Hair Transplant | Female Dealing With Two Bad Hair Transplants - How Can I Fix This?

Female Dealing With Two Bad Hair Transplants - How Can I Fix This?

I had two bad hair transplants that have left me with very little hair in the back of my head, and with lots of bald spots that I can’t hide. I now also have much less hair in the front then I had before my two hair transplants.

To add to that, my scalp has a white zigzag like scar around the hair line, it cost over $25,000 (FUE) with supposidly one of the best hair transplant doctors.

I am a woman who always had such long full silk-like hair (all my life) the best hair really, so I was thinning a bit in the front , but now I have to worry about the loss of all the hair from the back, only not to have it grow in the front. Scarring in the front, and hair not growing in (6 months after second transplant and nothing is growing) also lost more hair due to shock loss that didn’t grow back!

I am beside myself and cry every day, drink (to forget) gained 20lbs, no more karate, gym, going out with my husband, friends, and I am avoiding friends and family etc. This is killing me!!!! I lost myself and I’m so mad. How could this happen to me, what went wrong? How can I fix this?

Please help.
Eve
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Dear Eve:

Thank you for your question.  Yours is a complex situation, and I wish that I had photography to review to be as accurate as possible in this attempt to assist you.

Specifically, I am interested in the timing of the two transplant procedures.  You mentioned that the second procedure was performed six months ago so there has not yet been an adequate amount of time that has passed to assess the final result.  How long of an interval was there between the first and the second procedure?  Generally, I recommend at least six to nine months to assess the result of an initial transplant procedure prior to considering a second.  The reason for this is because the vast majority of my patients will be satisfied with the result of the initial procedure alone and not opt for a second procedure.

I am interested in your race.  For example, it would be unusual for a Caucasian to heal with severely abnormal scarring.  An African American may have more of a propensity to develop hypertrophic and/or keloid scarring along with scalp pigment changes.  But a preoperative assessment should have been performed to assess for this type of potential condition.

It is highly unusual for a patient to develop “zigzag” scarring along the hairline, (I assume that you are describing the frontal hairline) with the size of the surgical blades that are utilized to create the recipient sites, (usually only 0.6 mm to 1.0 mm in length).

How many total follicles were transplanted in each procedure?  Generally, the number of follicles transplanted utilizing the Follicular Unit Extraction, (FUE) technique are much smaller than the number of follicles transplanted per session utilizing the traditional “strip” harvesting technique.  So two individual FUE procedures may have led to less follicles transplanted in total compared to a single session using a “strip” harvesting technique.

It sounds like there is generalized thinning involving your donor scalp post transplant.  This may represent a condition called Anagen Effluvium which can occur when the FUE technique is used.  Basically what occurs is that the follicles surrounding the individual extraction sites are injured/shocked by the donor harvesting process causing generalized thinning of the donor zone.  This can be noticeable for months post transplant, but I would expect it to be self limited, (i.e. slowly improve over time).  Unfortunately, some physicians might not even know that this is a complication associated with the FUE technique.

Female hair loss is classified according to the Ludwig scale, (Ludwig 1, 2, or 3, for mild, medium, or severe hair loss).  What was your Ludwig classification?  I do not recommend surgical hair restoration for Ludwig 1 patients.  I do not feel that they have “crossed over the bridge of hair loss” enough to warrant a surgical procedure.  And in my opinion a Ludwig 1 patients risk of transplant induced shedding of the natural non-transplanted hair, (i.e. “shock loss”) is too high.  Ludwig 2 and 3 patients are good candidates for surgical hair restoration.

In other words, the FUE technique has been marketed as a “scar-less” as well as a “better and more modern” alternative to traditional hair restoration technique.  Clearly this is not always the case.  As with any surgical procedure there are indications and contraindications.  But as you can imagine, there is no “one size fit’s all” technique that is appropriate for each and every patient.  Each and every patient has unique traits that need to be discussed and assessed preoperatively when developing a treatment/surgical plan.

So what do you do now?  I would address your concerns with your hair transplant surgeon directly.  Review your preoperative photography and compare this to where you are currently.  It may be that just being patient is the best course of action for now.  If you are in significant distress with your result, you may want to ask your transplant surgeon to refer you to a reputable non-surgical hair replacement center such that you can wear hair extensions, a weave, or even a wig for a temporary period until the final result of your transplant can be assessed.

I hope that my response has been of some assistance to you.  I feel that I could have been more helpful with a review of your photography, (pre- and post transplant) as well as knowing more specifics about your two individual procedures.

With Best Regards,

Robert J. Reese, DO
Member, International Alliance of Hair Restoration Surgeons
Member, American Hair Loss Association

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