So, you had a hair transplant; now when can you expect to actually see the results? How do you know whether you are “on track” or whether you are growing faster or slower compared to the average patient?
Hair transplant “growth” and the appearance of results is actually based on two different factors: “popping” and maturation. Popping refers to new, transplanted hairs penetrating or “popping” through the scalp; maturation refers to the thickening, darkening, and naturalization of these hairs. A hair transplant reaches its final growth state when all hairs have “popped” through the scalp and each hair has fully matured by thickening, darkening, and normalizing in texture.
After being transplanted, the hair follicles go into a natural resting phase. The small hairs in the follicles will shed within 2-4 weeks after the procedure, and no new hair growth is seen until month 3 when the follicles awake. The new follicles wake and begin growing hairs at month 3; changes are seen up through the 12th month and often times even up to the 18th month after surgery. This means the full growth and appearance of a transplant is not complete for at least a year; sometimes a year and a half.
The popping of new transplanted hairs progresses as follows:
By month 3, the new hairs begin “popping” through the scalp. By the end of month 3, approximately 30% of the hairs have penetrated through. 40% have come through by month 4, and 50% by month 5. By 6 months, approximately 60% – 70% of the new hairs have fully penetrated through the scalp. By the 9th month, approximately 90 – 100% of the hairs have “popped” through the scalp, and most of the changes of a hair transplant from that point forward are due to maturation.
Maturation refers to darkening, thickening, and normalizing of the transplanted hairs. When the hairs first penetrate the scalp between the 3rd and 5th month, they are very fine, transparent, short, and wispy. This is referred to as an “immature” appearance. By the 6th month, the result is considered around 40-50% “matured.” At this point, most patients are happy and begin to see a real cosmetic benefit. They are cutting, styling, and blending the new transplant with their native hair. However, the hair is still quite immature at this point. The hairs are still thinner than native scalp hairs, and also appear somewhat “wiry” or “kinky” – a temporary texture change which will normalize. While patients are usually very happy by 6 months, they must remember that this is really only the “half way” point when it comes to the overall results. Only around 70% of the hairs have penetrated through the scalp, and those that have are thinner and somewhat “frizzy” compared to the rest of the native hair. The hairs continue to look somewhat “wiry” and thin through the 8th month. Then, between the 9th and 12th month, the hairs begin their final maturation. At this point almost all new hairs have “popped” through the scalp, and now the hairs really fully darken, thicken (each shaft becomes “fatter”), and the texture normalizes or “smooths out” to match the rest of the hair.
For many patients, a hair transplant is fully “grown” at the 12 month mark. 100% of the hairs have popped through the scalp and all of these hairs have fully darkened, thickened, and normalized. It is important to remember, however, that this timeline is just a rough average. Many patients grow quicker, and many also grow slower. Just because you find yourself ahead of or behind the curve does not mean your result will be better or worse. It just means it may take less or more time to reach its final conclusion. All patients have unique physiologies, so all patients will grow differently. This is why many hair transplant doctors wait until 18 months to make a final assessment of results. A lot of patients truly do see changes up until and even through the 18th month, so do not feel discouraged if your doctor believes you are still “immature” and have room to grow beyond the 12 month mark. This is especially true for patients who undergo transplants in the mid-scalp or crown (back) region. These areas grow and mature slower than those in the front, and most doctors believe it takes a full 18 months to see the final results in these regions.
Patients must remember that this is a rough guideline. It may be helpful to review as your results unfurl, but it is not a guarantee nor should you compare your progress to it religiously. All patients grow differently, and it is the destination and not the journey that matters with hair transplants.