Written and medically reviewed by Dr Arth Shah, MBBS (Gujarat University, 2009), MS General Surgery (Sardar Patel University, 2014), MCh Plastic & Reconstructive Surgery (B.J. Medical College, Ahmedabad, 2017). Gujarat Medical Council registration G-25994. Practising in Ahmedabad since 2018.
You go home the same evening. The first wash is at day two or three. Swelling peaks around day three and settles. Crusts come away by day ten and the grafts are secure from about then. At two to four weeks the transplanted hair falls out – almost all of it, and this is expected. Nothing visible happens for the next two months. Growth starts around month four, becomes obvious at six, and the final result is at twelve months. The hard part is not the surgery; it is months one to three, when nothing appears to be happening.
Most pages about hair transplants stop at the end of the operation. This one starts there, because the operation is the short part. What follows is twelve months, and almost all of the anxiety happens in that period rather than on the day. At week three your new hair falls out. At month two nothing has happened and you begin to wonder whether it worked. At month three you take a photograph, compare it to the one from before, and cannot tell the difference. All of that is normal, all of it is expected, and almost nobody explains it in advance – which is why the forums are full of people at week three convinced something has gone wrong. So this page is the timeline. What happens on each day of the first week, what happens in the shedding phase, what happens in the months when nothing appears to be happening, and what the growth actually looks like month by month. Plus the practical aftercare – washing, sleeping, sun, gym, caps – and a clear list of what is normal against what is worth ringing us about. It is written to be read before you book and again afterwards. If you have had a transplant somewhere else and have landed here worried about something, the timeline applies equally – the biology does not change between clinics.
The consultation should take about half an hour and you should leave it with four things: a graft number, a hairline drawn on you, a written quote, and a clear answer about whether you are a good candidate at all. If you leave with only a price, you have not had a consultation.
Your scalp and, more importantly, your donor area are examined – under magnification, because donor density is the constraint that determines what is achievable. Your hair loss is staged. Your family history and any medication you are on are gone through. If you are a woman, the assessment is different and there is more to exclude first – see female pattern hair loss.
The hairline is drawn on you, with you sitting upright, and you look at it in a mirror. You should be allowed to sit with it. This is the single most consequential decision in the whole process and it is worth ten unhurried minutes.
Stop smoking, stop alcohol a few days out, and stop blood thinners and most supplements as instructed. Arrange four to five days where you do not need to be seen, transport home on the day, and someone you can call. None of this is onerous but the smoking one genuinely matters.
|
What |
When |
Why |
|
Smoking and all nicotine |
At least 2 weeks before, and 2 weeks after |
Nicotine constricts the small vessels that keep grafts alive. This is the single aftercare instruction with the clearest effect on your result, and it is the one most often ignored. |
|
Alcohol |
3-5 days before |
Increases bleeding during the procedure. |
|
Aspirin, blood thinners |
As instructed |
Bleeding. Never stop a prescribed blood thinner without medical advice. |
|
Fish oil, vitamin E, most supplements |
1-2 weeks before |
Several affect clotting. |
|
Minoxidil |
Practice varies, some surgeons stop it a few days before and restart at 2-4 weeks |
Scalp irritation and bleeding. |
|
Hair dye and chemical treatments |
About a week before |
Scalp irritation. |
What to arrange
Wash your hair normally the night before or that morning with a mild shampoo and no product afterwards. Eat a proper breakfast – it is a long day and you are awake for all of it. Do not shave the donor area yourself. Bring a button-up shirt, something to watch or read, and any regular medication.
Bring: button-up shirt, headphones, phone charger, regular medication, and a cap for going home.
Plan for a full day – typically eight hours for a standard session and up to twelve for a large one. You are awake throughout, under local anaesthetic. You can talk, use your phone, watch something and eat lunch. The only genuinely uncomfortable part is the anaesthetic injections at the start of each phase.
|
Roughly when |
What happens |
|
On arrival |
Consent, photographs from standard angles, and a final check that nothing has changed since the consultation. |
|
First 30-45 minutes |
The hairline is redrawn and agreed with you, awake and sitting up. See below – this is the part to slow down for. |
|
Then |
The donor area is trimmed. For FUE that is usually the back and sides; for FUT only a narrow band; for female or unshaven work, considerably less. |
|
Next |
Local anaesthetic to the donor area. The injections sting for a few minutes. After that you feel pressure and movement, not pain. |
|
2-4 hours |
Extraction. The longest phase. You lie face down or sit forward. This is the part where people watch something or doze. |
|
Alongside |
Grafts are sorted under magnification and counted. Ask for the final count. |
|
Midday |
A break and something to eat. You are not fasting and you should eat. |
|
1-2 hours |
Anaesthetic to the recipient area, then the sites are made – at the angle and direction that determine whether the result looks natural. |
|
2-3 hours |
Placement. Single-hair grafts along the front, multi-hair units behind. |
|
Last 20 minutes |
Check, dressing to the donor area, aftercare kit and instructions, and your first follow-up booked. |
|
Evening |
You go home. |
Everything else on the day is technique. This is the one decision that is yours, and it is permanent.
A good hairline is higher, softer and more irregular than most people initially want. It should suit your face at fifty rather than at twenty, because the hair behind it will keep receding and a hairline placed too low ages badly and cannot easily be undone. Look at it sitting up, in a mirror, in good light. Take a photograph of it. Ask what it will look like in fifteen years if your loss progresses. A surgeon who is happy to spend ten minutes on this is one who has thought about it; being rushed through it is the single clearest warning sign on the day.
The first ten days are the visible part. Redness and small crusts across the recipient area, swelling around days two to four, and a first wash at day two or three. Most people work from home for the week. By day ten the crusts have gone and the grafts are secure.
The first wash is the thing everyone is nervous about, and it is usually done at day two or three – often in the clinic the first time so you can see how. The technique matters: no direct shower pressure on the grafts, no rubbing, no fingernails. Pour water gently, let a diluted mild shampoo sit, rinse by pouring, pat dry with a clean towel or let it air dry.
This is the one that surprises people. Swelling of the forehead is common and sometimes tracks down around the eyes. It typically appears on day two, peaks on day three, and is gone by day five. It looks alarming and it is harmless. It happens because fluid from the anaesthetic and the tissue response drains downwards with gravity. Sleeping propped up reduces it. A cold compress on the forehead – not on the grafts – helps. Some surgeons prescribe a short course of steroids to reduce it. If one side swells markedly more than the other, or the swelling comes with increasing pain or fever rather than settling, that is different and worth a call.
Small crusts have formed over each graft and are starting to loosen. The redness is fading. This is usually the point at which people feel presentable enough to go out with a loose cap, if the clinic has cleared cap-wearing. Do not pick them. Gentle washing lifts them off on their own schedule; picking one off early can take the graft with it.
By around day ten the crusts have come away with washing and the grafts are anchored. This is the point at which the anxiety about dislodging something largely ends. The scalp may stay slightly pink for another week or two.
For FUT, sutures or staples come out at day 10 to 14 – see FUT hair transplant for the donor-specific detail.
|
Day |
What you see |
What you can do |
|
0 |
Crusts forming, redness, donor dressing |
Home. Sleep propped up. Nothing touches the grafts. |
|
1-2 |
Redness, crusts, tightness |
First wash as instructed – gently, no pressure, no rubbing. |
|
2-4 |
Forehead swelling, sometimes around the eyes |
Keep sleeping propped up. Cold compress on the forehead only. Normal but startling. |
|
5-7 |
Crusts loosening, redness fading |
Continue gentle washing. Do not pick. Desk work from home. |
|
7-10 |
Crusts largely gone, scalp pink |
Grafts secure. Caps usually allowed. Back to work for most people. |
|
10-14 |
Looking close to normal, still slightly pink |
FUT sutures out. Still no gym, no swimming, no direct sun. |
Almost all of your transplanted hair is going to fall out, starting around week two or three. This is expected, it happens to nearly everyone, and it is not a sign that anything has gone wrong.
The follicle stays exactly where it was placed. What sheds is the hair shaft it was carrying. The follicle then rests for a couple of months before starting a new growth cycle. You have not lost the grafts – you have lost the hairs they came with. This is the single most alarming thing that happens after a hair transplant, and it is the reason this page exists. People who were not warned about it spend week three convinced they have wasted a great deal of money, and some of them go looking for a second opinion before anything has had a chance to happen.
What else can happen in this window
This is the hardest part of the process, and it is entirely psychological. The shedding has finished, nothing is growing yet, and the area often looks no different from before surgery – sometimes slightly worse if there was shock loss. There is nothing to do except wait, and waiting is harder than the operation was. Two things help. The first is knowing in advance that this is exactly what happens. The second is photographs: take standardised ones – same light, same angles, same distance – monthly, and do not compare in the mirror. Month-to-month change at this stage is invisible to the naked eye and obvious in a photograph six months apart. If you have a large area to cover and this phase is difficult, scalp micropigmentation is sometimes used alongside a transplant to add apparent density – though it is normally done after the grafts have grown rather than during this window.
Growth starts around month four as fine, soft, often lighter-coloured hairs. It becomes obvious at five to six months and is roughly half the final result by then. At nine months you are at about seventy to eighty percent. Twelve months is the honest point to judge the outcome, and the crown always finishes last – sometimes as late as eighteen months.
|
Month |
What is happening |
Roughly |
|
4 |
First growth appears. Fine, soft, sometimes paler than your normal hair. |
10-20% |
|
5-6 |
Growth becomes obvious. Texture still finer than final. |
40-50% |
|
7-9 |
Hair thickens and takes on normal colour and texture. |
70-80% |
|
10-12 |
Close to the final result for the hairline and mid-scalp. |
90%+ |
|
12-18 |
The crown finishes. This is when to judge, and when to take the comparison photograph. |
Final |
Two honest caveats
Comparison photographs are in the before-and-after results gallery. Ask what interval each one was taken at – a six-month photograph and a fourteen-month photograph are very different claims.
Most of this is common sense applied carefully for a fortnight. The two that genuinely affect your result are not smoking and not disturbing the grafts in the first ten days. The rest is about comfort and avoiding avoidable problems.
|
Activity |
When |
|
Walking |
Immediately, and worth doing |
|
Desk work |
2-5 days depending on how visible you need to be |
|
Light cardio |
About 2 weeks |
|
Weights and heavy lifting |
3-4 weeks – and longer after FUT, because tension on a healing donor closure widens the scar |
|
Swimming pools |
3-4 weeks |
|
Sea water |
4 weeks |
|
Direct sun on the scalp |
Avoid for 4 weeks; use a cap once permitted, then sunscreen |
|
Sauna and steam |
4 weeks |
|
Contact sport |
4-6 weeks |
If you take one instruction from this page, take this one. Nicotine constricts the small blood vessels that keep newly placed grafts alive, and the grafts depend entirely on that blood supply for the first days. Two weeks before and two weeks after is the usual advice, and it is the aftercare instruction with the clearest effect on how much of what you paid for actually grows. Alcohol thins the blood and increases swelling. Avoid it for the first five days or so, and go easy for a couple of weeks.
This is the part that determines whether you are still happy in five years, and it belongs on the recovery page rather than being left to the consultation.
A transplant moves hair that is resistant to pattern baldness. It does nothing for the native hair around it, which keeps thinning. Without medical treatment you can end up with a transplanted hairline in front of a scalp that has continued to recede – and that is the commonest reason people need a second procedure sooner than they expected.
|
Normal |
Call the clinic |
|
Redness and small crusts for 7-10 days |
Increasing pain, redness or swelling after day three rather than settling |
|
Forehead swelling on days 2-4 |
Swelling with fever, or markedly worse on one side |
|
Transplanted hair falling out at weeks 2-4 |
Bleeding that does not stop with ten minutes of gentle pressure |
|
Itching in the donor and recipient areas |
Pus, an offensive smell, or spreading warmth |
|
Numbness for weeks to months |
A graft dislodged in the first few days – do not try to replace it yourself |
|
The odd small pimple as hairs emerge |
A spreading crop of pustules |
|
Nothing visible happening at months 1-3 |
Fever above 38 C |
|
Some shock loss of native hair |
Anything that worries you enough to look it up at 2am |
Hair transplant surgery at Rejuva Aesthetica is performed by Dr Arth Shah – MBBS (Gujarat University, 2009), MS General Surgery (Sardar Patel University, 2014), MCh Plastic and Reconstructive Surgery (B.J. Medical College, Ahmedabad, 2017), Gujarat Medical Council registration G-25994. Practising in Ahmedabad since 2018, the year he founded the clinic.
If you are researching before booking, a consultation takes about half an hour – your donor area is examined under magnification, your loss is staged, and you leave with a graft number, a hairline drawn on you and a written quote. If the honest answer is that you should wait or start medication first, that is what you will hear.
Rejuva Aesthetica – Plastic & Cosmetic Surgery Clinic 102, Himalaya Emerald, Besides IOC Petrol Pump, Near Shivranjani Over Bridge, Jodhpur, Ahmedabad, Gujarat 380015 Phone: +91 74360 00990 | 079 2692 9299 Monday to Saturday, 9:00 AM to 7:00 PM. Closed Sundays and public holidays. |
Because that is what is supposed to happen. At two to four weeks most transplanted hairs shed while the follicle resets into a resting phase. The follicle stays exactly where it was placed - what sheds is the hair shaft it was carrying. Growth restarts at around month four. This happens to nearly everyone and it is the single most alarming part of the process.
Usually the first wash is at day two or three, and it is often demonstrated in clinic so you can see the technique. No direct shower pressure on the grafts for the first ten days - pour water gently, use a diluted mild shampoo, no rubbing and no fingernails. Normal washing including shower pressure usually resumes at day ten to fourteen.
Forehead swelling typically appears on day two, peaks on day three, and is gone by day five. It can track down around the eyes, which looks alarming and is harmless. Sleeping propped up at 45 degrees reduces it, and a cold compress on the forehead - not on the grafts - helps.
Growth starts around month four as fine soft hairs, becomes obvious at five to six months, reaches about seventy to eighty percent at nine months, and is essentially final at twelve. The crown finishes last, sometimes as late as eighteen months. Nothing visible happens between the shedding phase and month four.
Almost certainly not. Months one to three are the phase where nothing visible happens - the shedding has finished and growth has not started. It is the hardest part psychologically and it is entirely normal. Take standardised photographs monthly rather than judging in the mirror, and reassess at month six.
Walking immediately. Light cardio at about two weeks. Weights and heavy lifting at three to four weeks, and longer after FUT because tension on a healing donor closure can widen the scar. Swimming pools at three to four weeks and sea water at four.
Usually from about day ten, and it should be loose - nothing that grips or has to be pulled on over the grafts. Helmets come later, typically three to four weeks, because of the pressure and friction. If you ride daily, plan for that before you book.
Most people take four to five days to a week. You could physically work from day one, but the recipient area is visibly red and crusted for seven to ten days, so it depends on whether you mind being seen. By day ten the crusts have gone and most people look unremarkable.
Nicotine constricts the small blood vessels that supply newly placed grafts, and those grafts depend entirely on that blood supply in the first days. It is the aftercare instruction with the clearest effect on how much of what you paid for actually grows. Two weeks before and two weeks after is the usual advice.
Temporary shedding of the native hair around the transplanted grafts, usually in the first two to three months. It is a response to the trauma of surgery, it is commoner where the existing hair was already thinning, and it normally recovers. It can make the area look temporarily worse than before surgery, which is worth knowing in advance.
No. Realistic graft survival in competent hands is in the region of 85 to 95 percent. Anyone promising 100 percent is overstating it. The variables are how the grafts are handled, how long they spend outside the body, and how they are placed.
Quite possibly, and it is not a sign anything went wrong. Either the plan was staged deliberately, or your hair loss has progressed and the area behind the transplant needs attention. Medical treatment for the native hair is what pushes that further away.
Scissors on the transplanted area from about a month; clippers on the donor from about two to three weeks. Colouring is usually left for at least four weeks and longer is safer.
The local anaesthetic injections at the start of each phase are the uncomfortable part and they last a few minutes. After that you feel pressure and movement rather than pain. Afterwards there is tightness and mild soreness for a couple of days, usually managed with simple painkillers. FUT patients find the donor area tighter and sorer than FUE patients do.
Propped up at about 45 degrees on your back for the first three to five nights, which reduces swelling and keeps anything from touching the grafts. A travel pillow helps stop you rolling. Change the pillowcase daily for the first week.
Folliculitis around emerging hairs, which is common in the first few months as new hairs push through the skin. The occasional one is normal and self-limiting. A spreading crop of pustules is not, and should be reported.
Usually. Numbness in the donor and recipient areas is common for weeks to months as small sensory nerves recover. After FUT a narrow band of lasting reduced sensation above the donor scar is not unusual and is a nuisance rather than a problem.
For pattern hair loss, almost certainly yes - and it is one of the more important conversations to have. A transplant moves resistant hair; it does nothing for the native hair around it, which keeps thinning. Without medical treatment you can end up with a transplanted hairline in front of a receding scalp. Minoxidil is usually restarted at two to four weeks.
It is commonly offered. The evidence for PRP specifically improving graft survival is thinner than the evidence for PRP in pattern hair loss generally, so it is better described as a reasonable adjunct than an established one. It is more clearly useful in the years afterwards for maintaining the native hair.
Yes - the biology does not change between clinics and the timeline applies regardless. If something specific is worrying you, speak to the clinic that performed your surgery first, since they know what was done. If you cannot get an answer, you are welcome to contact us.
Slightly. Female transplants are usually performed without shaving the head, so the visible recovery is considerably easier to conceal - but placing grafts between existing hairs carries a risk of shock loss to that native hair, which can make the area look temporarily worse at two to three months.
The timeline is similar but the visible phase is harder to hide, because you cannot cover your face with a cap. The face is pink with small crusts for seven to ten days and facial swelling is common on days two to four.
Yes. Most out-of-town patients arrive the day before, have the procedure, stay one night for the first wash and check, and travel home. Later reviews can often be handled with photographs.
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