Patchy results 11 months post FUE hair transplant - will PRP or a 2nd procedure help? (photos)

Question

I am 11 months post fue. I have full, healthy hair, never experienced hair loss. I had a transplant to reduce my forehead size. I have posted a photo of my day of post-op and a photo of my results now. I am fine with both of my sides. However, there are patches in the center of my hairline I’m concerned with. Is it likely this hair will grow? Is PRP a good option, or is it likely not going to lead to results because the grafts/ follicles cannot be recovered and I should do a 2nd fue instead?

Amir Yazdan, MD · Answer

Hello, in my opinion based on your photos you most likely need another procedure to add more density. Since you stated you lowered your hairline I would assume you do not have any native hair in that area, therefore PRP would not really benefit you as it is mainly to strengthen existing hair. Hope this information helps, feel free to reach out for any further questions at (949) 374-2563

Christine M. Shaver, MD · Answer

PRP is unlikely to make a noticeable difference there. I would recommend a 2nd hair transplant. Also important to consider if there in inflammation under the scalp (such as in Frontal Fibrosing Alopecia) that could have attacked some of the transplanted grafts.

Rahil B. Roopani, MD · Answer

Hello, PRP can be a great addition to your hair restoration treatment regimen but unfortunately, it may not work to get you the results you are looking for in your frontal scalp region. You may consider an evaluation for a second procedure (FUE) but I would recommend waiting for a few more months in case there are some hair follicles that were transplanted and not showing up just yet.

Marco Barusco, MD · Answer

Hair transplants take time to fully grow. I warn my patients that it may take up to 15 to 18 months before the full results are in. So, my advice is to be patient and, of course, contact the surgeon who performed the transplant to discuss your overall results.

Suleyman Tas, MD, FEBOPRAS · Answer

Dear Terrific5241,

Thanks for the question. In our experience, hair doesn't survive well on the forehead muscles. If the hair was transplanted in this area, there is a high risk that it won't survive. However, there are many factors that determine the final results of the hair transplant, such as the hair transfer procedures themselves, aftercare, nutrition, following the recommendations of the doctors, the number of grafts placed in the bald area, and specifically, as mentioned above, the tissues on which it has been transplanted. Based on your pictures, it appears that you can go for a second session of a hair transplant to achieve denser hair and cover the areas where the grafts didn't survive. Of course, you can also consider a PRP session; however, it may not fully address your issues as you might expect. For more information and to see before-and-after pictures, you may check the link below for additional revision cases.

Regards
TAS TEAM

Sanusi Umar, MD · Answer

Generally, PRP is recommended to get before the HT surgery and, at most, 3-4 months after it to assist with growth. At this point, you may not see much improvement in your transplant result with a PRP treatment. Unfortunately, it's likely that the grafts weren't implanted in an aesthetic pattern or, for one reason or another, you've experienced a low graft survival rate in those areas.

You'd need to get a follow-up surgery to fill in those spots.

Make sure you first understand what went wrong in the surgery - did an experienced doctor perform it, were you advised on the correct aftercare and followed that advice, did you have periodic follow-up appointments to ensure everything was going well throughout those 11 months, etc. 
It's also possible you have an undiagnosed scalp disease that has compromised your results despite a well-executed surgery by your surgeon.

If you realize the patchy appearance is due to a mistake on the practitioner's side, look for a surgeon with a better track record of FUE surgeries. If the issue was in the aftercare, learn how to fix those mistakes before your subsequent surgery.

Farhad Rejali, NMD · Answer

Hi, PRP can help the growth of grafts especially in the first few months,however usually to reach a density such as your own hairs needs at least two session in each area ,usually maximum number of grafts per sqcm is 40-50/cm which is callaed dense packing technique and is not possible in all patients ,but if the hair diamter is good enough ,reaching density about half of normal can have a good coverage .Best luck

John Diep, MD · Answer

The best option at this moment is likely doing a second hair transplant procedure because most of the hair growth should have grown out by 12 months already. It is very highly unlikely for more density from doing PRP at this stage. You may try to apply Rogaine to help increase the hair density, but it is unlikely to fill in all of the gaps.

Arslan Musbeh, MD · Answer

At 11 months post-FUE, you’re very close to your final result — by this time, around 90–95% of the transplanted hairs have already grown.
If you’re still noticing visible gaps or thinner areas in the center of your hairline, it’s unlikely that new hairs will grow after this point.

PRP (Platelet-Rich Plasma) can improve hair thickness and scalp health but it cannot regenerate grafts that didn’t survive. It’s a supportive treatment, not a corrective one.

If those patches have remained unchanged for several months, this typically indicates that some grafts did not take. In such cases, the most effective solution is a small touch-up FUE session (usually 300–500 grafts) to even out the density.

Before deciding, it’s best to have your scalp examined under magnification by your surgeon or another qualified specialist to confirm whether those areas contain any dormant hairs.

Summary:

At 11 months, the result is nearly final.

PRP helps existing hairs but won’t fill missing grafts.

A minor revision FUE is the most reliable option for better density.

This answer has been approved by Dr. Arslan Musbeh.

George Abrahamian, MD · Answer

Hello, Dr. George Abrahamian MD here from La FUE Hair Clinic, Pasadena, CA. Usually at the 11/12 month mark, you should be seeing the vast majority of your results. Though PRP can help expedite the growth process, typically at the 11/12 month mark if the density is not where you want it to be, then a supplementary transplant will be the better option. If there are no hair follicles (or if the transplanted follicles didn't survive) in the areas where we want to improve the density, then the PRP will have nothing to act on to improve, and may not be an effective option for what you are looking for. This is due to the fact that your procedure was not to treat areas of alopecia, and more so to lower the hairline and reduce the size of the forehead. 
If the area has never grown hair, then the skin and underlying tissue is not designed to grow hair. This means that if hair is implanted into those areas, the survival rate can significantly diminish. Though this can affect the entire area, this is most commonly seen near the center of the hairline/scalp, as that area is considered to be a watershed area (an area that receives the least amount of blood flow due to arterial anatomy). However, PRP with or without exosome therapy at the same time as transplant can significantly boost the overall survival of the grafts, leading to a more successful transplant. 
I hope this helps, and best of look on your hair transplant journey!

Patchy results 11 months post FUE hair transplant - will PRP or a 2nd procedure help? (photos)

Answers (15)

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