Why does some hair transplant fail?
July 14, 2024 | By : Dr. Sangay Bhutia (Hair Transplant Specialist in Delhi)
Hair transplant surgery is a procedure which has helped people to regain not just the hairs but also the lost confidence. This treatment has proved to be a very reliable and permanent solution for hair loss. Although many advancements have taken place in surgical techniques and also in technology but still some procedures are not successful and they fail.
There are numerous factors that makes a procedure successful. Here are some factors to consider which can lead to failure or undesired results
1. Age of the patient: It is an important factor that should be kept in mind while planning a procedure. Important reason that many hair transplants fail is that they are performed on patients who are young (early twenties). If the donor area and the hair loss has not stabilise then, over a period of time, the result will start to fade. This stability of hair loss can be assessed by evaluating the thinning or miniaturisation of the hairs particularly in the donor area. Ultimately these hairs which have undergone miniaturisation will disappear. This may not be significantly evident in the young age. This may give a misleading impression about the candidacy of the patient. So, it is always wise to wait and not perform surgery in early twenties age group.
2. Candidacy: One of the important reasons for the failure of hair transplant surgery is that the selection of the candidate is not done properly and strictly. It is not only the age but also the extent & stage of the hair loss, donor graft availability in terms of quantity & quality, condition of the scalp and any medical condition affecting the hair, which should be considered while deciding the candidacy of the patient for surgery. So, Patients with advance stage of hair loss and limited donor graft availability may not achieve the desired result.
3. Experience and expertise of the doctor: Inexperience surgeon or the doctor who does not have the proper expertise may not be able to provide the desired result. There are many critical steps that depend on the experience of the doctor like properly creating recipient site, graft handling, angle of implantation, defining the density by properly distributing the grafts. Inadequate experience may lead to aesthetically unpleasant result. So, one should be very careful in deciding about the doctor for their hair transplant surgery.
4. Infection: Infections during the immediate post-operative period can significantly affect the hair transplant result. Infections can happen due to poor surgical technique, improper sterilization and disinfection, or improper post-operative care. Patients having additional medical problems like diabetes are prone to infections. It is very important for the patients to disclose their medical history and for surgeons to evaluate and treat any scalp or medical problem before proceeding with hair transplant.
5. Improper Post-Operative Care: Post-operative care is that part of the procedure which has equal weightage as that of the actual surgery itself. Patients must carefully follow the post-operative instructions provided by their surgeon. This will ensure optimal graft survival and hence good result. If the patient does not follow these instructions then graft dislodgement, infection, or poor healing can happen, which will ultimately compromise the result of the transplant.
6. Medications which Increase Bleeding: Anti-coagulants or blood thinners such as aspirin and clopidogrel (antiplatelet medicine), may significantly increase bleeding, which can cause grafts to pop out of the recipient sites. It may also cause blood to accumulate under the skin causing hematoma, which may lead to infection and poor graft survival.
7. Insufficient Blood reaching the target area: The healing and graft uptake after hair transplant procedure depends mainly on the blood supply of the area. Less blood supply to the operated areas can lead to graft failure Large number of grafts placed with very close spacing between the sites can lead to impaired blood supply. One should be very careful while operating on patients with bleeding or clotting disorder. In extreme cases where blood supply is significantly hampered, scalp necrosis can take place which when heals leave a very bad scar.
8. Inexperienced Staff: Hair transplant is not a procedure that can be done by one person and its success not only depends on the surgeon, but also on the technicians and staff. The team should be well trained and experienced in all the steps of the surgery, particularly in handling the grafts. The team should be well versed with all the steps of the surgery so that a well-co-ordinated seamless surgery can be done. Inexperienced staff can cause mishandling of the grafts thereby leading to graft wastage, which will compromise the outcome.
9. Unrealistic Expectations: Patients may have unrealistic expectations about the outcome of hair transplantation. This can lead to disappointment about the hair transplant. It is essential for the treating doctor to counsel properly about the procedure and its limitations. Doctor should explain in detail about what can be and cannot be achieved by going for the procedure. It is important to note that these kind of unrealistic expectations are more common in young age group patients.
