Can badly angled grafts be fixed?

Question

I'm 8 weeks after fue but already can see many hairs growing on my temples. The left temple has many hairs growing upwards at a different angle to my native hair. The right side is much better, and I recall that the technician planted the left side and the doctor planted the right. I suspect that the technician made some errors. If it reaches 2 inches and through length and weight hangs downwards then it will be OK. Can the graphs be adjusted safely in the future? How long should I wait? Thanks

Jae Pak, MD · Answer

It is very difficult to fix a bad hair transplant.  It is impossible to fix the angles once the surgery is complete. If the angles of the hairs are wrong, it happened when the doctor made the sites.  Unless the techs made the incisions, the techs cannot place the grafts in the wrong direction.

Edward Ball, MRCS · Answer

The direction and angle of grafted hair at the temples really is crucial because they would naturally be very flat and fine hairs in this area. This is determined by the recipient incisions being made very acutely but also the rotation of the grafts as they are inserted. Even fairly straight hair has a slight curl to it and this needs to be directed down to the skin and slightly backwards in the temporal peaks. This aspect is determined at the point of graft insertion. Many doctors have highly skilled technician assistants help with the placing of the grafts but ideally the doctor would check and adjust every graft themselves to ensure this rotation element is perfect by the end of the surgery. At the 8 week stage some of your grafted hairs may look like they are growing when in fact they are lengthening as they shed. This process can give them an appearance of rather unusual angles. They may well still grow back in a more natural direction in a few months time.

Alan S. Feller, DO · Answer

Temple transplants are more challenging as the areas are always tight and the angles are always very acute. You have to almost lay the blade flat to insure a good angle of growth because the contracture from the scarring process may kick the angles up. So the doctor needs to compensate for that. The doctor must have made the recipient sites, so the angle the hairs would sit at was set by the doctor. Doesn't matter who actually inserts the follicles. So not a technician problem in this case. A good clinic does not leave the VERY important detail up to technicians. That is doctor territory. You are not out of luck yet though. Hair can often be trained to lay a particular way. Good healing and growth to you. Dr. FellerGreat Neck, NY

Roy Stoller, DO, FAOCO, FAAO · Answer

At eight weeks it is hard to predict the final out of a hair restoration procedure.  The quality, density and angle of the growing hair will continue to change, often up to a year or more.  It is probably too soon to come to a conclusion.Grafts that are not angled correctly can be fixed by removing them, usually via an FUE type procedure.  These grafts are usually viable and can be reused.  My suggestion is that you discuss with your surgeon and let him/her know your concerns.Good LuckDr S

William Rassman, MD (retired) · Answer

This is a big problem when doctors don't know how to put in the correct angle of the grafts. This is very difficult to fix and I would need to see it to determine what could be done, if anything.

Michael Meshkin, MD - Account Suspended · Answer

One of very important factors in getting a natural result from hair transplant procedure is the angle and orientation of the incisions made in the recipient area.  Many times this fActor is overlooked and many doctors are starting to hand this part of the procedure to technicians. It is important before the procedure to find out who is performing both harvesting of the grafts and also making the incisions into the recipient are.  If this part of the procedure is not done properly, then the end result will be very unnatural and unfortunately can not be fixed unless the graft is entirely removed and replaced.

Brian Goertz, MD (retired) · Answer

Not unlike the three rules of buying real estate: Location, location, location. The hair angles after transplantation cannot be adjusted. Hairs planted by the doctor or technician should not matter as long as the recipient sites were made correctly at the "proper angle" and the grafts were handled and cared for properly. It can likely be repaired by a skilled hair transplant surgeon, the incorrectly planted hairs can be removed by FUE or sacrificed using laser hair removal, but see an expert first. See my post on "avoiding a bad hair transplant".

Can badly angled grafts be fixed?

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