Industry studies show that 10% to 15% of grafts in the worst-performing zone of a transplant will underperform without being detectable by casual visual inspection alone. Density tracking with objective measurements is the only reliable method to identify poor graft survival early enough for corrective action.
This content is for informational purposes only and does not constitute medical advice. Consult your hair restoration surgeon if you have concerns about your transplant results.
Why Some Grafts Fail to Grow
Under optimal conditions, FUE and FUT procedures achieve graft survival rates of 90% to 95%. That means 5% to 10% graft loss is considered normal. Poor growth becomes a clinical concern when survival drops below 80% in any specific zone.
Several factors cause graft failure:
- Desiccation during surgery: Grafts left outside the body too long without proper hydration
- Improper handling: Mechanical damage during extraction, storage, or implantation
- Poor recipient site blood supply: Scar tissue or previous surgery limiting blood flow
- Post-op trauma: Dislodged grafts from touching, sleeping on, or bumping the recipient area
- Infection: Bacterial folliculitis destroying grafts before they anchor
The challenge is that delayed growth (normal) and poor survival (abnormal) look identical during the first 4 months. Only density tracking at the right checkpoints distinguishes between them.
The Expected Growth Timeline
Understanding normal growth milestones is essential before you can identify poor performance.
| Month | Expected Density (% of Final) | What You Should See |
|---|---|---|
| Month 1 | 0% | Shock loss phase, transplanted hairs fall out |
| Month 2 | 0 to 5% | Dormant phase, very little visible growth |
| Month 3 | 5 to 15% | Early sprouts, fine vellus hairs emerging |
| Month 4 | 15 to 30% | Noticeable new growth in most zones |
| Month 6 | 50 to 60% | Significant density increase, hairs thickening |
| Month 9 | 75 to 85% | Near-final density, texture maturing |
| Month 12 | 90 to 95% | Full result for most patients |
| Month 18 | 100% | Definitive final assessment |
Month 6 is the critical evaluation point. By this time, enough growth has emerged to separate slow growers from non-survivors.
Step-by-Step Poor Growth Detection
Step 1: Know Your Graft Distribution Plan
Before surgery, ask your surgeon for a written graft distribution map showing how many grafts were placed in each zone. Without this baseline, you have no benchmark to measure against.
Typical zones include the frontal hairline, mid-scalp, temple points, and crown. Each zone receives a specific number of grafts per cm2 based on the surgical plan.
Step 2: Track Monthly From Month 3
Starting at month 3, take standardized photos of each transplanted zone monthly. Use the same lighting, angle, and camera distance every time. Upload to myhairline.ai for automated density measurement.
Record your readings in a simple tracking table:
| Zone | Grafts Placed (per cm2) | Month 3 | Month 4 | Month 6 | Month 9 |
|---|---|---|---|---|---|
| Frontal hairline | Target | Reading | Reading | Reading | Reading |
| Mid-scalp | Target | Reading | Reading | Reading | Reading |
| Temple left | Target | Reading | Reading | Reading | Reading |
| Temple right | Target | Reading | Reading | Reading | Reading |
| Crown | Target | Reading | Reading | Reading | Reading |
Step 3: Apply the Month 6 Threshold Test
At month 6, calculate the percentage of target density achieved in each zone:
Density achieved = (Current reading / Target grafts per cm2) x 100
Classify each zone:
- On track (50% or above): Growth is progressing normally
- Borderline (40% to 50%): Growth is below average but may catch up by month 9
- Underperforming (below 40%): This zone has a graft survival issue
Any zone below 40% at month 6 is statistically unlikely to reach acceptable density by month 12, even accounting for late bloomers.
Step 4: Compare Zone Performance
Poor graft growth is rarely uniform across all zones. Comparing zones against each other reveals whether the issue is patient-wide (systemic cause) or zone-specific (surgical cause).
All zones underperforming equally suggests a systemic issue such as poor post-op care, smoking, nutritional deficiency, or an underlying condition affecting hair growth.
One or two zones significantly behind others suggests a localized surgical issue such as graft damage during placement, poor blood supply in that area, or improper angle and depth of recipient sites.
This distinction matters because it changes the corrective approach.
Step 5: Document and Present to Your Surgeon
Create a comprehensive report including:
- Pre-op graft distribution plan (from your surgeon)
- Monthly density readings for each zone from month 3 onward
- Side-by-side comparison photos at consistent intervals
- The month 6 threshold calculation showing which zones fall below 40%
- Zone-by-zone comparison highlighting disparities
Present this data objectively. Surgeons respond better to documented evidence than to emotional frustration, and clear data makes the case for revision grafting or corrective action far stronger.
Corrective Options for Poor Growth
| Intervention | When Appropriate | Expected Outcome |
|---|---|---|
| Revision grafting | After month 12 confirms poor survival | Fills in underperforming zones |
| PRP injections | Month 6 to 9, to stimulate existing weak grafts | 30 to 40% density boost in treated area |
| Minoxidil | Month 3 onward, to support new growth | 40 to 60% of patients see improvement |
| Low-level laser therapy | Ongoing, to support follicle health | Modest density improvement |
PRP therapy costs $500 to $2,000 per session and may stimulate underperforming grafts that are alive but dormant. Your surgeon can determine whether the grafts are truly dead or simply growing slowly.
Preventing Poor Growth: Pre-Op and Post-Op Factors
Tracking data from thousands of transplant patients reveals consistent factors that correlate with better graft survival:
Pre-operative preparation: Stop smoking at least 2 weeks before surgery. Optimize nutrition with adequate protein, iron, zinc, and biotin.
Post-operative compliance: Follow washing instructions precisely. Avoid touching the recipient zone. Sleep elevated for the first week. No exercise for 2 weeks.
Medication support: Finasteride (80% to 90% halt further loss, 65% experience regrowth) and minoxidil (40% to 60% moderate regrowth) protect both transplanted and native hair.
Start Tracking Your Transplant Growth
The earlier you identify underperforming zones, the sooner you can take corrective action. Upload your transplant zone photos to myhairline.ai/analyze to get objective density readings that separate normal delayed growth from genuine graft failure.
This article is for informational purposes only and does not constitute medical advice. Consult a board-certified hair restoration surgeon for evaluation and treatment of poor transplant growth.