Graft survival rate is the single most important metric for evaluating hair transplant success. A well-performed FUE procedure achieves 90-95% graft survival, meaning that for every 1,000 grafts placed, 900-950 will produce permanent hair. Tracking this number helps you understand whether your result is on track.
What Graft Survival Actually Means
Each transplanted graft contains a follicular unit with 1-4 hair follicles. When a graft "survives," it means:
- The follicle re-established its blood supply in the new location
- The dermal papilla (growth center) remained intact during extraction and placement
- The follicle entered a new anagen (growth) cycle and began producing hair
When a graft fails, it means the follicle died before establishing blood supply. The tissue is absorbed by the body, and that site will not produce hair. Graft failure is permanent for that specific follicular unit.
Expected Survival Rates by Procedure Type
| Procedure | Expected Survival Rate | Max Grafts Per Session | Key Factor |
|---|---|---|---|
| FUE | 90-95% | 5,000 | Individual extraction preserves follicle integrity |
| FUT (Strip) | 90-95% | 4,000 | Dissection under microscope maintains intact units |
| DHI | 90-95% | 3,500 | Choi pen minimizes time outside body |
All three major techniques achieve similar survival rates when performed by experienced surgeons. The differences lie in donor scarring, recovery time (FUE: 7-10 days, FUT: 10-14 days), and maximum graft counts per session.
Factors That Reduce Graft Survival
Several variables can push survival below the 90-95% benchmark:
Out-of-body time: Grafts begin losing viability after 4-6 hours outside the body. Extended procedures exceeding 8-10 hours may have lower survival in the grafts placed last. Proper storage solutions (HypoThermosol, ATP) extend viability.
Desiccation: Grafts that dry out during the procedure lose viability rapidly. Surgeons keep extracted grafts in chilled saline or specialized holding solutions to prevent drying.
Handling trauma: Crushing grafts with forceps, placing them too deep, or pushing them into recipient sites at wrong angles can damage the follicle root. Experienced technicians handle grafts with minimal contact.
Recipient site sizing: If the recipient channel is too small, the graft is compressed. If too large, the graft sits loosely and may not establish blood supply. Proper sizing matches the graft diameter exactly.
Post-operative damage: Bumping, scratching, or dislodging grafts in the first 7-10 days post-surgery can cause failure. Grafts are not securely anchored until approximately day 10-14.
Smoking: Nicotine constricts blood vessels, reducing oxygen delivery to newly placed grafts. Studies show smokers have measurably lower graft survival. Surgeons recommend quitting at least 2 weeks before and 4 weeks after surgery.
How to Track Graft Survival at Home
You cannot count individual surviving grafts without clinical tools, but you can monitor progress using these methods:
Method 1: Reference Zone Photography
- Choose a 2x2 cm area in the transplanted zone (hairline is easiest)
- Ask your surgeon how many grafts were placed in that specific area
- Photograph the zone monthly under consistent lighting from the same angle and distance
- At month 12, count visible hairs in that reference zone
- Divide by the estimated grafts placed to calculate approximate survival percentage
Method 2: The Grid Method
- Print or draw a 1 cm grid on transparent film
- Place it against the transplanted area at month 9 or 12
- Count follicular units visible in each square centimeter
- Compare against the surgeon's stated placement density per cm2
Method 3: Clinical Trichoscopy
The most accurate method uses a trichoscope (dermatoscope with 20-70x magnification) to count follicular units per cm2:
- Schedule a trichoscopy exam at months 6 and 12
- The device provides exact follicular unit counts per cm2
- Compare against the surgeon's placement density records
- Many clinics include complimentary trichoscopy follow-ups
Graft Survival Impact on Final Density
Here is how different survival rates affect your final density outcome:
| Grafts Placed | 85% Survival | 90% Survival | 95% Survival |
|---|---|---|---|
| 1,000 | 850 active | 900 active | 950 active |
| 2,000 | 1,700 active | 1,800 active | 1,900 active |
| 3,000 | 2,550 active | 2,700 active | 2,850 active |
| 4,000 | 3,400 active | 3,600 active | 3,800 active |
| 5,000 | 4,250 active | 4,500 active | 4,750 active |
The difference between 85% and 95% survival on a 3,000-graft procedure is 300 grafts. At an average of 2.2 hairs per graft, that is 660 hairs. In a focused zone like the hairline, 660 hairs represents a visible difference in density.
Timeline for Assessing Graft Survival
Tracking graft survival requires patience because not all grafts activate simultaneously:
| Time Point | What You Can Assess | Reliability |
|---|---|---|
| Month 3 | First emerging hairs, very early indicator | Low (only 10-20% of grafts active) |
| Month 6 | Moderate growth pattern visible | Medium (40-60% active) |
| Month 9 | Strong growth, most grafts producing hair | High (70-85% active) |
| Month 12 | Near-complete picture of survival | Very high (85-95% active) |
| Month 18 | Final assessment, all survivors active | Definitive |
Do not make survival judgments before month 9 at the earliest. Slow-starting grafts are common and do not indicate failure.
When Graft Survival Is Below Average
If your trichoscopy or self-assessment at month 12 suggests survival below 85%, several options exist:
PRP therapy: Platelet-rich plasma injections ($500-$2,000 per session) may stimulate dormant follicles. Three to four sessions at 4-6 week intervals, followed by maintenance every 3-6 months.
Medical support: Adding minoxidil (40-60% see regrowth) to the transplanted area can help remaining grafts produce thicker hair shafts, partially compensating for lower graft count.
Touch-up procedure: A second session targeting low-density areas. Surgeons typically recommend waiting until month 18 for a full assessment before planning additional grafts.
Want to know how many grafts you need for your stage and what density to expect? Get your personalized assessment at myhairline.ai/analyze.
Medical disclaimer: This article is for informational purposes only and does not constitute medical advice. Individual results vary based on patient health, surgeon skill, and adherence to post-operative protocols. Consult a board-certified hair restoration surgeon for personalized guidance.