The hair transplant patient journey spans 12 to 18 months from initial research to final results, and graft survival is at stake at every stage. FUE, FUT, and DHI procedures deliver 90-95% graft survival when each phase is handled correctly, but patients who understand the full timeline make better decisions and get better outcomes. Here is what happens at each step and where graft survival is most at risk.
This article is for informational purposes only and does not constitute medical advice. Consult a qualified hair loss specialist before making any treatment decisions.
Phase 1: Research and Self-Assessment (Weeks 1-4)
Your journey starts before any clinic involvement. This is when you determine your Norwood stage and understand your graft requirements.
| Norwood Stage | Typical Graft Range |
|---|---|
| Norwood 2 | 800 - 1,500 |
| Norwood 3 | 1,500 - 2,200 |
| Norwood 4 | 2,500 - 3,500 |
| Norwood 5 | 3,000 - 4,500 |
| Norwood 6 | 4,000 - 6,000 |
| Norwood 7 | 5,500 - 7,500 |
Patients who research clinics independently have 45% lower revision rates. This phase is not a formality. It directly affects your outcome.
What to do: Upload a photo for an AI hairline assessment to establish your baseline Norwood stage. Research 3-5 clinics through ISHRS/ABHRS directories and independent review platforms. Prepare a list of questions about graft survival protocols.
Graft survival impact: None directly, but the quality of your research determines which clinic handles your grafts.
Phase 2: Consultations (Weeks 4-8)
Schedule video or in-person consultations with your shortlisted clinics. Each consultation should include:
- Norwood staging with magnification or trichoscopy
- Donor area density assessment
- Miniaturization mapping across the scalp
- Graft count recommendation with justification
- Discussion of medical treatment (finasteride, minoxidil)
- Post-op care protocol review
- Pricing breakdown
Graft survival impact: The surgeon's assessment of your donor density and scalp characteristics determines how many grafts can be safely harvested. The safe extraction limit is 45% of donor area follicular units. Exceeding this risks visible donor thinning.
Compare consultations side by side. If graft count recommendations vary by more than 20%, ask each clinic to explain their reasoning.
Phase 3: Pre-Operative Preparation (Weeks 8-12)
Once you have selected a clinic, the pre-op period begins. This is when you create the conditions for maximum graft survival.
Medical Treatment
- Start or continue finasteride (1mg daily) if prescribed. It halts further loss in 80-90% of patients and protects native hair surrounding the transplant area.
- Begin minoxidil (5% topical, twice daily) if recommended. It supports blood flow to the scalp, which benefits graft survival.
Lifestyle Adjustments
- Stop smoking at least 2-4 weeks before surgery. Nicotine constricts blood vessels and measurably reduces graft survival.
- Discontinue blood-thinning supplements (fish oil, vitamin E, aspirin) per your surgeon's timeline.
- Avoid alcohol for 7 days before the procedure.
Logistics
- Book accommodation near the clinic if traveling (minimum 3 nights post-op, ideally 5-7).
- Arrange time off work (7-10 days for FUE, 10-14 for FUT).
- Prepare recovery supplies: neck pillow, button-up shirts, saline spray, prescribed medications.
Graft survival impact: Smoking, blood thinners, and poor scalp health at the time of surgery all reduce graft viability. This phase is about eliminating preventable risk factors.
Phase 4: Procedure Day
A typical FUE session for 2,500 grafts takes 6-8 hours. Here is what happens.
Morning: Donor Extraction
The surgeon extracts follicular units from the donor area using a 0.7-1.0mm punch tool. Each graft is placed in a chilled holding solution to maintain viability. Skilled surgeons keep transection rates below 5%.
Midday: Recipient Site Creation
The surgeon creates recipient sites in the balding area at precise depths and angles. This step determines the direction, density, and naturalness of the final result.
Afternoon: Graft Placement
Grafts are placed into the recipient sites. The team works systematically to minimize the time between extraction and placement. Total out-of-body time should stay under 4-6 hours.
Graft survival impact: This is the highest-risk phase. Out-of-body time, storage solution quality, handling technique, transection rate, and recipient site design all affect how many grafts survive.
Phase 5: Immediate Recovery (Days 1-10)
The first 10 days determine whether properly placed grafts anchor and establish blood supply.
Days 1-3
- Grafts are held in place by clotted blood only
- Sleep at a 45-degree angle to reduce swelling
- No touching, scratching, or rubbing the recipient area
- Take prescribed antibiotics and anti-inflammatory medication
Days 3-7
- Gentle washing begins per clinic instructions
- Crusting forms around each graft
- Swelling may peak around days 3-4 and then subside
- Avoid direct sunlight, strenuous exercise, and swimming
Days 7-10
- New blood vessels grow into the grafts (neovascularization)
- Crusts begin to fall off naturally
- Risk of mechanical graft loss decreases significantly
- Light daily activities can resume
Graft survival impact: This is the second highest-risk phase. Improper washing, physical contact with grafts, sleeping flat, and ignoring activity restrictions all increase graft loss. Follow post-op instructions exactly.
Phase 6: The Shedding Phase (Weeks 2-8)
Most transplanted hair shafts fall out between weeks 2 and 8. This is normal and expected. The follicle remains embedded in the scalp and will produce new hair. This phase is called telogen effluvium and happens to nearly all transplanted grafts.
Graft survival impact: None. The shedding of visible hair does not indicate graft failure. The follicular unit is intact beneath the skin.
Phase 7: Early Growth (Months 3-6)
New hair begins emerging from surviving grafts around month 3. Growth is uneven. Some areas fill in faster than others. The hair is initially thin and may have a different texture than your native hair.
By month 6, approximately 50-60% of final density is visible. This is when patients begin to see the shape of their result, though it is still incomplete.
Graft survival impact: If large patches show no growth at all by month 6, consult your surgeon. Spotty growth is normal; complete absence in a zone may indicate localized graft failure.
Phase 8: Maturation and Final Results (Months 6-18)
Full density emerges between months 9 and 18. Hair thickens, texture normalizes, and the transplanted hair blends with native hair. Final results should be assessed at 12 months minimum, with some patients continuing to see improvement through month 18.
Ongoing Medical Treatment
- Continue finasteride to protect native hair (80-90% halt further loss)
- Continue minoxidil if prescribed
- Consider PRP sessions ($500-$2,000 each) to boost density if recommended by your surgeon
Graft survival impact: By this phase, graft survival is determined. Your focus shifts to maintaining native hair through medical treatment and monitoring for further progression.
For a detailed look at the biological factors behind graft viability, read the graft survival rates overview. To understand what quality aftercare looks like, see our guide on evaluating post-op support.
Frequently Asked Questions
How do I find a reputable hair transplant clinic?
Use ISHRS and ABHRS directories as starting points, cross-reference reviews on RealSelf and Google, and schedule video consultations with the surgeon directly. Ask to see before/after photos of patients at your Norwood stage and request to speak with former patients. Clinics that resist any of these requests should be treated with caution.
What credentials should a hair transplant surgeon have?
Board certification in dermatology or plastic surgery is essential, plus specialized training in hair restoration such as ISHRS fellowship or ABHRS diplomate status. Ask how many procedures they perform monthly and how many years they have focused specifically on hair transplant surgery. Experience with your specific Norwood stage matters.
How do I know if before/after photos are real?
Legitimate photos show consistent clinical lighting, fixed camera angles, and multiple views of the same patient. Ask for 12-month post-op results and donor area images. Be skeptical of heavily edited images, single-angle shots, or results that only showcase the most favorable cases without showing the full range of outcomes.
Ready to start your patient journey with objective data? Upload a photo at myhairline.ai/analyze for a free AI-powered hairline assessment. Knowing your Norwood stage and graft estimate before your first consultation puts you in control from day one.