29 Year Old Female Dissatisfied With Hair Transplant Results

29 Year Old Female Dissatisfied With Hair Transplant Results - Do You Do Repair Work on Women?

Written by Raymond J. Konior, MD on May 29, 2008

I had a hair transplant about two years ago from a well known hair loss clinic here in Chicago. I am very disappointed in the results and was wondering if you do repair work on women. I an 29 years old and had 400 hair grafts placed in a thin area of my hair line. My hair seemed to have gotten worse after the hair transplant. Can this be fixed?
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Repair work traditionally refers to a surgical procedure that is designed to improve, remove or camouflage the adverse effects of a poorly performed surgical hair restoration. Common problems requiring attention during a repair procedure include detectable plugs or minigrafts, asymmetric hairlines, and visible scars. Your letter seems to imply that you have had one or a combination of the following: 1) poor graft growth; 2) not enough grafts to satisfy your density needs; or 3) damage to the residual native hair follicles.

The fact that your hair density has deteriorated may be related to progression of your hair loss process, or it may have arisen from shock loss secondary to the transplant procedure itself. You need to have a thorough examination prior to considering any additional surgery in order to define the nature of your thinning and to determine the net effect from your last procedure, i.e. what percentage of grafts survived, what density the grafts produced, and whether or not you suffered shock loss in the recipient site.

Female patients commonly exhibit a thinning or diffuse loss, which is why they seek surgical restoration. Grafting into zones of thinning hair predisposes the patient to shock loss. Patients affected by shock loss commonly complain that their hair looks thinner following the transplant procedure. Despite the fact that the grafts may be growing, the stress and trauma of the surgical intervention “shocks” enough of the residual hair to produce an overall reduction in recipient site density. Some patients have extraordinarily sensitive hair and may be prone to shock loss despite the best performed surgical procedure. However, shock loss more often occurs secondary to poor surgical technique and / or over-grafting the recipient zone. An experienced surgeon will recognize the potential for shock loss when attempting to graft into a zone of thinning hair. The surgeon must consult the patient in advance of the procedure about the risk for shock in order to prevent such an unexpected disappointment.

There are several modifications of the procedure that can be implemented to minimize the risk of shock loss. Some of the more important considerations include the following: 1) careful placement of anesthetic blocks; 2) using the smallest recipient site openings possible so as to minimize tissue trauma; 3) perfect angling of recipient site openings in order to prevent collateral follicular damage; and 4) avoiding over-grafting which could compromise regional blood circulation.

You may be an excellent candidate for correcting your current situation. You first need to be examined in order to determine what went wrong with your first procedure and to identify the nature of your thinning process. Meticulously performed follicular-unit grafting should then help you achieve the result that you are hoping for.

Female Hair Transplant Patient With Frontal Thinning - Raymond J. Konior, MD
Illustration: Female patient with diffuse frontal thinning. Postoperative result following a single session of densely packed follicular-units.