Graft survival rate is the single most important metric for determining whether your hair transplant succeeded. The standard benchmark is 90 to 95% survival with an experienced surgeon, meaning 9 out of every 10 transplanted follicular units should produce permanent hair. Tracking this number gives you objective data instead of relying on how your hair looks on any given day.
This article is for informational purposes only and does not constitute medical advice. Consult a qualified hair loss specialist before making any treatment decisions.
What Graft Survival Means
When a graft "survives," the transplanted follicular unit successfully re-establishes blood supply in its new location, enters the growth cycle, and produces hair permanently. A graft that does not survive fails to reconnect with the local blood supply and the follicle dies. Dead grafts never produce hair.
Graft failure happens primarily in the first 7 to 14 days after surgery, during the critical revascularization period. Once a graft establishes blood flow, its long-term survival rate is extremely high. By the time new hair becomes visible at month 3 to 4, the question of whether a specific graft survived has already been answered biologically. The lag between survival and visibility is simply the time it takes for the follicle to cycle into anagen and produce enough hair shaft to be seen.
Expected Survival Rates by Procedure Type
| Procedure | Expected Survival Rate | Recovery Time |
|---|---|---|
| FUE (Follicular Unit Extraction) | 90 to 95% | 7 to 10 days |
| FUT (Follicular Unit Transplantation) | 90 to 95% | 10 to 14 days |
| DHI (Direct Hair Implantation) | 90 to 95% | 7 to 10 days |
All three methods achieve comparable survival rates in the hands of experienced surgeons. The survival rate depends more on surgeon skill, graft handling, and patient compliance than on the specific extraction or implantation technique.
How to Track Your Graft Survival
Method 1: The Photo Grid Technique
This is the most accessible method for patients tracking their own results at home.
Step 1: At your 2-week post-op appointment, ask your surgeon to mark a 1 cm x 1 cm reference square in the transplanted zone using a small, washable dot at each corner.
Step 2: Photograph this square monthly from the same distance and angle. Use your phone's macro mode or a clip-on macro lens for consistent close-up shots.
Step 3: Count the visible follicular units in the square at each monthly interval. Record the number in a simple spreadsheet or notes app.
Step 4: Compare your counts to the number of grafts that were placed in that area (your surgeon's operative notes should include placement density per zone).
Method 2: Professional Trichoscopy
Trichoscopy uses a dermoscope at 20x to 70x magnification to count follicular units per cm2 with high accuracy. This is the gold standard method.
Schedule trichoscopy at these intervals:
- Pre-operative baseline: Documents your starting density
- Month 6: Provides an early progress check
- Month 12: The primary survival assessment point
- Month 18: Final confirmation (if needed)
Your surgeon can compare the trichoscopy FU count in transplanted zones against the surgical plan to calculate an actual survival percentage.
Method 3: Total Hair Count Comparison
For a rough estimate without specialized equipment:
- Record the total number of grafts placed (from your surgical report)
- Multiply by 2.2 (average hairs per graft) to get expected total hairs
- Multiply by your estimated survival rate (0.90 to 0.95) for expected surviving hairs
- Compare this number to visible hair count in the transplanted zone at month 12 to 18
| Grafts Placed | Expected Hairs (90% survival) | Expected Hairs (95% survival) |
|---|---|---|
| 1,000 | 1,980 | 2,090 |
| 2,000 | 3,960 | 4,180 |
| 3,000 | 5,940 | 6,270 |
| 4,000 | 7,920 | 8,360 |
For detailed benchmarks at the halfway point, see our guide on density per cm2 by zone.
Timeline for Assessing Graft Survival
| Period | What You Can Assess |
|---|---|
| Day 1 to 14 | Graft security (are grafts staying in place, no dislodgement) |
| Weeks 2 to 6 | Shock loss phase (cannot assess survival during this period) |
| Months 3 to 4 | First new hairs appear (early signal of survival) |
| Months 6 to 8 | Meaningful count of growing follicles possible |
| Months 10 to 12 | Reliable survival rate calculation possible |
| Month 18 | Definitive survival rate (all surviving grafts visible) |
Do not attempt to calculate survival rates before month 8 at the earliest. Slow-responding grafts can take 6 to 8 months to produce their first visible hair, and counting before this point will underestimate your actual survival rate.
Factors That Reduce Graft Survival
Understanding what can lower survival rates helps you protect your investment:
Surgical Factors
- Extended graft-out-of-body time (should be under 2 hours)
- Excessive graft handling or desiccation
- Recipient sites created at incorrect depth or angle
- Overcrowded placement that restricts blood flow to individual grafts
Patient Factors
- Touching, scratching, or dislodging grafts in the first 10 days
- Sleeping face-down or pressing the transplant zone against surfaces
- Smoking (reduces blood supply to the scalp)
- Not following post-operative washing and care instructions
- Strenuous exercise too soon after surgery (typically restricted for 2 to 4 weeks)
Environmental Factors
- Sun exposure to unprotected grafts in the first month
- Infection from contaminated water or poor hygiene
- Trauma to the transplant zone from hats, helmets, or accidental impact
Warning Signs of Poor Graft Survival
Contact your surgeon if you notice:
- Grafts physically falling out or being dislodged in the first 2 weeks
- Signs of infection (unusual swelling, pus, foul odor, fever)
- Complete absence of new growth in any transplanted zone after 5 to 6 months
- Patchy growth with large bald areas surrounded by growing areas at month 8 or later
Early intervention matters. If graft survival is compromised due to infection, prompt treatment can save follicles that are struggling but not yet dead.
Supporting Graft Survival with Medication
Finasteride (80 to 90% halt loss, 65% regrowth) and minoxidil (40 to 60% moderate regrowth) do not directly improve transplanted graft survival, but they protect your native hair from continued thinning. This matters because losing native hair around the transplant zone can make an otherwise successful transplant look thinner than expected.
PRP therapy ($500 to $2,000 per session) may support graft survival and early growth when administered at the time of surgery or in the weeks following. Some clinics include PRP as part of their standard transplant protocol. Check our guide on expected density at 12 months to see how survival rates translate into visible coverage.
Frequently Asked Questions
When will I see results after hair transplant?
New hair growth first appears between months 3 and 4. However, you cannot reliably assess graft survival until month 8 to 10, when the majority of surviving grafts have produced visible hair. Final survival assessment is best done at month 12 to 18 using trichoscopy.
Is shock loss after hair transplant normal?
Shock loss is a normal and expected phase. Nearly all transplanted hairs shed within 2 to 6 weeks post-surgery. This shedding does not count as graft failure because the follicle remains viable beneath the skin. New growth from these follicles starts around month 3 to 4.
How do I know if my hair transplant is working?
Track a small marked area of your scalp with monthly close-up photos. Count the visible hairs or follicular units in that area over time. By month 6, you should see an upward trend. A professional trichoscopy at month 12 provides the most accurate survival rate measurement.
Want to assess your current hair loss stage? Upload a photo at myhairline.ai/analyze for a free AI-powered hairline assessment and see where you stand on the Norwood scale.