth may vary from person to person. Most of the native hair will grow back at this time.

Month 6

Transplanted hair has entered into the anagen phase.

Months 6-9

Patients can notice a considerable amount of hair emerging from the scalp. The donor area is completely healed.

1 year

About 80% of hair growth is achieved. The density and thickness of hair growth may vary.

What Is The Cost Of Hair Transplantation?

The cost of hair transplantation may be around $4,000 to $15,000.

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