Growth peak

[HarryHonolulu]

Hey all

when should one expect the most growth after FUE? Months 1-6 or 7-12? 

I’m in month 6 and definitely growing well - just curious if I should expect new hair in the next few months or if all the follicles should have sprouted by now

[Melvin- Admin]

Depends on the individual, those who start growing early usually stop growing earlier. On average I would say growth is done around the 10th month. Although, it becomes less visible each month that passes.

[txtransplant]

Growth peak. Hmm, not sure exactly what you are asking. But they say 18 months is your absolute full result, though you have pretty much maxed out what you will see by months 12 for almost everyone.  If what you are asking is when do you see the biggest changes? I would say month 5-8.  I think this makes sense as the resting phase is usually about 4 months. So thin hairs start really popping up around month 5 and are almost all doing their thing by month 7.  After about month 8 things usually continue to improve, but at a much more modest rate than that.  No two patients are the same. A tiny percent (maybe 2%) never shed and have almost full growth almost out of the gate. And a small number of patients don't shed all of it, myself included shed only a portion of the new grafts, and some of the grafts stay from day one and grow. It seems like maybe 25% have a small to medium percent of hairs that grow right from the start. Most people shed every new graft or nearly all. And sadly for a few patients, they have poor regrowth. Sometimes that is Dr. error. But even the best doctors have failures and that is just biology. Sometimes your body just rejects the implants.  Everyone is at a different rate. But even the slowest 10% will see most of their result buy month 12. I have never seen someone who looked thin and like a weak hair transplant result at month 12 then have a great result by months 18. I have seen plenty of subtle improvements on patients in that time though. And another thing. All the real home run cases I have seen, they are always looking great by about month 8. I think by about month 8 you have a pretty good idea of where you are headed. 

Some basic facts or observations.  Many doctors claim they get over 95% regrowth on transplanted grafts. The medical journals seem to suggest it is closer to 85% on average. I do think skilled physicians with an ideal patient can do that. But I think most people with a respected doctor and good scalp and hair characteristics should reasonably be expecting around 88-90% to grow. Anything more being a bonus and less being still reasonable.  Most of the failures here I see are one of two things. Biggest is patient going to a doctor who doesn't do this as a specialty. Even the more reputable hair mills where technicians and not doctors do the work seem to be better choices than the local plastic surgeon who does the occasional HT.  The other failures are varying degree of just an unlucky bit of biology on the patients part. For every patient that has results that far exceed the average there is is one who falls far below the average. It could be stress, bad aftercare, or just unknown biology the same way we all hear and react differently. Set your expectations at average, know the pitfalls and do your math! Understand how many grafts you truly need per cm2 and how important the thickness of each hair is.  A patient with 45 grafts per cm2 with very thick hairs and all double and tripple FU's will have like 8x the visual coverage of another patent with 45 grafts per cm2 with thin hair and mostly singles.  So in this case one guy with the same number of grafts could look like rock star thick hair while the other guy might look very thin and stringy even if both had 100% regrowth.  People don't do their homework and account for this. I think you would have a lot less disappointed patients if they new better what to expect and what they need to achieve the look they want.  But here are some guidelines;

You need about 1/2 your original hair density to look like you have hair. Now for most people I think this is not really accurate. You will look not THINNING at first glance with this. But in the sun or under bright light, you not going to look like you have the hair of a 11y old. Again, depends how think your hair is. If your hair is super thick then maybe 50% is still enough to look full. If your hairs are straight, thinner and your follicles are not spaced close, then guess what, 50% of your original density is going to look pretty thinned.  That's life!  Simply put, some people were born for this and some were never meant to do more than warm the bench. People with great hair characteristics,  Hairs above 60 microns, density of 100 fu per cm2 and milti hair grafts are the big winners here, Now if they have a bit of a wave or closer match to scalp color....even better. Last statistic I read said mature men average between 60 and 100 follicles per cm2 and average hair thickness was 50 microns. Couple that with the average FU graft being 2.2 hairs per FU.   Know your reality here to know where you are going.

If your hair is 30 microns v 70. Guess what? You will get closer to 4x the volume of hair on your head with the same number of hairs. 

 

So know your math! 2,000 grafts on someone with very thin, straight hair and lot's of single hair grafts is going to have something like 1/12 the coverage that a guy with really really thick wavy hair and lot's of 3 hair grafts.  And that is not even getting into scalp contrast to hair.  You realize quickly even 100% regrowth by the best surgeon in the world we are already vastly different as patients. If you know what your microns are, density, and such, then you can know what to expect after you see hundreds of results and pick a doctor. You might realize you are a great candidate or that you are in over your head trying to get a great hairline again. I seen way too many guys here making two huge mistakes. Being to aggressive in their hairline for what they have to work with. They always end up looking thin and disappointed when someone looking at it knowing all this could see the mess coming before it started. Unfortunately doctors know that those patients will just go to someone else who tells them what they want to hear and they try and do the best they can to help their patients. But it is cycle I see repeated over and over. Granted, there a few surgeons who flat out refuse to do this. H&W is one that comes to mind where I never see this simple math ignored. Sure, like every practice, they have some home runs and some guys who's bodies just didn't work well with HT. That's just different people's biology...not DR. error there. But I never see them take on a patient and not give them the proper math to meet their goals when they do operate. I am sure they loose some patients because of this. On the other hand, I see lot's of good work in Turkey too. But way too often no real modeling is done and you have a patient with the wrong density over too large and area left disappointed. 

 

 

 

 

[HarryHonolulu]

13 hours ago, txtransplant said:

Growth peak. Hmm, not sure exactly what you are asking. But they say 18 months is your absolute full result, though you have pretty much maxed out what you will see by months 12 for almost everyone.  If what you are asking is when do you see the biggest changes? I would say month 5-8.  I think this makes sense as the resting phase is usually about 4 months. So thin hairs start really popping up around month 5 and are almost all doing their thing by month 7.  After about month 8 things usually continue to improve, but at a much more modest rate than that.  No two patients are the same. A tiny percent (maybe 2%) never shed and have almost full growth almost out of the gate. And a small number of patients don't shed all of it, myself included shed only a portion of the new grafts, and some of the grafts stay from day one and grow. It seems like maybe 25% have a small to medium percent of hairs that grow right from the start. Most people shed every new graft or nearly all. And sadly for a few patients, they have poor regrowth. Sometimes that is Dr. error. But even the best doctors have failures and that is just biology. Sometimes your body just rejects the implants.  Everyone is at a different rate. But even the slowest 10% will see most of their result buy month 12. I have never seen someone who looked thin and like a weak hair transplant result at month 12 then have a great result by months 18. I have seen plenty of subtle improvements on patients in that time though. And another thing. All the real home run cases I have seen, they are always looking great by about month 8. I think by about month 8 you have a pretty good idea of where you are headed. 

Some basic facts or observations.  Many doctors claim they get over 95% regrowth on transplanted grafts. The medical journals seem to suggest it is closer to 85% on average. I do think skilled physicians with an ideal patient can do that. But I think most people with a respected doctor and good scalp and hair characteristics should reasonably be expecting around 88-90% to grow. Anything more being a bonus and less being still reasonable.  Most of the failures here I see are one of two things. Biggest is patient going to a doctor who doesn't do this as a specialty. Even the more reputable hair mills where technicians and not doctors do the work seem to be better choices than the local plastic surgeon who does the occasional HT.  The other failures are varying degree of just an unlucky bit of biology on the patients part. For every patient that has results that far exceed the average there is is one who falls far below the average. It could be stress, bad aftercare, or just unknown biology the same way we all hear and react differently. Set your expectations at average, know the pitfalls and do your math! Understand how many grafts you truly need per cm2 and how important the thickness of each hair is.  A patient with 45 grafts per cm2 with very thick hairs and all double and tripple FU's will have like 8x the visual coverage of another patent with 45 grafts per cm2 with thin hair and mostly singles.  So in this case one guy with the same number of grafts could look like rock star thick hair while the other guy might look very thin and stringy even if both had 100% regrowth.  People don't do their homework and account for this. I think you would have a lot less disappointed patients if they new better what to expect and what they need to achieve the look they want.  But here are some guidelines;

You need about 1/2 your original hair density to look like you have hair. Now for most people I think this is not really accurate. You will look not THINNING at first glance with this. But in the sun or under bright light, you not going to look like you have the hair of a 11y old. Again, depends how think your hair is. If your hair is super thick then maybe 50% is still enough to look full. If your hairs are straight, thinner and your follicles are not spaced close, then guess what, 50% of your original density is going to look pretty thinned.  That's life!  Simply put, some people were born for this and some were never meant to do more than warm the bench. People with great hair characteristics,  Hairs above 60 microns, density of 100 fu per cm2 and milti hair grafts are the big winners here, Now if they have a bit of a wave or closer match to scalp color....even better. Last statistic I read said mature men average between 60 and 100 follicles per cm2 and average hair thickness was 50 microns. Couple that with the average FU graft being 2.2 hairs per FU.   Know your reality here to know where you are going.

If your hair is 30 microns v 70. Guess what? You will get closer to 4x the volume of hair on your head with the same number of hairs. 

 

So know your math! 2,000 grafts on someone with very thin, straight hair and lot's of single hair grafts is going to have something like 1/12 the coverage that a guy with really really thick wavy hair and lot's of 3 hair grafts.  And that is not even getting into scalp contrast to hair.  You realize quickly even 100% regrowth by the best surgeon in the world we are already vastly different as patients. If you know what your microns are, density, and such, then you can know what to expect after you see hundreds of results and pick a doctor. You might realize you are a great candidate or that you are in over your head trying to get a great hairline again. I seen way too many guys here making two huge mistakes. Being to aggressive in their hairline for what they have to work with. They always end up looking thin and disappointed when someone looking at it knowing all this could see the mess coming before it started. Unfortunately doctors know that those patients will just go to someone else who tells them what they want to hear and they try and do the best they can to help their patients. But it is cycle I see repeated over and over. Granted, there a few surgeons who flat out refuse to do this. H&W is one that comes to mind where I never see this simple math ignored. Sure, like every practice, they have some home runs and some guys who's bodies just didn't work well with HT. That's just different people's biology...not DR. error there. But I never see them take on a patient and not give them the proper math to meet their goals when they do operate. I am sure they loose some patients because of this. On the other hand, I see lot's of good work in Turkey too. But way too often no real modeling is done and you have a patient with the wrong density over too large and area left disappointed. 

 

 

 

 

Wow. Thx !

 

Yes. Growth peak. When do you grow the most. 

 

Edited February 13, 2019 by HarryHonolulu

[LaserCap]

I gather you are asking after a transplant procedure.  So the question could be phrased better.   When can I expect the most benefit from a hair transplant?  

Most agree that the hair starts growing after 3-4 months. It then starts very weak and, in time, the hair itself strengthens.  Most also agree that you will see the most benefit after 12 months.  That is not to say that there are patients out there that can take 18-24 months to really mature everything.  The problem, however, is that as the transplants are improving, you are continuing to lose native hair. (if you've shown the propensity to lose, you will continue losing).  My suggestion is to be patient and to be doing some type of medical therapy to help you retain and perhaps even enhance the native hair otherwise you are NEVER going to see much of an improvement.

[LonelyGraft]

Hey Harry

I've referred a few people to this thread started by Dr Bloxham. It should help answer your questions at least partly. He separates hair transplant results between new sprouts aka "popping" vs maturation/thickening of new hair. Of course these are all averages according to him and patients may experience results ahead or after the timeline. According to his timeline, at 6 months, your hairs have matured by about 40% and sprouted by about 60% so I'd say you have more to come!

 

 

[HarryHonolulu]

5 hours ago, jj51702 said:

Hey Harry

I've referred a few people to this thread started by Dr Bloxham. It should help answer your questions at least partly. He separates hair transplant results between new sprouts aka "popping" vs maturation/thickening of new hair. Of course these are all averages according to him and patients may experience results ahead or after the timeline. According to his timeline, at 6 months, your hairs have matured by about 40% and sprouted by about 60% so I'd say you have more to come!

 

 

Thank you ! This is what I was looking for 

[LonelyGraft]

5 hours ago, spex said:

 

 

Spex this seems like a really informative post especially those timeline photos. However those 3 links in ur first post don’t work. Any chance you can link us to those threads?