What to Expect from DHI Results: Before and After by Stage
DHI (Direct Hair Implantation) produces natural-looking results when the procedure is matched correctly to the patient's Norwood stage and graft needs. 84% of dissatisfied transplant patients cite unmet expectations as the primary cause of their unhappiness. This guide walks through realistic before-and-after outcomes by Norwood stage so you know exactly what to expect.
The DHI Results Timeline
Before examining results by stage, understanding the timeline is essential. DHI results do not appear overnight. The change follows a predictable biological pattern:
| Time After Surgery | What You See |
|---|---|
| Day 1 to 3 | Redness, swelling, visible scabs over graft sites |
| Week 1 to 2 | Scabs healing, initial redness fading |
| Weeks 2 to 6 | Shock loss: transplanted hairs fall out (normal) |
| Months 2 to 3 | Scalp may look similar to pre-surgery or slightly thinner |
| Months 3 to 4 | Fine new hairs begin emerging |
| Months 6 to 9 | Visible density improvement, hairs thickening |
| Months 12 to 18 | Final density and thickness achieved |
The graft survival rate for DHI is 90% to 95%, meaning the vast majority of placed follicles will produce permanent hair. The wait is for these follicles to complete their growth cycle and produce mature, thick strands.
DHI Results by Norwood Stage
Norwood 2: Slight Temple Recession
Before: Mild recession at the temples creating a slight M-shape. Many patients are uncertain whether treatment is needed.
Typical procedure: 800 to 1,500 grafts focused on the frontal hairline and temporal points.
After at 12 months: The temple recession is filled in, creating a natural youthful hairline frame. Because the treatment area is small and graft density is high relative to the area covered, Norwood 2 patients consistently achieve the most dramatic improvement.
Expected density: 40 to 50 FU/cm2 in the hairline zone, blending naturally with dense native hair behind it.
Satisfaction rate: Over 90% of Norwood 2 DHI patients report meeting or exceeding their expectations.
Norwood 3: Deep Temple Recession
Before: A clear M-shaped hairline with deep temple recession. The frontal hairline has receded 1 to 2 cm from its original position.
Typical procedure: 1,500 to 2,200 grafts covering the frontal zone and temples.
After at 12 months: The frontal hairline is restored to a natural position with a micro-irregular border. The temple triangles are rebuilt, framing the face. The transition between transplanted and native hair is seamless when performed correctly.
Expected density: 35 to 45 FU/cm2 across the treatment zone.
Key detail: Single-hair grafts are placed in the front row of the hairline (10 to 15 degree angles), with multi-hair grafts behind for density. This creates the natural soft-to-dense gradient seen in non-transplanted hairlines.
Norwood 3V: Temple Recession with Vertex Thinning
Before: Deep temple recession combined with thinning at the crown. Two separate areas need attention.
Typical procedure: 2,000 to 2,800 grafts split between frontal restoration and crown coverage.
After at 12 months: The frontal zone is restored and the crown thinning is reduced. However, crown results are often less dramatic than frontal results because the crown is a larger area and the grafts are distributed more thinly.
Expected density: 35 to 45 FU/cm2 frontally, 25 to 35 FU/cm2 in the crown.
Realistic note: Most patients prioritize the frontal zone (60% to 70% of grafts) because it has the greatest visual impact in face-to-face interactions. The crown receives the remaining grafts for reduction in see-through rather than full coverage.
Norwood 4: Advanced Recession with Enlarged Vertex
Before: The frontal recession has progressed further, and the vertex bald spot has enlarged. A bridge of thinner hair may still connect the front and crown areas.
Typical procedure: 2,500 to 3,500 grafts covering frontal zone, midscalp, and partial crown.
After at 12 months: Solid frontal density with improved midscalp coverage. The crown may have reduced thinning but is unlikely to appear fully dense from a single session. This is near the upper limit of what DHI can achieve in one sitting (3,500 grafts).
Expected density: 35 to 40 FU/cm2 frontally, 30 to 35 FU/cm2 in the midscalp.
Honest assessment: Norwood 4 is the boundary where patients need to make strategic choices about where to allocate grafts. Full coverage of all zones in a single DHI session may not be possible.
Norwood 5 and Above: Extensive Hair Loss
Before: Significant hair loss with only a narrow band remaining on the sides and back.
Typical procedure: 3,000 to 4,500+ grafts required, often exceeding the single-session DHI limit of 3,500.
After at 12 to 18 months: Results depend heavily on strategy. Patients who focus grafts on the frontal zone achieve a strong hairline with thinner coverage behind. Those who spread grafts evenly get moderate improvement everywhere but dramatic improvement nowhere.
Expected density: Variable depending on graft distribution strategy.
Realistic note: Norwood 5+ patients considering DHI should plan for two sessions or consider FUE (which supports up to 5,000 grafts per session) for the initial procedure, with DHI reserved for precision hairline work.
What Separates Good Results from Poor Results
Characteristics of a Good DHI Result
- Natural hairline with micro-irregular border (not a straight line)
- Consistent graft angle matching native hair growth direction
- No visible cobblestoning or pitting
- Seamless transition between transplanted and native hair
- Appropriate density for the treatment area
Characteristics of a Poor DHI Result
- Straight, uniform hairline that looks artificial
- Visible pluggy appearance (grafts placed at wrong angles or depths)
- Cobblestoned texture on the scalp surface
- Obvious density difference between transplanted and surrounding areas
- Scarring in the donor area from over-extraction
How to Evaluate Before-and-After Photos Critically
When reviewing DHI before-and-after photos from any clinic, apply these criteria:
- Timeline: Results should be shown at 12 months minimum. Photos at 6 months do not represent final outcomes
- Consistent conditions: Same lighting, angle, and hair styling in before and after
- Dry hair: Wet hair can appear thinner or thicker depending on styling
- Multiple angles: Front, profile, top-down, and close-up of the hairline
- Stage match: Look for patients at your Norwood stage specifically
- No editing: Watch for color correction or Photoshop manipulation
Maintaining Your Results Long-Term
A successful DHI result at 12 months can change over time if native hair loss continues. Protecting your investment requires ongoing attention:
| Strategy | Purpose | Effectiveness |
|---|---|---|
| Finasteride (1mg daily) | Halt native hair loss | 80% to 90% halt, 65% regrowth |
| Minoxidil (5% topical) | Support native density | 40% to 60% regrowth |
| PRP therapy | Boost scalp health | 30% to 40% density increase |
| Annual monitoring | Track progression | Early intervention if loss resumes |
Know Your Stage Before Comparing Results
The single most important factor in predicting your DHI outcome is your current Norwood stage. A Norwood 2 patient will have a fundamentally different experience than a Norwood 5 patient. Knowing your stage lets you look at the right before-and-after cases and set expectations that match reality.
Get your free AI hair loss assessment at myhairline.ai/analyze to identify your Norwood stage and understand what DHI results look like for patients at your specific level of hair loss.
Medical disclaimer: This article is for informational purposes only and does not constitute medical advice. Individual results vary based on factors including surgeon skill, graft count, hair characteristics, and post-operative care. Consult a board-certified dermatologist or hair restoration surgeon for personalized treatment recommendations.