Unsatisfactory result from FUE 12 months post-op. Could this mean that my scalp is rejecting transplanted hair? (Photo)

Question

I had FUE session a year ago in Dec. 2014. The first photo is pre-op. The other two are current photos. Since month 11, hair started falling everyday. My doctor says to wait till 18 months. I have only taken Evening Primrose Oil daily in this year as I had negative side effects from Propecia and Finasteride spray. My doctor added that a second FUE session will give more hair coverage. Perhaps it is the effects of DHT or other hormonal imbalance that is causing even the transplanted hair to fall?

Jae Pak, MD · Answer

If you were completely bald to start with what you got may be a good result.  It depends on what was done.  You need to show a before and after photo side by side and indicate how many grafts were placed.

Kapil Dua, MBBS, MS · Answer

It is very difficult to comment as to what went wrong in your case. It will be better if you can share your immediate post op pictures which will show the area in which grafts were implanted and also the donor area to know from which part of the scalp the grafts were extracted. The best will be to meet your doctor as only he can comment about the post op yield in your case.

Jeff Donovan, MD, PhD · Answer

For anyone who experiences less than desired outcomes a few things need to be considered:How many grafts were transplanted? 1000? 2000? 3000?Does the surgeon feel the outcomes are good (expected)? Is there any underlying scalp disease?Are there other medical reasons for the loss?I can't evaluate what is going on without an up close examination. A biopsy is sometimes (but not always) required as well.

Rashid M. Rashid, PhD, MD · Answer

Your hairs look very fine and thin so that may be part of the issue.  It also maybe that your before hairs fell out and all that remains are your after grafted hairs. Like everything in medicine, hair transplants do not always work in every patient.   A second procedure may be worth a shot and if that doesnt produce results it may just be the scalp.  As long as you are going to a dedicated hair transplant clinic the odds are in your favor but they are never 100%.

R. Stephen Mulholland, MD (retired) · Answer

Dear Yerma,

Thank you for your clinical post and
photographs.  Sorry to hear about your
disappointment following the FUE hair transplantation procedure.  There are several reasons that could result
in this kind of outcome.  First the
number of graphs transplanted to the area might have been small in number and
spread out in surface area and as such the amount of densification would be
minimal. Some of the grafts themselves
may have died during the transplant process or more commonly some of the donor
site hair, which had been suffering from the advanced ill effects of too much
5-alpha-reductase in the scalp may have been prone to a process called telogen
effluvium.  TE or shock loss of hair in
the recipient area is not uncommon and this hair rarely returns.

I think that you should see your
transplant physician and discuss the nature of the etiology.  If it was telogen effluvium or the recipient
hair, a second transplantation procedure may work quite nicely as the surviving
transplanted hair in the recipient area are quite hearty and not as subject to
male pattern alopecia.

I hope this information is of some
assistance and best of luck.

To find out more, please visit the
link below.

R. Stephen Mulholland, M.D.

Certified Plastic Surgeon

Yorkville, Toronto

William Rassman, MD (retired) · Answer

Of course, you and your doctor should discuss the situation. FUE works, always when it is done properly unless there is an underlying disease present in the scalp. There are a series of autoimmune diseases that can impact hair transplant growths. From the pictures you are showing, without seeing your before pictures for side by side comparisons, it is impossible to determine what, if anything went wrong.

Unsatisfactory result from FUE 12 months post-op. Could this mean that my scalp is rejecting transplanted hair? (Photo)

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