Getting a hair transplant represents a substantial financial and emotional investment. At the risk of perpetuating stereotypes, men don’t like talking about their emotions, yet hair loss has an effect that’s more demoralizing than most care to admit. The desire to project an image of vitality and the increase in self-confidence that results is a strong motivation in undergoing hair restoration surgery.
But what if you took the big step, and the outcome has fallen far short of your expectations? Should you resign yourself to dissatisfaction and regret? The hopeful news is that this may not be the end of your hair restoration journey. We’ll cover three common reasons why a hair transplant sometimes doesn’t achieve the patient’s aesthetic goal.
You’re Expecting to See Full Growth Too Soon
Of all the reasons we’ll discuss, this could very well correct itself. Hair transplant surgery isn’t magic. The surgeon wields a scalpel, not a wand. The “after” of the before-and-after patient photos that impressed you about the surgeon you chose most likely were taken one year post-op. During this time, your newly transplanted hair goes through various stages of shedding and growth.
Moreover, individual hairs don’t grow at the same rate. As our blog post – “What to Expect After Your Hair Transplant” – covers, while you might assume all of your hair will come in at the same time, don’t be alarmed if it’s somewhat patchy and grows out at different rates. Actually, this is typical of normal growth, but you don’t notice it with a full head of hair. About six months after your hair transplant, you may see that the new growth is not necessarily full or consistent around your head, but be patient. Despite the different growth rates, it usually looks natural throughout this time.
Backing up somewhat, the first stage of growth is the hair from the newly implanted grafts falling out. This indicates that the grafts are establishing themselves in their new location, and will start producing hair again – typically in about two months.
A good hair transplant surgeon will be sure to tell you what to expect during each phase of growth, so you shouldn’t experience anxiety about how your new hair is coming in. A good surgeon also will keep the lines of communication open to answer any questions you may have during this time. If your surgeon has addressed your expectations, all has gone well and there are no complications, you’ll see the desired result. However, this is assuming your surgeon has the skill to deliver the desired result – which leads to our next reason.
You’re Unhappy with Your Hairline and/or Scalp Coverage
Once your hair has grown out, your hairline or scalp coverage may not be as you had envisioned. Common reasons for dissatisfaction with a hairline are that it’s too far forward, or just looks “off.” You may not be able to put your finger on it, so to speak, but there is an explanation as to why your new hairline doesn’t have the appearance of natural growth.
While you may have an idea of where your restored hairline should be, a hair transplant surgeon’s technical skill should be informed by a strong aesthetic sensibility. Dr. Marco Barusco – Founder and Chief Medical Officer at Tempus Hair Restoration – follows the classic “rule of thirds” as put forth by Leonardo da Vinci in determining each patient’s ideal hairline position.
As our blog post – “Principles of Male Hairline Design” – covers, in addition to properly positioning the hairline restoration to your facial features, implanting each follicular unit (hair graft) to create the appearance of natural growth is essential to preventing the result from looking like a hairpiece.
“There are no straight lines on the human body,” says Dr. Barusco. “You don’t want to put anything in a straight line because it doesn’t look natural. It will catch peoples’ eyes for the wrong reason. You want to create variability.”
During the transplant procedure, Dr. Barusco implants hair grafts to build macro and micro irregularities into the hairline. Each follicular unit graft can contain one to three (or even four) hair follicles, which Dr. Barusco varies to further create a natural effect.
Dr. Barusco also takes great care in creating a frontal temporal transition to achieve this visual variability. “If I just design a hairline and go straight into the hair without creating that soft transition to the temples, it’s going to look artificial. The effect will be so obvious that people will either know you’ve had a transplant, or think you’re wearing a hairpiece. Neither is a desirable outcome.”
As for scalp coverage, a common reason for dissatisfaction is that there isn’t as much hair covering bald areas as you’d expected. So we pause at this point to emphasize the importance of consulting with your prospective surgeon before the procedure. When discussing your goals for your outcome, you should have a candid discussion with the surgeon about your expectations for your hairline and overall scalp coverage.
For example, Dr. Barusco has had patients who wanted hair on areas of the scalp that he considered secondary – that is, not as obvious as the hairline – yet that was the area on which the patient wanted to see hair growth. Learning what the patient wants is an important part of the consultation.
“However, patients need to be realistic. If you say you want the hair you had when you were 18, that will not be possible with a hair transplant. No one will be able to give you that unless you get a hair piece. But if I don’t tell you that – or worse, I lead you to believe that can happen – that’s wrong. If I don’t know what your goals are, I may make a recommendation that’s not appropriate.”
Your Hair Transplant Failed
Unfortunately, this is becoming an increasingly common situation as more clinics utilize robotic devices illegally operated by unlicensed technicians, or follow other unethical practices. Hair transplants performed by black market clinics outside of the United States – most commonly Turkey – are notorious for hiring unqualified, unlicensed individuals to harvest hair follicles and implant them into the recipient area. Our blog has several posts on this topic, which we encourage you to read.
The reasons a transplant can fail are numerous, including the following:
- Poor diagnosis of the reason for hair loss – there may be a medical reason that a transplant can’t address.
- Poor understanding of hair and scalp anatomy.
- Poor understanding of hair physiology.
- Poor planning of the transplant procedure.
- Poor preparation of hair grafts, resulting in fewer viable grafts.
- Poor technical execution of the transplant procedure – placing hairs at the incorrect angle or direction; placing transplanted hairs too close together, etc.
- Poor management of the limited number of donor hair follicles – overharvesting the donor area.
- Damage to existing hair follicles by overly aggressive surgery.
Can an Aesthetically Unpleasing or Failed Hair Transplant be Corrected?
This can only be determined by a consultation with a hair restoration surgeon who has extensive experience in corrective procedures. Depending upon the amount of healthy follicles remaining in the donor area and other factors, it is possible, in many cases, to mitigate the damage of bad hair transplants and achieve the look the patient had originally anticipated. Unfortunately, there are situations in which the damage is too extensive to be corrected. Again, only a consultation with a highly experienced, ethical hair restoration surgeon can provide an assessment of the degree to which a bad outcome can be repaired.
But how do you find one? You don’t want to repeat the circumstances that led you to misplace your trust in your original surgeon, but as we often warn, there is much misleading “information” regarding hair transplant surgery that works against consumers educating themselves about how to choose a qualified surgeon.
The website of the International Society of Hair Restoration Surgeons (ISHRS) is an excellent place to start. It provides consumers with unbiased information on a wide range of issues – including how to be sure that a properly trained and licensed physician performs your hair transplant procedure, questions to ask during your consultation and many others.
We also invite you to visit Dr. Barusco’s YouTube channel, Hair Loss Medical Advice, where you can learn as he discusses such issues as the types and causes of hair loss, hair transplant procedures, and much more. And of course, our blog features informative posts, updated every month.
Ultimately, choose your surgeon based on experience, results and integrity. Dr. Barusco’s long list of accomplishments, his notable artistic ability and his successful surgical team make Tempus Hair Restoration a renowned practice. We understand that the main concern you may have is cost, which is why we offer financing options that can place this important goal within reach.
Contact us to schedule your free virtual consultation. Dr. Barusco conducts every consultation himself, giving you the opportunity to learn your options in the comfort of your home – or any location, on any internet-enabled device.
Dr. Barusco conducts consultations in English, Spanish and Portuguese. For your greater convenience, Tempus Hair Restoration offers a two-night complimentary hotel stay to out-of-town clients who travel 100 miles or more to our Port Orange, Florida, surgical center. No matter how far the distance, we welcome the opportunity to help you on your hair restoration journey!