Hair transplantation is one of the most popular methods for combating baldness in both men and women. Although the technology and methods used in hair transplantation, such as FUE (Follicular Unit Extraction) or FUT (Follicular Unit Transplantation), are constantly evolving, not every procedure is successful. There are many factors that can cause the transplant result to fall short of the patient’s expectations. In this article, we will look at the most important reasons why a hair transplant can fail.
Why a hair transplant can fail
1. Improper patient qualification
Not everyone is a good candidate for a hair transplant. People suffering from certain types of alopecia, such as alopecia areata caused by autoimmune diseases, may not benefit from the procedure. Also, patients with insufficient hair in the donor area (usually the back of the head) may have difficulty achieving a satisfactory result.
2. Poor transplantation technique
Improper transplantation technique can lead to failure. If follicular units (grafts) are improperly harvested, stored or implanted into the scalp, they may not take in properly. A common mistake is to implant the grafts at the wrong angle or depth, resulting in unnatural-looking hair.
3. Surgeon experience
The success of a hair transplant largely depends on the skill and experience of the surgeon. Inexperienced specialists can make technical mistakes that affect the final result of the procedure. Choosing a reputable clinic with an experienced team is crucial.
4 Improper care after the procedure
The care of the scalp after transplantation is of great importance to the success of the procedure. Patients must follow the doctor’s instructions to wash the scalp, avoid scratching the skin and avoid sun exposure. Improper hygiene or returning to intense physical activities too soon can lead to damage to transplanted hair follicles.
5. Infections and inflammation
Any surgical procedure carries the risk of infection, and hair transplantation is no exception. A scalp infection can damage transplanted hair follicles, leading to their death. To prevent this, it is important to follow the doctor’s hygiene instructions and avoid touching the scalp with dirty hands.
6. Unrealistic expectations of the patient
Sometimes the problem is not in the procedure itself, but in the patient’s expectations. A hair transplant can improve appearance, but it does not always provide the density of hair that the patient had in his youth. The effect of the procedure depends on the number of grafts available and the natural structure of the hair.
7. Scalp blood circulation problems
Healthy blood flow in the scalp is crucial for proper acceptance of transplanted hair. People with circulatory problems, diabetes or who smoke may have a higher risk of transplant failure.
8. The body’s reaction to the transplant
Although the patient’s own hair is transplanted, the body may react differently to the procedure. Sometimes hair follicles are discarded, resulting in hair follicle death. This is rare, but possible.
9. Graft acceptance time
Transplanted hairs need time to accept and start growing. The first effects are usually visible after 3-4 months, and the full result after about a year. Patients who judge the effect of the procedure too early may be disappointed.
10. Poor condition of the scalp
The condition of the scalp before transplantation is of great importance. Skin problems such as psoriasis, seborrheic dermatitis or infections can hinder the acceptance of transplanted hair.
The experience and knowledge of the trichologist is essential
The most common causes of failed transplants are faulty execution of the procedure and patients’ previously undiagnosed diseases. Let’s start with mistakes during the procedure.
Mistakes can be made at many stages, which will affect the success of the hair transplant itself. The procedure is not as simple as many may think. It requires manual dexterity , knowledge of how to store biological material, attention to detail and imagination. Harvesting hair follicles uses a motorized tool with a blade that must incise the fairly hard epidermis, so cutting through the soft tissue of the hair follicle is not difficult. An incision that is too deep, at the wrong angle or in the wrong direction of growth will cut the hair follicle in half and thus destroy it.
The hair follicles must survive the time from harvesting to implantation, which is usually several hours, outside the patient’s body. They must be provided with the right conditions by storing them in special tissue storage fluid and at a lower temperature.
Implanting hair follicles with tweezers also has risks. The follicle itself is about 6 mm long, so it is important to precisely catch it from the epidermal side. Catching a hair follicle with tweezers is tantamount to destroying it. Precision is key here.
Proper diagnosis
What if, despite a properly performed procedure, the hair does not fully grow back? Any such case should be well diagnosed. Often a scalp biopsy is necessary to see if there is any inflammatory process going on in the skin and around the hair follicles. Follicular lichen planus is a disease for which there must be a genetic predisposition. Often it is not possible to diagnose it before treatment, because it does not produce symptoms, and only the treatment itself causes the first symptoms. The disease itself is autoimmune, which means that the patient’s body begins to attack its own hair follicles and leads to scarring alopecia.
Keratosis disorder, is another condition that can affect the quality of regrowth after hair transplantation. The first symptoms also often appear only after the procedure itself, within 2 to 3 months. Infection of the scalp after the procedure can happen. Sometimes topical antibiotics are not enough and oral treatment must be implemented, which should be administered without undue delay. Untreated skin infection causes chronic inflammation and destruction of hair follicles, so as soon as an infection is suspected, it should be diagnosed and treated quickly.
Post-surgical recommendations
Failure to follow post-surgery recommendations can also affect the amount of hair regrowth. Avoiding sunbathing of the transplanted area, avoiding the use of saunas, proper grooming all matter and medical recommendations should be followed. The lack of regrowth after experiencing severe and prolonged stress after the procedure has also been documented.
The patient had a loved one die suddenly two months after the procedure, and the hair grew back, but in an unsatisfactory amount. After a year, the patient went through all the diagnostics including a scalp biopsy, and no clear cause for the lack of success of the procedure could be found. The patient, aware of the risk of another failure, decided to undergo a second procedure. This time the hair grew back completely properly, with the expected density.
Summary
If you decide to undergo the procedure with an experienced doctor who has performed thousands of hair transplant procedures, the risk that the procedure will “fail” in your case due to the doctor’s fault is virtually zero. When hair doesn’t start to grow three or four months after the procedure, it’s definitely worth a follow-up visit so that the doctor can assess whether to take diagnostic steps, implement treatment or continue to wait and watch.
Choose a medical facility that employs doctors with professional experience in the field of hair transplantation. View the available before and after photos available at the facility to ensure that the results meet your expectations. By doing so, you reduce the risk of treatment failure and disappointment.
Hair transplantation is an effective treatment for baldness, but it is not always successful. Proper patient qualification, selection of an experienced surgeon and adherence to post-procedure care recommendations are crucial. Realistic expectations and proper preparation for the procedure can increase the chances of a satisfactory outcome. If you’re considering a hair transplant, it’s worth discussing all risks and options carefully with your specialist.
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