Recent Hair Transplant Didn’t Grow - Is This The Fault of The Surgeon?

Written by Bradley R. Wolf, MD on April 15, 2008

I recently had a hair transplant and most of the grafts didn’t seem to grow in. Is this the fault of the physician and improper graft placement or am I just a bad candidate?

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It is unfortunate you experienced suboptimal growth. The degree of difficulty with respect to harvesting the donor follicles and placing the grafts differs greatly from patient to patient. Negative factors include scarring from prior surgery in the donor and/or recipient, greater than normal amount of bleeding, mushy/soft grafts, slippery grafts, tight, and/or sun damaged recipient skin. If a patient is unlucky enough to have all these negative factors present, it is likely that less than 100% of grafts placed will grow. On the other hand if the scalp hasn’t had prior surgery, bleeding is less than normal, grafts are firm and easily placed in flexible, normal skin, growth rates can approach 100%. Any combination of these independent variables can occur causing growth rates to vary.

A good surgeon will recognize a higher degree of difficulty and adjust the procedure to compensate for a negative variable(s). If grafts are difficult to place and placing one graft causes the adjacent graft to pop out, the spacing among incisions must be increased making dense packing difficult. Taking time to properly place grafts in difficult cases often solves a lot of problems.

There are cases, of course, in which surgeon or assistant error can cause failure of a percentage of growth. These include but are not limited to inexperienced surgeon and/or staff, non-recognition of increased degree of difficulty, or situations in which multiple surgeries are done in one day, and/or adequate time is not alloted to a difficult patient.

To specifically answer your question, it could be a combination of the factors you mention or either one alone. Make sure you wait at least one year after surgery to critically judge final results. Also contact your surgeon immediately with any problems you encounter.

Bradley Wolf, MD
Medical Advisor, International Alliance of Hair Restoration Surgeons
Member, American Hair Loss Association