A hair transplant is the movement of genetically resistant hairs. These are hairs that are at the back of scalp in the limited space called the donor area. Little openings are made called stab incisions and grafts are placed individually where the scalp is losing hair. A graft is composed of skin, the hair, the root or the dermal papilla, and some of the tissue that surrounds it. When this is performed, a phenomenon called shock loss happens. This is when hair grafts and the existing hairs in the scalp temporarily shed. Although hair thinning can be to the point where you barely see any hair, using a microscope, we are able to see that there are many miniaturized hairs. Nonetheless, even there are existing hairs, a lot of those hairs go into shock. A transition period occurs for several months after hair transplant where there is no growth. As a general rule of thumb, at one year most of grafts have grown in. However, from my own experience, I have seen patients who start growth as late as 18 months. There are different factors that will affect the results in one year. One of those factors has to do with the rate of hair growth. In our practice, we do a procedure called Hair Regeneration that reverses thinning hair. When we do this treatment, we follow our patients every 3 months. Because of this, we are able to classify people as fast, medium and slow growers. People who have very advanced hair loss tend to be slow growers. We do the combination of Hair Regeneration treatment with extracellular matrix and platelet-rich plasma to maximize the survivability and the yield of the hair transplant, as well as to reverse the hair thinning concurrently. Patients who appear to have less hair or didn’t have much growth at 12 months have robust growth of their thinning hair as well as their transplant at 18 months. It is not unusual for people to come us who have had "mega sessions" where tremendous amounts of hair implanted and not have any growth. Factors such as elevated blood pressure and manipulation of the grafts can make the patient lose up to 90% of the hair grafts. This is not a very encouraging thing to hear when you have a limited donor space and amount of hairs. In your case scenario, we probably can just wait and see how you are doing for another 6 months or so and then try to determine what the yield is. The survivability of grafts is critical for the success of a hair transplant. This means that although you may move 2000 or 2200 hairs, your yield may be 10%, 20%, 30% less than what you’ve transplanted. In the popular method of FUE or follicular unit extraction, there is a very high rate called transection where the hair follicle gets cut and the important part of the hair doesn’t grow. Interestingly, some of those hairs will have enough stem cell activity present that they can grow, but unfortunately, a lot do not. We have been using Hair Regeneration as a way to help people who have had transplants done elsewhere. They come to us 1 month after their transplant and had Hair Regeneration treatment. As early as 6 to 7 months, they had robust growth of both their existing and their transplanted hair. Hair Regeneration maximizes the healing process and accelerates the growth of hair grafts. I think that it is very important that you meet with your doctor, discuss the details of your surgery, have your doctor examine your scalp and let him evaluate with a microscope your situation. Moving on, you’re going to have limitations of what your donor area can produce for your next hair transplant if you’re going to consider it. This is why a lot of people who have had previous transplants continue to find us. We do Hair Regeneration injection for them to thicken their thinning hair and for many people, they actually avoid a second transplant. That way, they can save the donor area and have that banked for later if they were ever to need it. I hope that was helpful, I wish you the best of luck, and thank you for your question. This personalized video answer to your question is posted on RealSelf and on YouTube. To provide you with a personal and expert response, we use the image(s) you submitted on RealSelf in the video, but with respect to your privacy, we only show the body feature in question so you are not personally identifiable. If you prefer not to have your video question visible on YouTube, please contact us.