Safe zone? How do you know if your grafts have taken root?

[hairyharry]

Other than waiting 4-6 months before the new hair starts to grow, is there any way to know whether your grafts have taken?
If they haven't fallen out in the first 7-10 days, can you reasonably assume they've taken root and you're in the "safe zone."

 

[A Fue Good Men]

No way to know really.

[NARMAK]

Without a microscopic analysis of pretty much the exact number of hair grafts and their individual follicular makeup, it's almost impossible to see what the percentage of survival is. The generally held belief is that it will never be 100%, but in good hands of the best doctors under the best circumstances, 98% survival could even happen. 

[pkipling]

I wanna point out that the grafts "falling out/shedding" even 7 days post-op is normal and doesn't indicate anything one way or the other about the final result, nor does that indicate a lost graft. As a general rule, an actual graft being dislodged is accompanied by some level of pain and bleeding. If not, it's most likely just the hair follicle itself shedding, which is typically nothing to be alarmed about. Also keep in mind that it's actually harder than we think to dislodge a graft, and the chances of that happening decrease significantly after Day 3. 

This is from a study performed by Dr. Bernstein addressing the question of when grafts can be dislodged:

"The study showed that for the first two days, pulling on a hair always resulted in a lost graft, but the chance of the graft being removed started to decrease by the third day. By the sixth day pulling on a hair would no longer dislodge the graft. Pulling on an adherent scab always resulted in a lost graft through day five, with the incidence decreasing through day eight. However, by nine days post-op, grafts were no longer at risk of being dislodged."

[THE TRUTH]

Great question.

I also wondered about that many times in the past. 

There is no general consensus about this particular question. 

Some people look great even after 3 weeks post op when all scabs have fallen off without the hairs and keep most of their hairs before the shedding and yet end up with a crappy result....

Others start shedding hairs attached to scabs very early like a week post op and get a great result. 

There is that famous study from Bernstein and Rassman on graft anchoring but just because your kept most of your hairs after day 10 doesn't mean all the grafts have survived.

You will get a good idea of survival rate around the 4-5 months mark. 

[Rahal Hair Transplant]

Hairyharry,

To be clear, the follicular units “take root” between 5 to 7 days. In other words, they can’t just be plucked out anymore. It would literally take surgery to remove them. But just because they’ve taken route, doesn’t mean that the transplanted hairs themselves won’t still shed.

Consider the transplanted hair shed a lot like natural hair shock loss. Even though the natural hair is clearly deeply rooted, some of the hairs actually shed due to trauma to the scalp during surgery. It might take 8 to 10 weeks or so for shock loss to occur.  But it can and does happen.

Transplanted hair on the other hand is literally moved from one section of the scalp to the other. Therefore, the trauma to these hair follicles are more severe.  As a result, these hairs typically shed faster which is typically between 4 to 6 weeks although it can occur sooner.

Note also that mostly all of these transplanted hairs will actually grow during the first 4 to 6 weeks before the actual hair shed.  If anything, this is proof that the hairs have taken root.

I think your question however, is not whether or not the hairs take root but whether or not the transplanted hairs will actually grow back and continue to grow. You want to know if there’s any proof other than waiting to see if that happens right?

Proof however, is a radical word to use in this case so if we are asking if there’s any proof I would say no. Evidence however, is another story.  Here is the evidence that the transplanted hair has taken and will continue to grow prior to actually seeing it happen 

1. you’ve selected a reputable surgeon with a proven ability to produce consistent excellent results

2. The transplanted hair actually grows before it starts to shed. 

3. The hair actually starts to grow back in 3 to 5 months after the date of the procedure. You can usually tell first by feeling your scalp and feeling what seems like peach fuzz. Because transplanted hair typically starts to grow thin and colorless and gradually gets thicker, darker and longer.

Above are essentially all the signs and all the evidence that the hair that was transplanted will actually grow and mature.

I hope this helps.

Rahal Hair Transplant

Edited May 10, 2022 by Rahal Hair Transplant

[Rahal Hair Transplant]

One other thing… The “safe zone“ typically refers to the area of the donor that’s 100% DHT resistant.   This is typically an area on the sides back of the scalp that a surgeon will take hair from for transplanting.

Hairs that are extracted outside of the donor area safe zone and then transplanted may actually fall out just as they would have if they weren’t moved in the first place. This would only occur if genetic hair loss continues to the point that it affects those hairs.  Typically men who advance to a Norwood class 6 and definitely 7 are at greater risk of this happening which is why it’s important for hair surgeons to extract donor hair from the universal donor area safe zone rather than outside of it.  In this case “universal” refers to an area that is truly safe for everyone regardless of how advanced their hair loss gets  

An individuals’ “safe zone” however, can extend beyond the universal zone.  There are risks when taking hair outside the universal safe zone however, if a surgeon feels confident that an individuals hair loss pattern and family history of hair loss won’t take an individual beyond a certain point of hair loss, they might decide to take hair outside of the universal zone in order to obtain a greater number of grafts to assist with density.  This of course, is done with the patient’s informed consent.

The reason why I bring all this up is because you used the term “safe zone“ but I don’t believe you were referring to this. I wanted to explain what the safe zone meant in hair transplant terminology because I believe you used the term referring to growth.

Best wishes,

Rahal Hair Transplant

Edited May 10, 2022 by Rahal Hair Transplant