Patient: One year post hair transplant, I have slow growth. One year back, I had a hair transplant of 2250 grafts. Hair has grown back after shedding but they're not growing in length even after 5 months.

Doctor: Thank you for your question. You've submitted a photo, a limited photo, with the concern that it's been about one year since your hair transplant and you're not seeing significant growth. And you stated that there were some shock loss and so naturally, here you are at one year and you are concerned about your results. Although I don't know exactly the details of your procedure, although you did describe the number of grafts you had, clearly by the photo you submitted, it does not appear that there is a significant amount of growth happening at this time. If you haven't had this discussion with your doctor, I'm going to just go over with you a little bit of what the issues of hair transplantation and how growth can be affected and a little bit about what we do in our practice that we have applied to try to improve the growth of that hair transplants as well as helping people who come to us who had hair transplants whether it was recent or in the past several years prior. Let's begin with just the basic review of what is involved in a hair transplant, and what happens. First a hair transplant is basically the movement of genetically resistant hairs. These are hairs that are in the back of the scalp in a limited space called the donor area that are individually placed in areas where the scalp is losing hair. Little openings are made and we refer to those as stab incisions. Then those grafts are placed individually. Now the graft is comprised of skin, the hair, the root or the dermal propeller, and some of the tissue that surrounds it. Now, when this is performed, there are two things that happen that are related to what we call shock loss. One is, the hair grafts themselves temporarily shed as well as the existing hair in the scalp. Although hair thinning can be to the point where you barely see any hair, with the microscope, we are able to often see that the hairs that are in the scalp that is balding or where the hair is thinning, actually there are many miniaturized hairs. Nonetheless, even if there is existing thicker hairs, a lot of those hairs go into shock. A transition period occurs for several months typically after hair transplant where there's no growth. In the beginning, you're able to see your existing hair and the hair that was transplanted and you can feel the short little ends of those grafts. Then comes a period where you don't know what's going on and whether or not you're ever going to have some hair growth.

As a general rule of thumb, we help people that at one year, most of the grafts will have grown in. Now from my own experience, I can tell you that there are different factors that will affect the results at one year and one of those factors has to do with the rate of hair growth. In our practice we do a procedure called hair regeneration, and although it's not a transplant, it is a method that we developed to reverse thinning hair. When we do this treatment we follow our patients every three months and prior to recent history, we actually had assumed following the similar pattern as a hair transplant model that most people would grow within a year. We've changed that. Now we see that a lot of people grow as far out as 18 months. In a way we've learned to classify people as fast growers, medium growers and slow growers. We find that a lot of people who have very advanced hair loss tend to be slow growers. Although we can see some early results and improvement with the hair regeneration treatment, we do see that as far out as 18 months people have had hair growth. We even have examples of patients who we did the combination of the hair regeneration treatment, which is a combination of extracellular matrix with platelet-rich plasma, combine that to maximize the survivability and the yield of the hair transplant as well as to reverse the thinning hair concurrently. We've seen patients where at 12 months, they appear to have less hair or didn't even have much growth at all. Then we see them again at 18 months and then they have robust growth of their thinning hair as well as their hair transplant. Now this is using our method that it combines not only the transplant method but also the hair regeneration that we developed. It is not unusual for people to come to us who have had mega sessions and had tremendous numbers of hairs implanted and not have any growth. People have come here from all over the world who have had these mega session procedures and I'm not saying that they are necessarily the procedures themselves but factors such as elevated blood pressure and manipulation of the grafts, you can lose up to 90% of the hair grafts. Now that's not a very encouraging thing to hear when you have a limited donor space and amount of hair.


How Long Will It Take My Transplanted Hair to Grow In?

Dr. Amiya Prasad discusses how hair transplant growth in patients with advanced hair loss may take up to 18 months to grow.