Recovery and risks

Day of surgery

A transplant takes 4 to 8 hours, with local anesthesia and sometimes a mild sedative. Large sessions may continue the next day. The scalp is bandaged at the end.[1]

Days 1 to 10

Bandages, if used, come off after a day. Gentle hair washing can start within 2 days. Stitches come out at 7 to 10 days. Many people return to work and light activity after several days.[1]

Weeks 1 to 4

Avoid vigorous exercise and contact sports for at least 3 weeks. Folliculitis, when it occurs, starts in the first 1 to 4 weeks. The surgeon usually sees patients several times in the first month.[1][2]

Weeks 2 to 8

The transplanted hairs fall out. This is expected. Native hair near the grafts can also shed (shock loss), with regrowth around 3 months.[1][2][3]

Months 3 to 12

By month 3 the hair may look thinner than before surgery. Growth resumes and runs about half an inch a month. Most patients see results at 6 to 9 months; some take 12.[1][2]

Medical treatment

Finasteride needs 3 months or more of daily use. Minoxidil labels give 2 to 4 months; AAD gives 6 to 12 months to judge it. PRP is repeated monthly for 3 months, then every 3 to 6 months. Gains from any medicine are lost after stopping.[1][2][3]

Folliculitis

Red bumps or pustules around grafts or donor sites. A multicenter FUE study reported 12.1%. In 751 women after FUT, 17 had folliculitis. Reported sterile folliculitis at the recipient site ranges up to 53.3%.[1][2][3]

Shock loss (effluvium)

Temporary shedding of native hair 2 to 8 weeks after surgery, reported in 0.15% to 15%, more often in women and with dense packing. A scoping review found up to 4.1% at the donor site and 6.5% at the recipient site.[1][2]

Donor scarring

FUT leaves a linear scar; hypertrophic or keloid scarring reached 15.1% in reported series. FUE leaves small white dots at punch sites, more visible in darker skin or short hair. Overharvesting can thin the donor area.[1][2][3]

Numbness, bleeding and infection

Two large series put overall complications at 1.2% and 4.7%. Reported rates reach 11% for persistent numbness, 8% for bleeding that needed treatment and 11% for infection.[1]

Graft failure and unnatural results

Some grafts do not take. If hair loss progresses after surgery, a patchy look can result and more surgery may be needed. Recipient-site necrosis is rare and linked to smoking, diabetes and dense packing.[1][2]

Finasteride and dutasteride side effects

Decreased libido, erectile dysfunction and ejaculation disorder each affected 1.2% to 1.8% of men on finasteride in trials. The label lists postmarketing reports of sexual dysfunction that continued after stopping, depression and suicidal ideation. In a 24-week trial, dutasteride side effects matched finasteride.[1][2]

Minoxidil side effects

Topical: scalp irritation, unwanted facial hair and early shedding. Oral, in 1,404 patients: hypertrichosis 15.1%, lightheadedness 1.7%, fluid retention 1.3%, tachycardia 0.9%. Pregnant or breastfeeding women should avoid minoxidil.[1][2][3]