Can Grafts Fall Out After A Hair Transplant?

Dr. Bernstein: After a hair transplant patients sometimes become concerned that their grafts have fallen out. However, what patients are looking at is a hair along with its internal root sheath. It is the sheath and hair shaft that is shed, but it is nothing to be concerned about. After about 3 months, the follicle will produce a new hair. Patients become concerned because when they look at the shed hair, they’ll often see a little bulb at the bottom of it. Patients mistake that bulb for the root (growth part) of the hair, but it is just the root sheath, not living tissue. The follicle doesn’t need it to produce a new hair. It is possible for a graft to fall out after a transplant, but this is extremely uncommon. If it happens, it usually only occurs within the first day or two after the procedure, and it is accompanied by some bleeding. We did a study to see at what point transplanted grafts become so securely anchored into the scalp that they cannot be dislodged. We found that after 10 days, grafts become so permanently part of the body that no amount of scrubbing or combing can dislodge them. To prevent accidental dislodging, in post-op care, the day after the surgery, we tell patients to shampoo their hair, but they should not rub the area as this can dislodge the grafts. Instead, they should gently tap the transplanted area to get it as clean as possible. After 10 days, however, patients can shampoo and wash their scalp normally.

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