Hair Transplant Didn’t Grow, Left With a Scar – Can It Be Fixed?

Two years ago I had a hair transplant in Washington state with very poor results. I spent over $8000 and very little of the transplanted hair has grown in. I was also left with a scar that can only be covered if I grow my hair out about 3 inches or so. The entire experience was bad. Is it possible to fix the bad hair transplant and do doctors guarantee their results?

I’m sorry you had a bad experience with your first hair transplant procedure. It’s a little hard from your letter to tell whether you really had poor growth, that is, a low survival rate of the follicles planted at your surgery – or whether the doctor or clinic led you on initially with some expectation that wasn’t lived up to in your eyes. Sometimes a clinic will promise a “full head of hair,” and that just isn’t possible in a single session by almost anybody. I’m assuming it was probably a little bit of both of the above, but the only way to be sure would be to have a graft count of what was placed, see your “before” photos, and then personally examine you. Photos would help some, but wouldn’t be as good as your possibly going to another reputable doctor in your area of the country and having him or her look at your results. Certainly, at the two year mark, you should be seeing everything you are going to get from your transplant.

Another possibility is that you had significant shocking of your pre-existing hair, so that the net gain from your transplant was a lot less than the sum of the grafts you received, since you went could have gone forward with your new grafts, but backward with the shocking. When shocking does occur, often a certain percentage of them do not return, usually those that are a little “wispier” and more vulnerable.

The fact that you need to keep your hair three inches long to cover the donor scar is a little bothersome. Have you actually measured the widest width of the scar? I’m assuming it is around 1cm wide at least if you have to cover it with hair kept that long. That means one of two things: the doctor took too wide of a strip in that area, creating too much tension and thus the stretching of the scar, or you have very hyper-elastic, stretchy skin and that would have happened in the best of hands. All of us, no matter how experienced or good we are, will have the occasional patient with a wide scar due to hyper-elasticity. Since you are already disappointed with your first session, you sound like you probably are going to need a couple of other sessions to get a result you will be happy with. The doctor may want to direct the donor harvest at those sessions in areas that are not above or below the widest segments of your scar. A narrow but longer donor strip will probably be needed, so as not to put additional tension on the closure of
the wound.

As to the aspect of “guaranteeing” a transplant result, most doctors don’t need to actually go to that formality, but any reputable hair surgeon I know of will try to establish a relationship of trust with you, show you
realistic photos of similar patients to yourself so you know what to expect from one session or two sessions. Then, if you are unhappy, they usually work with you to get you to a point where you are happy. In a few cases I have had where there was less-than-expected growth in an area, I usually figured a way to make that area good without charging the patient extra for that work.

I hope you will hang in there and try to see your transplant project to the end with a reputable physician with a proven track record of turning out consistently excellent results. I would stay away from places that started
out as hairpiece salons and hire a doctor off the street to do transplants just because there is some money in it.

Best wishes.
Mike Beehner, M.D.
Saratoga Springs, New York
Member, International Alliance of Hair Restoration Surgeons

Michael Beehner, MD Dr. Michael Beehner has been involved in hair restoration surgery since 1989 and has been full-time in transplanting hair since 1995. He has been a leader in the specialty during the past several years – conducting several important research projects, chairing the Examination Committee for the new American Board of Hair Restoration Surgery, serving as co-editor of the Hair Transplant Forum International, the principal journal of hair surgery in the world, lecturing at almost all of the various hair surgery conventions around the world, and authoring two chapters in the latest edition of Hair Transplantation, the principal text in our specialty, edited by Dr. Unger. In 2001 he published in Dermatologic Surgery the landmark article, “Nomenclature Proposal for the Zones and Landmarks of the Balding Scalp,” which put together for the first time a coherent system for naming all of these areas, which is now followed by all of the hair surgeons and dermatologists in the world. He has been a pioneer in the use of the “frontal forelock concept” for the extremely bald male and has done recent important research on “stretch-back” in scalp reductions and on the affect of “limited-depth recipient sites” on hair growth. For his research efforts, he was awarded the Platinum Follicle Award in 1999 by the International Society of Hair Restoration Surgery for the year’s best research, and on three separate occasions has been awarded a Research Grant Award by the ISHRS. Dr. Beehner is a member of the International Alliance of Hair Restoration Surgeons and recommended by the American Hair Loss Association. Visit Dr. Beehner's Website: www.saratogahair.com

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