It’s natural to have concerns about the stability of hair grafts after undergoing a hair transplant, particularly with regards to the length of time it takes for them to become firmly anchored and resistant to accidental displacement caused by activities such as hair brushing, shampooing, or scratching.
After investing money into a hair transplant, the last thing anyone wants is to jeopardise its success by inadvertently dislodging the grafts, especially for a procedure with such a high success rate in the UK. However, we also recognize the desire to resume regular activities as soon as possible such as returning to work, returning to exercise or having a haircut after a hair transplant.
This article will address these concerns by examining the nature of hair grafts, their behaviour during and after the hair transplant procedure, and the time required for them to become firmly secured.
Hair grafts are what are used in hair transplant surgery. Essentially, a hair graft is a strip of skin that contains hair. These strips of hair-bearing tissue contain healthy hair follicles that can then be transferred to areas on the scalp where there is little or no hair. The place from where the hair graft is removed is known as the ‘donor site’ and the place where they are transplanted is the ‘recipient site.’
In theory, any part of the body with hair could be used to create hair grafts. However, the most common place is the posterior scalp (the back of the head). This is because the hair from this area has high levels of sustainability. A typical single hair graft usually sprouts about two or three hairs. The shape and size of the grafts depend on the techniques, tools and technology used.
Hair grafts are taken from tissue in the donor area. The hair transplant surgeon removes a small area of hair-bearing tissue to transplant it to the recipient area. Hair graft tissue can either be removed from the donor area as one larger fleshy strip (as is the case for Follicular Unit Transplantation or FUT hair transplants) or as individual follicle clusters (as done for Follicular Unit Extraction or FUE hair transplants). In an FUE hair transplant, hundreds or even thousands of tiny punch incisions are made.
Once the hair grafts are obtained from the donor scalp area, the surgeon may need to prepare the follicle clusters before transplanting them into the scalp.
With FUT procedures, the surgeon will need to dissect the larger area of skin and tissue into smaller follicle clusters before they are ready to be transplanted into recipient areas.
With FUE procedures, the hair grafts are extracted using a sharp punch. This means that they are already small enough to be transplanted without much preparation.
Hair grafts are taken from the scalp and placed in a chilled saline solution to keep them cool and hydrated during the procedure if necessary. Once there are enough grafts, the surgeon will begin transplanting them into tiny incisions that are less than 1mm in width on the recipient’s scalp area.
The surgeon will then carefully consider the direction of the hair grafts so that the hair will grow in a way that looks natural.
The grafts are transplanted as quickly as possible and with extreme precision and care. This is because the grafts can dry out if they are exposed for too long.[4]
Once a hair graft is in position, light pressure is applied to promote quick healing as well as to stop any residual bleeding from the incisions.
An antibiotic or emollient ointment may then be applied to the area with a non-adhesive bandage covering both the recipient and the donor areas.
Dr. May performing hair transplant surgery
Extreme care must be taken in the few days after a hair transplant as the newly implanted grafts are vulnerable and could be lost. Think of it in a similar way to what happens when you re-pot seedlings in the greenhouse in your garden. If you do too much with them or cause them stress by changing their environment too quickly, they are much more likely to perish.
It can take a little while for hair grafts to “root in.” It takes the transplanted grafts around three days to start to regain blood supply.[5] As each day passes, the grafts become more secure in their new location. This is because the body produces Fibrin, a substance that secures them in place during the very first stage of healing.
Fibrin is a protein that is involved in blood clotting, helping to “plug” a wound site.[6] After the clot formation stage, the cells in the vicinity of the transplanted graft start to produce multiple proteins such as collagen that form a mesh connecting the implanted and recipient tissues together.
Eventually, the fibrin-based blood clot gradually dissolves. When the scalp has healed, the hair grafts are usually secure.
If you follow the surgeon’s recovery and aftercare advice, after around five to seven days, the hair grafts should be secure enough for you to gently wash your hair although you should not touch it by hand.
Generally, grafts are fully secure between 10 and 14 days after the hair transplant procedure. This is usually the time it takes for the scalp to heal around each new graft. After this initial two-week period, most people can confidently get on with their normal hair routine including using power showers and wearing hats without any problems.
Many surgeons advise avoiding exercise for at least two weeks (or sometimes longer) after having a hair transplant. This is because exercise tends to cause you to sweat which could contaminate the delicate scalp area and increase redness.
Following the surgeon’s post-operative instructions after a hair transplant is crucial if you want it to be a success. Certain activities such as showering and washing your hair too soon can cause the grafts to dislodge and fall out. The last thing you want following such a procedure is for it not to work as well as it could.
As mentioned, think of your new hair grafts like re-potted seedlings: handling them roughly, stepping on them, touching them or putting products on them may well cause them to wilt and struggle to root in properly. Handling them gently and caring for them will allow them to grow and flourish in the best possible way. Your transplanted grafts are the same. Allow them to ‘bed in’ and settle before handling them and be sure to follow your surgeon’s advice.
Quite often, we’re presented with things that you shouldn’t do to ensure that your hair transplant is a success. But are there any ways that you can help secure hair grafts? Firstly, your surgeon will tell you what to expect and how to care for your grafts to make sure the transplant is as successful as possible. This may include:
Using Minoxidil to encourage new hair growth and reduce shock hair loss. Read more about shock hair loss following a transplant.
Our understanding of this process is part of the reason we have a success rate of 97-100% for both our FUE and FUT hair transplantation procedures and why we have garnered so many positive reviews and awarded hair transplant clinic of the year for 3 years running.
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