I had 1225 grafts to my frontal hairline by Neograft last Month. I feel I did not get enough density. What can I do? (Photo)

It took 4.5 hours to remove grafts and 3 hours to insert. I feel that I had minimal scabs and grafts were not placed to create density. Is this normal for 1225 grafts to take that long? I thought doctor was doing the grafts, but he just supervised the Neograft techs. I paid for 1500 grafts, but they were only able to get 1225 and I have Enough donor.After viewing some photos of people with same #of grafts, that mine looks like there is less density.I am attaching photos of 1 week and 1 month.

Doctor Answers 12

A technician did your NeoGraft procedure and you are lacking density?

Dear Maz818,

Thank you for writing in.  Couple of comments:

a) 4.5 hours to remove 1225 grafts is a very long time to accomplish that.  Human tissue (eg: hair follicles/grafts) does not survive forever outside the body, and that's a bit concerning that your grafts were outside your scalp for such a length of time.  Typically, at dedicated centers that perform only hair restoration surgery, it takes less than half that time to extract that number of grafts.

b) A lack of density in the recipient area is due to the surgeon, and the density of the recipient sites that he or she created.  Assuming you went to a facility that's a dedicated hair restoration center, this should not be an issue, but if there is a lack of density, that is something to talk to your surgeon about.

c) It is literally illegal in California for a hair restoration surgery technician to use the NeoGraft device and perform any type of surgery whatsoever on a patient.  It is also illegal for a hair restoration technician to break skin, as in, they are not permitted to even give an injection with a needle.  They are prohibited in California from doing anything that causes the skin to be broken.  This is because hair restoration technicians (eg: "Neograft techs") in this country need to have the exact same medical qualifications as grass cutters.  As in, none whatsoever.  As such, when you have a person with literally zero hours of any medical training whatsoever performing surgery, well, you can figure out for yourself what might happen.

I would return to your physician's office and ask about why technicians were performing surgery on your head.  With a full donor area, 1225 is a rather small number to 'call it a day'...you mentioned that they "were only able to get" 1225 grafts...that's not a significant number for any type of FUE procedure, Neograft or not.

At this point, however, there's not much that can be done but wait it out and see what grows out, and see if you're satisfied with your final appearance.  That will take about 8-10 months following your procedure, and can take up to a full year to see the final results.

As with any surgery, but particularly in hair restoration surgery, it is critically important to select a surgeon who is highly experienced and technically qualified to perform surgery.  A physician does not need any training in surgery whatsoever in this country to call themselves a "hair restoration surgeon", and due to the increasing popularity of hair restoration, many non-surgeons are entering the field and having techs do the surgery as they are not able to or are not experienced enough to perform the surgery.


Atlanta Hair Restoration Surgeon
5.0 out of 5 stars 128 reviews

Neograft and poor results

Its hard to tell based on your photos however having techs perform your surgery and not a doctor is illegal especially in the state of california.  The creation of an incision into the scalp, and extraction of live tissue (hair) is considered surgery and cannot be delegated to technicians especially ones that are unlicensed. Obtaining 1225 grafts on a patient that has never had a strip procedure or any hair transplant procedure and has full donor density shows that there was unqualified people without experience and skill performing your procedure. I would recommend you followup with your doctor, discuss your concerns with them, then find a qualified hair restoration surgeon to try and fix your procedure as most likely you will need some form of a correction.

Amir Yazdan, MD
Irvine Hair Restoration Surgeon
5.0 out of 5 stars 20 reviews

Second Round of NeoGraft

While you have experienced some hair growth, I believe that you can have better results. I suggest you consider a second round of NeoGraft. Consider consulting another board certified facial plastic surgeon because the board certified credential ensures you receive the highest quality knowledge, treatment, care and skill available. Feel free to ask the surgeon for his experience, patient testimonials, Before & After's and background.

Ross A. Clevens, MD
Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 95 reviews

Too early

It's too early to see the final result, it can take 6-9 months to see the graft are and density. The grafted hair shafts shed in a month or so and grow back at different rates. It is difficult from these photos to see how you looked pre procedure. Your right side area appears quite large and if you also had grafts on your oft, 1220+ may not have been enough. You can always have more placed at a later date, after waiting almost a year to see how things look.

I agree with other responses here that 7 + hours for 1225 grafts is a long time.

Michael S. Beckenstein, MD
Birmingham Plastic Surgeon
4.9 out of 5 stars 18 reviews

Post-Neograft Results

I would certainly recommend a follow up appointment with your doctor regarding your concerns.  The time table that you have provided is rather long and the number of grafts extracted and the way they were placed (per the photos provided) demonstrate that the procedure may have been done sub-optimally.  

Hair transplant

Hi, it is difficult to tell much from the photo.  7.5 hours seems like the right amount of time for a technician to perform the procedure.  

Tim Neavin, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 31 reviews

Density after hair transplant

Your doctor should have told you that the transplanted hair shafts usually falls off after a few weeks and it will start to grow back after three to four months. It may take up to 18 months for all the hair to grow in, therefore you need to be patient. If you have concerns you can do a follow up visit with your doctor.

Michael Meshkin, MD
Newport Beach Hair Restoration Surgeon
4.8 out of 5 stars 27 reviews

Neograft and Density

At one month out from a hair transplant many things are going on.  Many of the follicles that were placed will begin to go dormant at 2-3 weeks after the operation.  This leads many to believe that the follicles did not take.  However, hair goes through three stages of growth.  After the transplant the hair in  the area and the hair transplanted as follicular units with go into a stage where they conserve nutrients and ready themselves for regeneration and growth.  Therefore, it may take 6-12 months for many of the hairs that were transplanted to begin to show through.  Thus, it would be difficult to say that your density is not appropriate until later in your healing process.  I would give it some time.  LED light treatments have been shown to help as well, so you may want to inquire about this in the near future.  Best of luck.

Jesse E. Smith, MD, FACS
Dallas Facial Plastic Surgeon
4.8 out of 5 stars 24 reviews

Follow up

If you believe you did not or will not get the density you were hoping for, you should discuss your concerns with your doctor.

If you are upset that your doctor did NOT do the surgery, then that is another issue.

Jae Pak, MD
Los Angeles Hair Restoration Surgeon
4.9 out of 5 stars 85 reviews

One Month Post Op

Unfortunately it is too difficult for me to really comment from these images.
Please feel free to submit additional close up photos as the healing phase progresses beyond one month.
John Frank
New York
Ohio

John E. Frank, MD
New York Hair Restoration Surgeon
4.9 out of 5 stars 49 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.