I have some spiky stubble hair that does not grow after 9 months of FUE transplant. Is this hair dead? Will a new shaft grow?

Dear gedela vinay,Thank you for submitting this question. If a graft perishes prior to implantation, it will not grow, and instead becomes a foreign body in the scalp. The remainder of the follicle is resorbed by the body and the hair remains alone. After 9 months this is most likely the case. Hair usually comes out of its dormant phase before 9 months. While there is a possibility that a new follicle will emerge from where you pulled the spiky hair out from your scalp, in my opinion that’s unlikely.There are 5 main reasons for failure in FUE procedures. One is patient-dependent, and the other 4 are surgeon/surgery team specific reasons for failure.Health of the patient. Diabetes, advanced age, use of tobacco, and other factors that can impair wound healing can also impair the growth of new follicles. This is the one factor that is patient-dependent.The follicles were allowed to warm up. The follicles must be cooled to specific temperatures while outside your body to ensure their survival. The cooler temperatures slow down the metabolism of the follicles allowing them to survive longer than otherwise while in the Petri dish awaiting transplantation. At our Center we use infrared temperature sensors that we use to regularly check the temperature of the grafts to an accuracy of within 0.1 degrees Fahrenheit. The follicles were allowed to dry out. All follicles must be kept moist with appropriate holding solutions. The industry standard is to use normal saline, which is simply salt water. At our Center we use a combination of Hypothermasol® (source: Biolife Solutions, Inc.) and Liposomal ATP (source: Energy Delivery Solutions, Inc.) to help feed the follicles and ensure maximal growth of all the transplanted follicles.The follicles were handled improperly. This is a function of the surgical technicians involved in the case. If they are part-time, or independent contractors, or inexperienced it can be a problem as if grafts are handled improperly they can be damaged or even terminated due to improper handling by inexperienced surgical technicians. At our Center we have a full-time staff of highly experienced surgical technicians. I have 6 full time staff on my surgical team, and our combined experience in hair restoration is over 60 years. Four of my techs have over 10 years continuous experience in the field of hair restoration surgery, including FUE.The follicles were left out of the body too long. This is the most common reason for FUE failures. Not matter what is done, follicles will not survive outside the body forever. Technically they are slowly perishing while outside your body, and if they are not efficiently replaced into the scalp, some don’t survive. I read on blogs about people having FUE procedures, and they describe arriving at the facility at 6AM and leaving at 11PM or later. A significant portion of grafts that were removed early in the AM would not have survived 12+ hours outside the body, and this can lead to poor growth. At our Center we have a “clock on the grafts” and all surgical staff are well-aware of the time the grafts have been outside the body. For FUE cases we are careful to make sure the grafts that were harvested early in the case are the very first ones to be implanted so the time spent outside the patient’s scalp is minimized.You have waited 9 months and are concerned about the growth of your FUE grafts. My suggestion is to meet with the physician who performed the FUE procedure to see what he or she thinks. After 12 months, if the spiky, non-growing hairs that come out easily with tweezers are still there and look the same, it is most likely that all of those spiky hairs represent grafts that did not survive the transplantation process. I hope this information is helpful to you.Kind Regards,KWA

Hello, Dr. George Abrahamian here from LA FUE Hair Clinic in Pasadena, CA. Typically during a hair transplant what happens is the hair follicle is excised from the donor, whether through FUE or FUT, and implanted into the recipient site. The recipient skin will then absorb the follicle, and that follicle will then mature over time. Typically, grafted hair follicles will start maturing around the 3rd month post transplant, and can take up to a year to fully cycle through their phases enough for you to see the final outcome. Once the body accepts the hair follicle, the hair that was grafted along with the follicle goes dormant, and will likely never grow. New hair should start to sprout from that follicle, but the transplanted hair itself likely won't. Starting approximately 10 days after hair restoration, the grafted hairs should start to fall out on their own, and once you're able to touch and massage the transplanted areas in the shower based on your clinics post operative timeline, you'll notice more and more of these short stubble hairs shedding, until most, if not all of the transplanted hairs fall out. In some instances, the body will retain this dormant hair, and it will essentially just be a foreign body that is present. If you look closely, especially 9 months after your transplant, you will likely see some new hair sprouting around the retained dormant stubble. I recommend speaking with your surgeon to see what your options are, but the majority of the time, manual removal of the stubble is indicated, as they can clog up the channel where the hair is trying to grow. It does not mean the graft didn't take, especially if you see hairs growing from the same channel, it just means that the body held onto that dormant hair for longer than anticipated. You can also try using your non surgical options like Minoxidil and Finasteride to try and shift the growth stage of the hair out of dormancy, but this is few and far in between, and these options are far more beneficial for hair that is already able to cycle through their anagen, catagen, telogen and exogen phases. I hope this helps.