Quality Turkish clinics achieve 90% to 95% graft survival, meaning nearly all transplanted follicles establish blood supply and produce permanent hair. This rate matches the best clinics in the US and Europe. The difference between a great result and a poor one comes down to specific, measurable quality indicators at the clinic level. This guide covers what those indicators are and how to evaluate them before you book.
This article is for informational purposes only and does not constitute medical advice.
What Determines Graft Survival
Graft survival depends on a chain of events. Every link in the chain matters. A single weak link can reduce survival from 95% to 70% or worse.
The Graft Survival Chain
| Stage | Critical Factor | Optimal Standard | Risk at Budget Clinics |
|---|---|---|---|
| Extraction | Transection rate | Under 5% | 10% to 20% |
| Storage | Solution type | HypoThermosol or ATP-enriched at 4C | Basic saline at room temp |
| Storage | Time out of body | Under 2 hours | 4 to 8 hours |
| Channel creation | Depth and angle | Matched to graft size | Inconsistent depth |
| Implantation | Handling | Minimal touch, forceps grip on tissue | Rough handling, graft crushing |
| Implantation | Desiccation | Kept moist throughout | Exposed to air and light |
| Post-op | Blood supply | Patient follows restrictions | Smoking, exercise too early |
Transection Rate
Transection occurs when the extraction punch damages the follicle during harvesting. A transected graft is partially or fully destroyed and will not grow. Skilled surgeons maintain transection rates below 5%. At hair mills where undertrained technicians perform extraction at high speed, transection rates can reach 10% to 20%.
Ask the clinic: "What is your average transection rate?" Any answer below 5% is excellent. Between 5% and 8% is acceptable. Clinics that cannot provide this number are not tracking it, which is a concern.
Storage Conditions
Once a graft is extracted, it begins to deteriorate. The rate of deterioration depends entirely on how and where it is stored.
| Storage Method | Temperature | Graft Viability at 2 Hours | Graft Viability at 4 Hours |
|---|---|---|---|
| ATP-enriched solution | 4C (refrigerated) | 98% to 99% | 95% to 97% |
| HypoThermosol | 4C (refrigerated) | 97% to 99% | 93% to 96% |
| Saline solution | 4C (refrigerated) | 95% to 97% | 88% to 93% |
| Saline solution | Room temperature | 90% to 93% | 75% to 85% |
| No solution (air exposure) | Room temperature | 80% to 85% | Under 60% |
Premium clinics use ATP-enriched holding solutions at refrigerated temperatures. This is a straightforward question to ask during your consultation and a clear differentiator between clinic tiers. For technique-specific details, review the FUE vs FUT comparison.
Implantation Technique
How grafts are placed into the recipient site affects survival. Key factors include:
- Handling: Grafts should be touched as little as possible. Forceps should grip surrounding tissue, not the follicle itself.
- Channel fit: The incision must match the graft size. Too large, and the graft sits loosely with poor blood contact. Too small, and the graft is compressed.
- Depth: Grafts placed too shallow may pop out or dry. Grafts placed too deep can develop cysts.
- Moisture: Grafts must stay moist during placement. Extended air exposure kills follicles.
Clinic Quality Indicators That Predict Survival
You cannot measure graft survival before your procedure, but you can evaluate the indicators that predict it.
High-Survival Indicators (Green Flags)
| Indicator | Why It Matters |
|---|---|
| JCI accreditation | Verified safety and quality protocols |
| Surgeon performs extraction personally | Lower transection rate |
| ATP or HypoThermosol storage | Better graft viability |
| 1 to 3 patients per day | Adequate time for careful work |
| Structured follow-up at 1, 6, 12 months | Tracks outcomes systematically |
| Published graft survival data | Transparency about results |
| ISHRS membership | Commitment to professional standards |
Low-Survival Indicators (Red Flags)
| Indicator | Why It Matters |
|---|---|
| 8+ patients per day | Rushed procedures, technician-heavy |
| "Unlimited grafts" marketing | Over-harvesting risk, speed prioritized |
| Basic saline storage at room temperature | Reduced graft viability |
| No transection rate data available | Not tracking quality |
| No structured follow-up protocol | Not measuring outcomes |
| Surgeon only designs hairline | Critical steps done by unlicensed staff |
| Under $2,000 for full procedure | Cost-cutting on equipment and staff |
Your Role in Graft Survival
Patient behavior during the first 14 days after surgery significantly affects how many grafts survive.
First 48 Hours (Critical)
- Sleep at a 45-degree angle to reduce swelling
- Do not touch, scratch, or rub the recipient area
- Take prescribed medications on schedule
- Stay hydrated (2 to 3 liters of water daily)
- Avoid bending over or straining
Days 3 to 7
- Follow the clinic's washing instructions exactly (typically gentle saline or prescribed shampoo)
- Do not pick at scabs (let them fall off naturally)
- Avoid direct sunlight on the scalp
- No hats or headwear unless approved by your surgeon
- No smoking (nicotine reduces blood flow to grafts by up to 30%)
Days 7 to 14
- Continue gentle washing protocol
- Scabs should be mostly gone by day 10 to 12
- No strenuous exercise (elevated blood pressure can dislodge grafts)
- Avoid swimming pools, saunas, and steam rooms
- Sleep position can gradually normalize
Impact of Smoking on Graft Survival
Smoking is the single biggest patient-controlled risk factor for graft survival.
| Factor | Non-Smoker | Active Smoker |
|---|---|---|
| Scalp blood flow | Normal | 20% to 30% reduced |
| Graft survival estimate | 90% to 95% | 75% to 85% |
| Infection risk | Baseline | 2x to 3x higher |
| Healing time | 7 to 10 days | 10 to 14 days |
| Scar visibility | Minimal | Increased |
Stop smoking at least 2 weeks before and 4 weeks after your procedure. This single change can be worth hundreds of surviving grafts.
Month-by-Month Survival Timeline
Understanding the normal growth cycle prevents premature panic. Many patients worry about graft failure during the normal shedding phase.
| Timepoint | What Is Happening | What You See |
|---|---|---|
| Day 1 to 3 | Grafts establishing blood supply | Redness, swelling, small scabs |
| Week 1 to 2 | Scabs forming and detaching | Scabs fall off, redness fades |
| Week 2 to 4 | Transplanted hairs shed (normal) | Hair falls out, area looks thin |
| Month 2 to 3 | Follicles in resting phase (telogen) | No visible growth, "ugly duckling" phase |
| Month 3 to 4 | New anagen (growth) phase begins | Fine, thin new hairs appear |
| Month 6 to 8 | Hair thickening and lengthening | Visible improvement, growing confidence |
| Month 10 to 12 | Approaching final density | Most grafts producing mature hair |
| Month 12 to 18 | Final result | Full thickness and density achieved |
The shedding at weeks 2 to 4 is not graft failure. It is a normal response where the transplanted hair shaft falls out while the follicle remains alive in the skin. New growth from that follicle begins at months 3 to 4.
How to Evaluate Your Result
At 12 months post-procedure, you can assess graft survival by comparing your result to expectations:
- 90% to 95% survival: Dense coverage matching pre-operative plan
- 80% to 89% survival: Good coverage, slight thinness in some areas
- 70% to 79% survival: Noticeable gaps, touch-up may be beneficial
- Below 70% survival: Significant under-density, revision procedure recommended
If you suspect poor survival at 12+ months, consult a hair restoration specialist (ideally independent from your original clinic) for an objective assessment.
Get Your Graft Estimate
Knowing your graft requirements helps you evaluate whether a clinic's recommendation and survival claims are realistic. Upload a photo at myhairline.ai/analyze for a free AI assessment of your Norwood stage and estimated graft needs. For pricing at different quality tiers, see the Turkey vs USA cost comparison.