Hair Transplant Timeline
Written by Hair Transplant Surgeon Ali Emre Karadeniz
Publish Date: 15.11.2019
The hair transplant timeline is the process of going through the hair transplant surgery until all healing has occurred and hairs are grown. Let's examine all the stages of hair transplant experience from the first step to the ultimate end.
The hair transplant timeline is the process of going through the hair transplant surgery until all healing has occurred and hairs are grown.
Hair transplant surgery is a procedure generally performed under local anesthetics just like dental surgery. However, because it is so labor intensive it's more time consuming. A hair transplant session could take up a whole day, even up to 8 hours or more. It's sometimes even divided into two or three days. But don't think hair transplant surgery as like a cosmetic surgery or any other surgery where you're actually lying down on an operating table unconscious for many hours. Hair transplant surgery is like spending a day in a hair transplant clinic, because there are many phases of this procedure that requires giving a break for both the surgical team and the patient. Therefore, hair transplant surgery is like spending a day in a facility rather than a typical surgical procedure where you lie down on a bed.
During Hair Transplant Procedure
- Photography and Design
- Local Anesthetics & Graft Excision
- Lunch Break
- Recipient Site Incisions
- Graft Placement
After Hair Transplant Procedure
- First 3 Months After Hair Transplant
- After 3 Months
- 6 Months
- 6-18 Months
- Re-Modelling Phase
Photography and Design
The procedure starts with photography and design. The pre-operative photographs are taken, hairline design is made by the surgeon, the area of donor harvesting and the recipient area are marked and the surgical plan is made. After that, shaving follows. After the shaving is done, the first part of the surgery can begin which is generally the graft harvesting or graft excisions. In case we're talking about FUE which is the most preferred hair transplant method nowadays, this involves doing local anesthetics on the donor area.
Local Anesthetics & Graft Excision
Some clinics prefer to do local anesthetics as a whole whereas others prefer to divide it into zones just to postpone injecting a huge amount of anesthetics at once and also prolong anesthetic time. We generally prefer to divide it into two or three portions, so we anaesthetize one area, once the graft excision is finished we move onto the second zone and apply anesthetics there and then so forth. It begins with local anesthetics and then graft excision is done which takes a couple of hours if it's done carefully.
In general we will give a lunch break at this point for the staff and the patient.
Recipient Site Incisions
After the lunch break, the second part that is "recipient site incisions" are going to be performed but before that we need to anaesthetize the recipient area. The hair line local anesthetics and the recipient area anesthetics are applied and then recipient site incisions are performed which should take an hour or a bit less.
By the time recipient the recipient site is also anaesthetized, most of the scalp becomes numb. After the recipient site incisions, the third and the last part begins: "Graft Placement".
The grafts are placed into their new locations after which the surgery ends depending on how large the session was. The wound management is done and the patient is ready to go home.
In some clinics the instructions are done immediately whereas in others it is done a day after. In our clinic in Turkey most of the time patient comes in for a cleanup and wash the following day in which the bandages are removed, donor and recipient areas are washed and the patient receives the necessary aftercare instructions. Now the patient is ready to go home.
First 3 Months After Hair Transplant
There's a period after the hair transplant procedure is done which extends up to 18 months that involves healing and then growing of new hairs; the healing time is the shorter portion. Most of the donor and recipient wounds heal within two days, that means the donor excision sites are mostly filled with tissue and recipient site scabbing has occurred, so there aren't wet open wounds to worry about by almost two days.
Within the first two weeks most of the healing occurs, all that is left is a short hair due to shaving and pinkness resulting from the healing at the donor and recipient sites. Pinkness may extend up to 6 months but because new hair growth is seen at the donor area a few week after the surgery this area is generally camouflaged by that time. However, the pinkness may be visible for some months if the recipient site is without any existing hairs.
The first 3 to 4 months of hair transplant are called "the ugly duckling period". The reason for this definition is because there's almost no new hairs grown yet. The donor and recipient sites can only look worse than before because there are the effects of the surgery. Although healing has occurred, there's pinkness, there may be some temporary slight irregularities and color changes. Since there's no new hairs yet, it looks worse than before. Patients have to be aware that for the first three to four months.
After 3 Months
3 months is when the first hairs start growing. Transplanting hairs is not like planting a tree where the tree continues to grow from where it was before. We are actually placing seeds, we are burying cells for it to create new hair follicles. The pieces of hair shafts we see and the scabs outside the skin surface are actually not the "mature tree". These are ones that are destined to wash off and disappear within weeks to months leaving an area that looks as if nothing was done except for maybe the slight pinkness. New hairs need to be created from these cells that are buried and that starts almost 3 months after the procedure. Therefore, we tell our patients not to expect any improvement in those months.
Approximately 3 months later, the first few hairs start growing. However, because the number of hairs growing in this period are so few, we don't recommend our patients to keep looking for new hairs because it's going to make them worried whether enough density is going to be achieved. It's better to leave that aside and actually forget about the hair transplant for about 6 months.
6 months is when more or less half or a bit more of the hairs may already have grown. It will start giving the first initial signs of a result or give an idea, but obviously it's not the final result.
Frontal hair transplants grow a little earlier than crown hair transplants. Frontal hair transplants can show full growth anywhere between 6 to 12 months whereas crown hair transplants may continue to grow until 18 months.
There's actually a re-modelling phase after the first year that takes another year or two years for the hair to reach its final volume, quality, directions and so forth. Although full hair growth may occur in one year, it may take another year or two years to mature up and get into the best possible shape.
Written By Dr. Ali Emre Karadeniz, MD, PhD
Ali Emre Karadeniz, MD (Dr. K) is the only American Board of Hair Restoration Surgery Certified Turkish plastic surgeon. He has performed over 2000 hair operations. He is an active member of the International Society of Hair Restoration Surgery (ISHRS). Her performs hair restoration surgery at AEK Hair Clinic in Istanbul, Turkey.