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Once the hair graft anchors to the scalp, is the hair guaranteed to grow?


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Or are there factors that could prevent it from growing? For example, assuming the hair grafts anchor to the scalp, could a lack of bloodflow permanently prevent the hair from growing? Or will the hair begin to grow once the proper bloodflow is restored? Thanks for your help.

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1 hour ago, HTHope said:

Great question I’m very curious about this too

thanks for the co-sign, HT! hopefully we’ll gain some insight into this matter

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3 minutes ago, lovinitl9 said:

if the graft was not hydrated properly or held out of the body for too long,  i think that would prevent it from growing 

thanks for the reply! yeah, I think that’s right. however, in that case, the graft never would have anchored to the scalp. I’m wondering if there are any instances where a graft can fail to grow AFTER it has successfully anchored. any ideas? thanks again. 

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3 hours ago, bsmit said:

 

thanks for the co-sign, HT! hopefully we’ll gain some insight into this matter

I’m very curious to know if inflammatory skin/scalp issues like dermatitis can harm grafts. Maybe the immune system would be involved?

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11 minutes ago, HTHope said:

I’m very curious to know if inflammatory skin/scalp issues like dermatitis can harm grafts. Maybe the immune system would be involved?

good question. healthy skin definitely helps promote hair growth; thus, unhealthy skin probably inhibits hair growth.

my question would be, assuming the grafts have anchored to the scalp, and assuming their growth has been inhibited by a skin condition, if you treat the skin condition, will the grafts begin to grow? or, alternatively, will they be permanently stunted? hopefully someone can shed some light on this. 

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23 minutes ago, bsmit said:

good question. healthy skin definitely helps promote hair growth; thus, unhealthy skin probably inhibits hair growth.

my question would be, assuming the grafts have anchored to the scalp, and assuming their growth has been inhibited by a skin condition, if you treat the skin condition, will the grafts begin to grow? or, alternatively, will they be permanently stunted? hopefully someone can shed some light on this. 

Totally on the same page with you. Maybe some of the more active doctors here such as @Michael Vories, MD or @Dr. Glenn Charles can help offer their opinion

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Even a dehydrated mishandled graft can "anchor" to the scalp. All that is required for the graft not to fall out is the epidermis closing around it. That doesn't mean the follicle survived and will receive blood supply to initiate growth. There's many factors at play and if they aren't all done with precision there is always a small chance of failure. 

Bosley 11-2016 FUE - 1,407 grafts

Dr. Diep 09-2017 FUE - 2,024 grafts

Dr. Konior 03-2020 FUE - 2,076 grafts

Dr. Konior 09-2021 FUE - 697 scalp to scalp, FUE - 716 beard to beard Total scalp FUE - 6,204 grafts 

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26 minutes ago, ruca2 said:

Even a dehydrated mishandled graft can "anchor" to the scalp. All that is required for the graft not to fall out is the epidermis closing around it. That doesn't mean the follicle survived and will receive blood supply to initiate growth. There's many factors at play and if they aren't all done with precision there is always a small chance of failure. 

I did not know that. thank you for clarifying. 

for the sake of this discussion, let’s assume that the anchored grafts were not dehydrated or mishandled. in other words, assume that the hair follicle survived and is capable of receiving adequate blood flow. if said graft fails to grow, due to inadequate blood flow, will said graft grow once blood flow is restored? or will said graft become permanently stunted?

thanks again

Edited by rhal22
reworded for clarity
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The revascularization process starts to occur very shortly after the graft is transplanted. If there is impedance to this for some reason (too dense packing - competition for blood supply,  too much trauma during implantation, incision site inadequacies such as wrong depth) then the graft will not survive. If revascularization doesn't occur then there is no growth. I think you're confusing shedding with failure to yield adequate blood supply. Shedding happens only to the hair shafts because of the "trauma" the follicle just went through. Being ripped from your home, put in solution, then reimplanted is a traumatic experience and as such the hair shaft goes into the telogen phase after a few weeks. Most grafts will grow a bit before entering telogen so that is a good indicator that blood supply is adequate and growth will return in 3-4 months. 

Bosley 11-2016 FUE - 1,407 grafts

Dr. Diep 09-2017 FUE - 2,024 grafts

Dr. Konior 03-2020 FUE - 2,076 grafts

Dr. Konior 09-2021 FUE - 697 scalp to scalp, FUE - 716 beard to beard Total scalp FUE - 6,204 grafts 

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4 minutes ago, ruca2 said:

The revascularization process starts to occur very shortly after the graft is transplanted. If there is impedance to this for some reason (too dense packing - competition for blood supply,  too much trauma during implantation, incision site inadequacies such as wrong depth) then the graft will not survive. If revascularization doesn't occur then there is no growth. I think you're confusing shedding with failure to yield adequate blood supply. Shedding happens only to the hair shafts because of the "trauma" the follicle just went through. Being ripped from your home, put in solution, then reimplanted is a traumatic experience and as such the hair shaft goes into the telogen phase after a few weeks. Most grafts will grow a bit before entering telogen so that is a good indicator that blood supply is adequate and growth will return in 3-4 months. 

is it possible for the hair follicle to survive but the actual growth to be delayed (either due to poor circulation or unhealthy scalp)?

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If you're asking if the hair doesn't immediately grow after implantation (before shedding) has it survived? Then the answer is it can survive and not immediately start growing. If you're asking if the graft doesn't immediately revascularize will it survive then the answer is no it will not. Poor circulation is anecdotal. It either gets adequate blood or it doesn't. If it doesn't it shouldn't grow immediately or in the future. Think of the hair follicle like a tiny organ in your body. It's genetic code is destined for one thing, to produce a hair shaft. If it has the right environment and blood supply it lives and can perform it's only function. If it's missing something it cannot perform what's it's code is destined to do. 

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Bosley 11-2016 FUE - 1,407 grafts

Dr. Diep 09-2017 FUE - 2,024 grafts

Dr. Konior 03-2020 FUE - 2,076 grafts

Dr. Konior 09-2021 FUE - 697 scalp to scalp, FUE - 716 beard to beard Total scalp FUE - 6,204 grafts 

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7 minutes ago, ruca2 said:

If you're asking if the hair doesn't immediately grow after implantation (before shedding) has it survived? Then the answer is it can survive and not immediately start growing. If you're asking if the graft doesn't immediately revascularize will it survive then the answer is no it will not. Poor circulation is anecdotal. It either gets adequate blood or it doesn't. If it doesn't it shouldn't grow immediately or in the future. Think of the hair follicle like a tiny organ in your body. It's genetic code is destined for one thing, to produce a hair shaft. If it has the right environment and blood supply it lives and can perform it's only function. If it's missing something it cannot perform what's it's code is destined to do. 

Can unhealthy scalp or underlying scalp issues such as inflammatory dermatitis prevent or destroy the vascularization process especially early on (within first month of a HT?)

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7 minutes ago, ruca2 said:

If you're asking if the hair doesn't immediately grow after implantation (before shedding) has it survived? Then the answer is it can survive and not immediately start growing. If you're asking if the graft doesn't immediately revascularize will it survive then the answer is no it will not. Poor circulation is anecdotal. It either gets adequate blood or it doesn't. If it doesn't it shouldn't grow immediately or in the future. Think of the hair follicle like a tiny organ in your body. It's genetic code is destined for one thing, to produce a hair shaft. If it has the right environment and blood supply it lives and can perform it's only function. If it's missing something it cannot perform what's it's code is destined to do. 

please allow me to clarify. assume all of the hair follicles survive and all of the grafts have shed. after they shed, is it possible for some hair follicles to grow back slower than others, due to unhealthy scalp or some other factor? thanks. 

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There are several factors that fan hinder growth, yes poor blood supply can hinder growth. However, it’s not likely, unless there’s severe scar tissue. There’s no guarantee that the graft will grow, even when it’s anchored.

If the graft was harmed or damaged during the extraction or transplantation, it’s not likely to grow. You can minimize the risk by going to a quality surgeon with a reputation of producing high-density results. 


I’m a paid admin for Hair Transplant Network. I do not receive any compensation from any clinic. My comments are not medical advice.

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It sounds like you're asking of there's anything a person can do or not do to make the grafts grow or not grow. Assuming everything was done right and the grafts are going to grow, there isn't really too much you can do that will affect it unless you are really trying to. Once the scabs fall off you should mostly just treat it as you would your normal scalp and hair except for maybe trying to stay out of the sun a bit more than you normally would and cut down or stop smoking if you smoke because that can restrict blood flow.

 

Al

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(formerly BeHappy)

I am a forum moderator for hairrestorationnetwork.com. I am not a Dr. and I do not work for any particular Dr. My opinions are my own and may not reflect the opinions of other moderators or the owner of this site. I am also a hair transplant patient and repair patient. You can view some of my repair journey here.

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9 hours ago, Melvin-Moderator said:

There are several factors that fan hinder growth, yes poor blood supply can hinder growth. However, it’s not likely, unless there’s severe scar tissue. There’s no guarantee that the graft will grow, even when it’s anchored.

If the graft was harmed or damaged during the extraction or transplantation, it’s not likely to grow. You can minimize the risk by going to a quality surgeon with a reputation of producing high-density results. 

thanks for weighing in, Melvin. I’m asking to assume that the graft was not harmed or damaged. In other words, assume that the hair follicle has survived and is capable of growth. are there factors, such as an unhealthy scalp, that can delay growth? if so, once you remedy the underlying condition, will the hair begin to grow?

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7 hours ago, BeHappy said:

It sounds like you're asking of there's anything a person can do or not do to make the grafts grow or not grow. Assuming everything was done right and the grafts are going to grow, there isn't really too much you can do that will affect it unless you are really trying to. Once the scabs fall off you should mostly just treat it as you would your normal scalp and hair except for maybe trying to stay out of the sun a bit more than you normally would and cut down or stop smoking if you smoke because that can restrict blood flow.

 

yes, this is exactly what I’m asking. thank you for clarifying.

assuming someone is a smoker, will that prevent the newly grafted hair follicles from growing? if so, will the hair begin to grow if the person quits smoking? or, alternatively, will the smoking permanently stunt the newly grafted hair follicle?

edit: this assumes that the hair follicles have successfully anchored to the scalp, survived, and are capable of receiving blood flow

Edited by bsmit
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2 hours ago, bsmit said:

thanks for weighing in, Melvin. I’m asking to assume that the graft was not harmed or damaged. In other words, assume that the hair follicle has survived and is capable of growth. are there factors, such as an unhealthy scalp, that can delay growth? if so, once you remedy the underlying condition, will the hair begin to grow?

There are some underlying conditions which can affect survival of the grafts. Conditions like Lichens planopilaris (LPP), which is a condition where the immune system attacks the hair follicles for unknown reasons, similar to alopecia areata. These conditions are rare, a scalp biopsy can rule these conditions out. 


I’m a paid admin for Hair Transplant Network. I do not receive any compensation from any clinic. My comments are not medical advice.

Check out my final hair transplant and topical dutasteride journey

View my thread

Topical dutasteride journey 

Melvin- Managing Publisher and Forum Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

Follow our Social Media: Facebook, Instagram, Linkedin, and YouTube.

 

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29 minutes ago, Melvin-Moderator said:

There are some underlying conditions which can affect survival of the grafts. Conditions like Lichens planopilaris (LPP), which is a condition where the immune system attacks the hair follicles for unknown reasons, similar to alopecia areata. These conditions are rare, a scalp biopsy can rule these conditions out. 

I apologize if I’m not being clear. I’m asking you to assume that all of the grafts have survived. please assume that the grafts have survived and are fully capable of growing. please further assume that all of the grafts have shed. are there factors, such as an unhealthy scalp, that can cause the grafts to grow back at a slower rate?

if so, once you remedy the underlying condition, will the grafts begin to grow? or can they be permanently stunted?

thanks again. 

 

edit: my use of the word “unhealthy scalp” could simply mean dandruff or an inflamed scalp, not necessarily a medical condition. 

Edited by bsmit
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Basically the hair will grow the same way it was growing before it was removed from the donor area and will continue to grow just as it would have if you hadn't moved it from the donor area to the recipient area. As you get older if the hair in the donor area on the back and sides starts to thin out, then the transplanted hair will be thinning at that time as well. The transplanted follicles have the same life span as they would have before and will react to medications, external forces, etc just as they would have reacted if they had not been moved and transplanted.

 

Al

Forum Moderator

(formerly BeHappy)

I am a forum moderator for hairrestorationnetwork.com. I am not a Dr. and I do not work for any particular Dr. My opinions are my own and may not reflect the opinions of other moderators or the owner of this site. I am also a hair transplant patient and repair patient. You can view some of my repair journey here.

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56 minutes ago, BeHappy said:

Basically the hair will grow the same way it was growing before it was removed from the donor area and will continue to grow just as it would have if you hadn't moved it from the donor area to the recipient area. As you get older if the hair in the donor area on the back and sides starts to thin out, then the transplanted hair will be thinning at that time as well. The transplanted follicles have the same life span as they would have before and will react to medications, external forces, etc just as they would have reacted if they had not been moved and transplanted.

 

yeah, that makes sense. so, in other words, the transplanted hairs will only be adversely impacted if the condition is severe enough to adversely impacted my native hair, correct? so, in theory, inadequate blood flow should only inhibit the growth of my transplanted hair if it would similarly inhibit the growth my native hair. is that essentially what you’re saying?

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On 5/7/2020 at 9:33 AM, bsmit said:

I apologize if I’m not being clear. I’m asking you to assume that all of the grafts have survived. please assume that the grafts have survived and are fully capable of growing. please further assume that all of the grafts have shed. are there factors, such as an unhealthy scalp, that can cause the grafts to grow back at a slower rate?

if so, once you remedy the underlying condition, will the grafts begin to grow? or can they be permanently stunted?

thanks again. 

 

edit: my use of the word “unhealthy scalp” could simply mean dandruff or an inflamed scalp, not necessarily a medical condition. 

Thanks for clarifying, one could take unhealthy scalp as different scalp conditions and ailments. Dandruff has no adverse effects on hair growth or grafts. In theory, if all grafts survive, they grow just as any other hair would on your scalp.

Now, as previously mentioned, there are definitely conditions that could affect the growth, but dandruff is not one of them. So the real question is what is "unhealthy scalp" if by unhealthy you mean flaky dandruff, then as mentioned it will have no effects at all. In my opinion, a scalp that is not healthy is one with conditions that attack the hair follicles, and or skin. Having dandruff does not constitute an unhealthy scalp.


I’m a paid admin for Hair Transplant Network. I do not receive any compensation from any clinic. My comments are not medical advice.

Check out my final hair transplant and topical dutasteride journey

View my thread

Topical dutasteride journey 

Melvin- Managing Publisher and Forum Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

Follow our Social Media: Facebook, Instagram, Linkedin, and YouTube.

 

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2 minutes ago, Melvin-Moderator said:

Thanks for clarifying, one could take unhealthy scalp as different scalp conditions and ailments. Dandruff has no adverse effects on hair growth or grafts. In theory, if all grafts survive, they grow just as any other hair would on your scalp.

Now, as previously mentioned, there are definitely conditions that could affect the growth, but dandruff is not one of them. So the real question is what is "unhealthy scalp" if by unhealthy you mean flaky dandruff, then as mentioned it will have no effects at all. In my opinion, a scalp that is not healthy is one with conditions that attack the hair follicles, and or skin. Having dandruff does not constitute an unhealthy scalp.

What about things like severe dandruff (seborrheic dermatitis) or psoriasis? These do involve the immune system which can potentially attack hair cells as well.

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