Chances of success with second FUE transplant?

Question

I had a transplant with 2100 grafts which only grew back 20-30% of hairs so it was a failure for me. I am now booked for a second attempt. Is there anyone that has experienced this and what was the outcome at the second attempt?

Jae Pak, MD · Answer

If the first surgery was a failure, you must understand why it failed before considering another surgery.  Sometimes it may have been just "bad luck" or an unknown cause.  These are things you need to discuss with your doctor.

Bernardino Arocha, MD, FISHRS · Answer

londonboy100,Exercise caution, why did the first not work? This is not typical or usual. Is there something wrong with your scalp? An underlying scalp condition like LPP(lichenplanopilaris) can result in sub-optimal growth. I would recommend work up? At the very least you need a scalp biopsy. But I would start with up close examination of your scalp, and dermoscopy. The other possibility is that the transplant was perform poorly. The donor available is a limited resource, no one has any to waste. Research thoroughly!Sincerely,Bernardino A. Arocha, MD

Munir Somji, BSc, MBBS · Answer

Hello. I am aggrieved to hear of your experience. Would you be able to provide some pictures showing some before and after results? There are many reasons for poor growth post hair transplant and this should be investigated thoroughly before undertaking another procedure. Full results post hair transplant sometimes take longer than 12 months. Please go back to your hair transplant surgeon and discuss these options or seek a second opinion. It is standard practice to have a full blood test prior to any hair transplant procedure and I am assuming that you had no such problems? Please note, until you have ruled out other causes of hair loss I would not recommend undergoing another procedure as you only have one donor area and you would not want to waste this.

Parsa Mohebi, MD, FISHRS · Answer

FUE transplant should have 95% plus growth if it is done right.  You need to do your research and find a good surgeon with consistent results, which is not hard to find through before and after pictures along with forums that the patients review doctors. We do use Snapchat in our office to walk the patients through the process of different types of hair restoration.

John Peter Cole, MD · Answer

Poor growth can occur from both FUT and FUE.  In some instances, the scalp is not healthy, which means is has a skin disease.  In other instances, the team doing your surgery is not very good.  They harvest grafts poorly, damage them on extraction, and damage them on re-insertion into the scalp.  This is common with FUE perhaps more so than with FUT.  There has been a trend in the hair restoration industry for physicians lacking the skills to perform hair restoration surgery to allow assistants without formal medical training to do the entire hair restoration surgery procedure.  This trend has resulted in some very bad results.  Therefore, if you are going in for a second surgery, make sure the physician is going to do your procedure.  If he has the ARTAS robot, run, don't walk out the door.  ARTAS can result in almost no growth and destroy a donor area in one pass.  Only physicians lacking in good hand eye coordination use the ARTAS.  Avoid these doctors entirely.  If the surgeon is going to allow assistants to do the surgery, decline his offer and go somewhere else.  Find out how many FUE procedures the physician has done and how long he has been doing FUE.  If he has been doing exclusive or his practice has been devoted to at least 90% FUE for 10 years, you might consider him unless he had extensive training with a physician with over 10 years of FUE experience.  These are some general guidelines to govern your next decision.  If you had bad results, find out why.  Was it a skin disease or was it poor surgical skill.  I would probably not do a large session next.  You should find a top quality physician and have a workup for a skin disease if it appears you have one and then do a test session to make sure you can get good growth.  Sometimes, bad work results in poor growth and then poisons the scalp for the rest of your life such that nothing will grow.  Ultimately, it's better to find a skilled physician in FUE for the first procedure rather than to avoid doing good homework on your physician before your first procedure.

William Woessner, MD · Answer

Just as the last physician states that there could be an underlying problem I agree that you may need to be worked up to rule out scalp problems. The more common problems concerning growth and FUE come from inexperienced FUE performance as well as inexperienced technicians that are not used to placing FUE grafts. FUE grafts are extracted in its natural groupings without much protective adipose (fat) surrounding the follicle. So extra caution must be used when placing them into recipient sites. I definitely would do more research before undergoing a second treatment. With FUE you will come to a decreased density in your donor where you will have to stop so that it isn't depleted. That means you should use the utmost caution this next go around. Lastly in my opinion it is a failure if less than 95% of growth on average does not grow in these times of FUE. Look for the experience.

Brian Goertz, MD (retired) · Answer

The results you speak of are not unusual in the last few years. It is a result of more inexperienced doctors entering the hair transplant industry as machines to assist in FUE have become commonplace. You may not have been a good candidate or the procedure was not performed correctly. Great results are not by chance. If grafts are cared for properly and patient selection is appropriate you can expect very good results.  Is your surgeon experienced? See you doctor again and ask why it failed? Only proceed to next procedure when you feel confident.

Chances of success with second FUE transplant?

Answers (7)

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