Shock loss after DHI is a normal shedding phase that affects most patients between weeks 2 and 4 post-procedure. The transplanted hairs fall out because the follicles enter a temporary resting state after being extracted and reimplanted using the Choi Implanter Pen. The follicles remain alive beneath the scalp, and new growth begins at months 3-4.
This article is for informational purposes only and does not constitute medical advice.
Why DHI Causes Shock Loss
During DHI (Direct Hair Implantation), each follicular unit is loaded into a Choi Implanter Pen and inserted directly into the recipient area without pre-made channels. While this gives surgeons precise control over angle and depth, the process still creates micro-trauma in the scalp tissue.
That trauma triggers the follicles to enter the telogen (resting) phase of the hair growth cycle. The existing hair shaft detaches and sheds, but the follicle itself remains intact and alive beneath the skin surface. After a resting period, the follicle re-enters the anagen (growth) phase and produces a new hair.
Transplanted Hair vs. Native Hair Shedding
There are two types of shock loss after DHI:
| Type | What Sheds | Why | Regrowth |
|---|---|---|---|
| Transplanted hair shedding | Newly implanted grafts | Follicle trauma from extraction and Choi pen implantation | 90-95% regrow within 3-6 months |
| Native hair shedding | Existing hairs near transplant zone | Micro-trauma and inflammation from nearby implantation | Most regrow within 3-6 months |
Transplanted hair shedding is almost universal. Native hair shedding near the recipient zone is less common but can be alarming when it happens. Both types are temporary in the large majority of cases.
Risk Factors for More Severe Shedding
Some patients experience heavier shock loss than others. Contributing factors include:
- Higher graft density: DHI allows denser packing (up to 80-90 grafts per cm2), which increases tissue trauma in the recipient area
- Existing miniaturized hairs: Thin, weakening hairs near the transplant zone are more vulnerable to shedding and may not return
- Larger session size: Sessions approaching the 3,500 graft maximum create more cumulative trauma
- Smoking or poor circulation: Reduced blood flow slows healing and can worsen shedding
DHI Shock Loss Recovery Timeline
Here is what to expect month by month after your DHI procedure:
| Timeframe | What Happens |
|---|---|
| Days 1-14 | Transplanted hairs remain in place, scabbing forms and falls off |
| Weeks 2-4 | Shock loss begins, transplanted hairs shed gradually |
| Weeks 4-6 | Shedding completes, scalp may look similar to pre-surgery |
| Months 3-4 | New growth emerges as fine, thin hairs |
| Months 6-8 | Noticeable density improvement, hairs thicken |
| Months 9-12 | Significant coverage visible |
| Months 12-18 | Final results with full thickness and density |
The period between weeks 4 and month 3 is often called the "ugly duckling phase." Your scalp may look the same or even thinner than before surgery. This is temporary.
When to Be Concerned
Contact your surgeon if you experience any of the following after week 6:
- Persistent redness, swelling, or pain at the transplant site
- Signs of infection (pus, unusual discharge, fever)
- No new hair growth by month 5
- Patchy regrowth with large bald spots within the transplant zone
These situations are uncommon with DHI's 90-95% graft survival rate but warrant a follow-up appointment.
How to Support Recovery During Shock Loss
You cannot stop shock loss from happening, but you can support healthier regrowth:
- Follow your surgeon's washing instructions carefully (gentle technique, no rubbing)
- Sleep elevated for the first 7-10 days to reduce swelling
- Avoid direct sun exposure on the scalp for at least 4 weeks
- Skip exercise for 2 weeks to prevent increased blood pressure to the scalp
- Ask your surgeon about finasteride or minoxidil to protect native hairs
For a complete overview of transplant methods including DHI, see our FUE vs FUT comparison. If you are unsure where your hair loss stands, check the Norwood scale guide for a visual reference.
Ready to understand your hair loss pattern and what to expect from a DHI procedure? Get a free AI hair analysis at myhairline.ai/analyze for a personalized assessment.