Graft security is a key milestone in hair transplant recovery. This is the point at which your grafts are secure enough that you can return to most of your daily activities. For most people, grafts are secure 10-14 days post-hair transplant, though there are some risk factors that mean you need to extend your hair transplant downtime beyond 2 weeks to ensure good long-term results.
The first 2 weeks after a hair transplant are the most important for allowing your grafts to heal properly, so they can anchor into your scalp and give you great long-term growth. In this article, we explore when grafts are normally secure, how you can tell if your grafts have fully anchored, and why it’s so important to avoid graft dislodgement. Plus, discover the risk factors that can delay graft security.
Key takeaways
Wimpole Clinic hair transplant surgeons Dr Peter Thomas and Dr Umear Ahmad provide expert clinical insights into graft anchoring, security, and hair transplant risk management for this article.
Grafts are fully secure between 10 and 14 days after the hair transplant procedure [1]. This is the time it takes for the scalp to heal around each new graft. After this initial two-week period, most people can confidently get on with their normal hair routine without any problems. Dr Thomas explains more:
“The grafts become more secure as time passes. I wouldn’t say they are ‘fully anchored’ until after 2 weeks. However, they are secure enough from day 10 that most daily activities would not be harmful. But it depends what a patient’s daily activities entail. If it’s heavy sweating, intensive activity, or wearing tight fitting hats, then there is still a risk of graft damage and we should remain cautious and say wait 2 weeks.”
Graft anchoring looks different for everyone, so as Dr Thomas explains, you’ll need to consider a variety of factors when assessing the security of your grafts:
“There isn’t a fully reliable sign. If the scabs are gone and the skin looks healthy after 10 days, then I would be confident they are secure. But if after 14 days the scabs are still forming, skin looks infected (oozing/red, etc), or you’re a high risk patient (for example, patients who are older, have poorly controlled diabetes, are heavy smokers or have peripheral vascular disease) this would suggest needing to be careful after 2 weeks for a while longer.”
Explore the signs of graft anchoring in more detail below.
Hair transplant scabs are an important indicator of graft anchoring. As the wounds heal, scabs and crusts form across the recipient site of your hair transplant. Pulling on a scab in the early stages post-transplant can result in the whole graft coming loose [2].
However, as your hair transplant healing progresses, it is important to take steps to encourage safe graft removal. Lingering scabs can increase the chances of graft dislodgement, so you want to remove as many as possible by the 14-day mark. This is achieved by carefully following the hair washing instructions given to you by your clinic.
Dr Thomas clarifies why scab removal is normally necessary after around 14 days:
“At this stage the grafts are secure and don’t need the protection from scabs. Leaving them longer than 14 days would be irritable or tight for the patient. It also improves how the scalp looks for patients who might already be conscious about their shaved head, redness, or swelling.”
Hair washing post-hair transplant is the safest and most effective way to remove scabs and crusts, but you must use specific techniques to preserve your grafts while removing scabs. Caj, a Wimpole Clinic patient advisor, explains more in this video:
Shedding of the transplanted hair is very common, affecting most patients to some degree [3]. And while it’s one of the more alarming post-operative symptoms, hair transplant shedding is actually a sign of graft security. Dr Thomas explains:
“The transplanted graft contains a hair that enters into a resting phase at the time of surgery. After this phase the hairs are shed, which is part of the normal hair cycle, but the trauma of surgery triggers it to move into these phases. We expect to see the shedding phase 2 weeks onwards after surgery. Graft dislodgement would occur earlier when they are not fully secured and would present differently. For example, you could see bleeding, or the whole follicular unit would be visible, not just the hair.”
Transplanted follicles start to shed their hair when they shift into the exogen phase of the hair growth cycle. This usually occurs around 14-30 days after a hair transplant.
After the shedding phase, the hairs move back into the anagen phase and start to grow. So if your transplanted hairs have started to shed, it’s a good sign that you’re on the right track for regrowth.
Learn more about shedding after a hair transplant from Wimpole Clinic patient advisor Adam:
It can take a little while for hair grafts to root in, but patience is essential. Good graft security allows you to get back to your normal activities after a period of downtime. Until your grafts are completely secure, you’re advised not to exercise vigorously, sleep in certain positions, or perform any manual jobs. That’s because these activities can increase your risk of graft dislodgement.
Dr Ahmad explains more:
“In terms of what patients can do to avoid accidentally dislodging the hair, there are a few things really. One is that we normally ask them to sleep on their back for the first week or two, because if they fall onto their sides or their front, they might catch the grafts, dislodge them, damage them. That’s why we tell them not to touch, scratch, or itch their scalps.
“We tell them to make sure they don’t knock their heads or hit their heads against anything, because any of those actions can potentially damage or dislodge the grafts. Also, I normally say not to go underneath the shower for a week, again, to avoid the grafts becoming dislodged or damaged. And for the first couple of weeks, I normally tell them to wear either zip-up tops or shirts with buttons and thus avoid anything going over their head. So no T-shirts, sweatshirts or jumpers.
“It’s a means of trying to reduce the chances of any grafts becoming dislodged. So basically just being really, really careful and protective of those grafts, particularly in the first two weeks.”
Secure grafts also ensure long-term hair transplant success. That’s why good aftercare in the early days post-transplant is so important.
The first phase is wound healing of the recipient site incisions. During this process, a clotting agent called fibrin is deposited throughout the site, creating a mesh-like scaffold that stabilises the grafts and allows for the generation and growth of new cells.
After the clot formation stage, the cells in the vicinity of the transplanted graft start to produce proteins like collagen that connect the new and existing site tissue. It then takes around 3-7 days for the grafts to reconnect to your blood supply [1]. This process is known as revascularisation.
From this point in the hair transplant timeline, your grafts start to anchor fully. But it’s important to wait the full 10-14 days (or more, if recommended by your surgeon) before becoming more active to avoid dislodgement that could spoil your results.
It depends on how far along in your recovery you are. The earlier it is, the easier it is to dislodge your grafts. Research shows that during the first 2 days, pulling on a transplanted hair will always result in a lost graft [2]. By day 6, this is no longer the case; the hair follicles are unlikely to come loose just by pulling a hair, though they can still be dislodged by pulling on a scab until day 5.
Graft dislodgement can happen as a result of many different actions or activities. Dr Thomas reveals some of those he sees most often:
“Rubbing or scratching the recipient area is probably the most common reason for graft dislodgement. Other causes are rolling onto the area during sleep, pulling clothing over the head, washing the head too aggressively, and wearing hats too early.”
Here’s a list of the most common causes of graft dislodgement:
To minimise the risk of dislodging your grafts, you should avoid certain activities for at least 7-14 days (depending on the activity and its risk level). Here are the activities you should restrict, along with when you can safely return:
It may be possible to repair damaged grafts if you can get a fast appointment with your hair transplant clinic. Here’s what to do:
If the grafts are dislodged more than 24 hours after surgery, it’s unlikely they can be salvaged. You’ll probably need to wait for your grafts to completely heal, then schedule a second hair transplant to repair any damage if needed.
It’s not possible to speed up graft anchoring beyond the standard timeframe of 10-14 days, but there are things you can do to support healthy recovery and ensure your graft anchoring doesn’t take longer than expected. Here’s Dr Thomas’s advice:
“Aftercare that will help support the grafts includes using saline spray, avoiding friction from hats or rubbing on pillows, and avoiding smoking and alcohol to improve blood flow and oxygenation. We often recommend avoiding certain medications that influence clotting or platelet function (such as ibuprofen, aspirin, and clopidogrel), and using short course steroid treatment to reduce inflammation and swelling.”
Some patient characteristics and surgical factors may slow down your graft anchoring process. Dr Thomas explains who may be at risk of delayed graft security:
“Patient factors include older patients, those with poorly controlled diabetes, patients who are heavy smokers, and patients with peripheral vascular disease. These patients may have poorer perfusion to grafts and slower healing. Good skin laxity and skin that’s free from scars helps support grafts more.
Dense packing of grafts can also mean greater demand for blood supply, nutrition, and oxygen in one area. If blood supply is insufficient to the grafts during the healing stage, it may affect their survival.”
If you’re concerned you’re at risk of slower recovery, speak to your clinic. They may be able to provide extra support or advice to ensure your grafts heal as quickly as possible, with minimal complications.
Here’s what you can do to help your grafts take root as quickly and effectively as possible:
If you’re worried about the impact of bumping your head post-transplant, or you have longer term concerns about your hair regrowth, get a professional opinion at our award-winning hair transplant clinic. With clinic locations around the UK, you can get an assessment within just a few miles, and find out if your hair transplant is on track for optimal growth.
Book a consultation to get started.
Discover more about graft security in these frequently asked questions.
No, not fully. After 5 days, you can expect your hair grafts to have fully scabbed over, but any friction, pulling, or picking could make the scabs come off, bringing your hair grafts with them.
Your hair grafts still aren’t guaranteed to be secure after 7 days. 10 days is normally the earliest point at which your hair grafts are secure.
Not usually. It’s very unlikely for your hair grafts to come out after a month. By this point they should have healed completely. If your hair grafts are still healing, seek advice from your clinic, as you may have an infection or another complication.
While your grafts should be fully anchored by 1 month after your hair transplant, shedding is common around this time. Shedding is a sign of progress, so try not to worry.
Minoxidil can help with the revascularisation process after a hair transplant, connecting grafts to the blood vessels to encourage healthy growth. Other treatments, like finasteride, can help reduce post-transplant shedding and keep your native hair intact, but won’t have a direct impact on graft anchoring.
Wimpole Clinic Services:
Hair Transplants, Beard Transplants & Eyebrow Transplants.
Talk to a specialist
Dr. Umear Ahmad (GMC Number: 6150115) graduated from Newcastle University Medical School in 2007 (MBBS) and has undertaken further post graduate studies in obtaining a Masters in Health Research (MSc) and Post Graduate Certificate in Clinical Education (PGC Clin. Ed.).
He undertook his junior doctor training in the Newcastle Upon-Tyne hospitals trust, which included time in cardiology, accident & emergency, general surgery and ENT, head and neck surgery.
Having trained in hair restoration in 2019 under the stewardship of world renowned hair transplant surgeon Dr. Akaki Tsilosani, Dr. Ahmad has dedicated his career to FUE hair transplants. He has presented at international conferences and is a member of the International Society for Hair Restoration Surgery (ISHRS).
Dr. Ahmad’s ethos is to always strive to do the very best for every patient. That means having a patient centred approach and putting the patient at the forefront of everything that he does.
He prides himself on being open and honest in helping patients make the correct decision rather than simply advising everyone to have a transplant. He is focused on creating natural looking, high quality hair transplant results.
Dr. Ahmad endeavours to ensure that patients have a positive experience from beginning to end; from initial consultation to the day of the procedure itself and throughout the aftercare process.
Aside from hair restoration, Dr. Ahmad is on the interview panel for Newcastle University’s undergraduate medical degree programme and also works for a charity called Freedom from Torture, undertaking medico-legal reports on a pro-bono basis.
Having undertaken a post graduate diploma in clinical education, Dr. Ahmad is passionate about teaching. He currently supervises junior doctors in hospital, teaches medical students and has also trained doctors in hair restoration surgery.
