I had a hair transplant but I’m not happy with the results what else can I do?
Surgical hair transplants are marketed to be the perfect solution for
male pattern hair loss and in select situations for female pattern hair loss
hair transplant surgery is very time and labor intensive with a significant
financial cost unlike cosmetic surgical procedures such as facelifts which
usually requires formalized training such as a Fellowship through the
American Board of Cosmetic Surgery hair transplant surgery is offered by a wide
range of physicians from different medical specialties without any
residency requirement I’ll discuss how I help people who come to me who have had
hair transplants performed elsewhere who present with a range of issues including
dissatisfaction with their results I’m Dr. Amiya Prasad I’m a Board-certified
cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive
surgeon I’ve been in practice in Manhattan and Long Island for over 20
years I have performed hair transplant surgery throughout my career I’m also
the founder of TrichoStem Hair Regeneration Centers this non-surgical
treatment for male and female pattern hair loss has been highly sought after
with patients coming to us from around the world
I developed trichostem hair regeneration based on wound healing technology are
used to improve the outcomes of hair transplant surgery a common complaint
about hair transplant surgery is the appearance of low hair density often
described as looking unnatural factoring for different ethnicities a rule of
thumb is that normal hair density ranges from about 50 to 100 hairs per square
centimeter of scalp unfortunately hair transplant surgery
has limitations technically and in the ability of the scalp to heal
effectively to support the growth of hair grafts this leaves hair transplant
patients with hair spaced much further apart than is seen with natural hair
density so hair transplant results can look somewhat sparse a commonly
recommended option is to try and perform a second or a third hair transplant
operation while most ethical hair transplant surgeons will avoid
performing hair transplant on men with pattern hair loss in their 20s I see a
fair number of patients who had one or even two transplants before the age of
30 the problem is that many men with pattern hair loss in their 20s are
losing hair very fast due to genetics and relatively high dihydrotestosterone
or DHT-sensitivity the transplant surgery cannot keep up with the rate and
extent of the ongoing hair loss in addition about 80% of these patients
contemporaries have a lot of hair so they aspire to look like other men in
their 20s this cannot be achieved with hair transplant many men who start
having hair transplant surgery dis young try to keep up with their contemporaries
they undergo multiple transplants by the time they reach their 30s they
experience rapid and progressive thinning and are left with very little
hair which was transplanted the amount of hair available for transplant is not
close to the amount of hair that’s lost the peak hair count in the teen years
number in about 100,000 hairs generally when someone first notices hair loss
they’ve already lost about half their hair as hair loss advances that
percentage becomes much higher the number of grafts available in the donor
area or the permanent zone located in the back and sides of
the scalp where the transplants are harvested from ranges from 1,500 to
4,000 grafts each graft contains about 1 to 3 hairs simply put a hair transplant
cannot replace all the hair that is lost so transplant surgery cannot cover the
whole scalp transplant surgery is typically focused on improving the
frontal hairline to frame the face both temporary and permanent hair loss can be
actually caused by hair transplant surgery the trauma of performing
transplant surgery can actually cause collateral loss of existing native hair
this occurs when hair is transplanted close to native hair follicles where a
combination of variables including direct injury vascular compromise and
inflammation result in loss of these existing native hairs hair transplant
surgeons often rationalize that the native hair was already thinning and was
going to be lost eventually if you are dissatisfied with your results after
some time has transpired after your hair transplant surgery it could be due to
not managing the progression of your hair loss after your surgery hair
transplant do not stop progressive hair loss native
hair continues to thin after a transplant leaving behind the
genetically resistant of thinning hairs that were transplanted this often
results in a pluggy look where isolated grafted hair continues to grow but
native hair has gone in our practice starting around 2011 I observed that
native thinning hair became thicker when we used a combination of PRP which
stands for platelet-rich plasma and an advanced wound healing material called
extracellular matrix made by the company ACell which we use to help improve the
outcomes of hair transplant surgery I recognize that most men who come for
consultation for hair transplant are men whose hair is thinning not bald
since thinning hair is already present at a naturally higher density than what
can be achieved with hair transplant I came up with the idea that there was a
potential to help my patients with thinning hair non-surgically
this concept became reality as I developed customized formulations and
methods of delivery and evaluated the results for men and women of all ages
ethnicities and variable levels of aggressiveness
and of course extent of hair loss I made observations and developed a
classification system which helps me optimize treatment lands that are based
on gender age age of onset of hair loss degree of hair loss and rate of hair
loss this became trichostem hair regeneration which was so consistently
effective that I built a free-standing Center specifically for this new
approach to hair loss in Northern Virginia TrichoStem Hair Regeneration
addresses thinning hair in men and women by reactivating hair which was not
growing due to a prolonged resting or telogen phase and by thickening hair
that was thinning before treatment we treat hundreds of patients a year from
around the world non surgically with results that in many situations provides
better scalp coverage than a hair transplant or even to hair transplant
surgeries we routinely see people who’ve had hair transplant prior to coming for
consultation there are certain specific situations we see regularly hair
transplant which was performed within three to six months of consultation hair
transplant which was performed within the past five years and hair has
continued to thin several hair transplants were performed prior to
consultation hair transplant was performed more than once and the patient
is considering having another hair transplant when a
patient comes in within three to six months after hair transplant there is a
potential opportunity to improve the outcome of the hair transplant surgery
particularly at the two to four month time frame this is based on the
principles of optimizing tissue and graft healing to maximize the growth of
the transplanted hairs as well as activate existing native hairs to grow
in thicker ultimately working in synergy with the transplant to maximize scalp
coverage I do look at each situation individually since a hair transplant
outcome can be considerably lower than anticipated even when everything goes as
planned I also advise some patients to wait until the hair transplant is fully
healed and their doctor determines that they have reached the point of maximal
growth which is around one year to 18 months after hair transplant many of our
patients who are several years out after hair transplant come because they are
looking for options to manage their hair loss which naturally continued after
their hair transplant surgery as the native hair is thin and disappear the
transplanted hair becomes exposed and looks somewhat more obviously
transplanted or as is often described pluggy often times these patients have
not followed up with the hair transplant doctor for any further management I
discuss the options they have for medical and non-surgical management as
well as the feasibility of additional surgical hair transplantation it’s
important to understand that hair loss is progressive and not cured but managed
my approach is to assess the volume of native thinning hair which are in the
same area as the transplanted hairs as well as the area where there aren’t any
or just a few transplanted hairs with TrichoStem Hair Regeneration I can
potentially improve the coverage without surgery in these areas I also
discussed from male pattern hair loss patients the role of DHT-blockers such
as finasteride to maximize the longevity of the hair growth cycles which allows
for longer-lasting scalp coverage generally I find that people who’ve had
one or more hair transplant surgeries are eager to do a less involved
procedure to see how much improvement they can achieve in situations where
hair loss has significantly advanced and hair transplantation is in the plans
particularly in the frontal hairline area I offer a comparable strategy as
previously mentioned in addition I find that many of these patients report that
their graft survival was considerably less than they had anticipated based on
the number of grafts transplanted this can occur even when the procedures
performed successfully in my practice as a specialist in revision eyelid surgery
and facial cosmetic procedures I see people where their tissue has been
scarred or been compromised by the blood supply after undergoing multiple
revision surgeries in order to ensure optimal healing when I perform surgery
for these patients I use PRP as well as PRP with a cell to enhance the quality
of the traumatized tissue and scar tissue to improve the probability of a
successful surgical procedure I suggest the same for someone who’s had
low grass survival after one or two hair transplants essentially I’m trying to
improve the scalp tissue quality after the skin has been traumatized and
potentially compromised by the blood supply and scarring this concept has
been successfully applied to patients who’ve had multiple hair transplant
surgeries very often when the patient has had more than three transplant
procedures the transplanted hair can grow with significant variability in
appearance one patient who we recently treated was
cutting his hair short to hide the situation after he underwent trichostem
hair regeneration he felt that he could confidently allow his hair to grow
longer and he appreciates how all his transplanted hair looks and feels it’s
important to remember that hair loss is not cured but managed I spent a
considerable part of my career performing hair transplant surgery as
the only option to improve scalp coverage by placing thicker hairs in
areas where hair was thinning or was completely gone after developing
TrichoStem Hair Regeneration since 2011 I’ve actually helped men and women with
thinning hair significantly improved their appearance for periods of 3 to 5
years or more without surgery the marketing of hair transplant surgery
does not communicate anything about the limitations and potential for sub
optimal outcomes nor is there any mention of managing hair loss after
transplantation is performed I’ve been able to apply the technology behind
TrichoStem Hair Regeneration to help people who’ve undergone one or more
transplants optimally manage the ongoing challenge of maximizing scalp coverage
for as long as is genetically possible I hope you found this information helpful
thank you for your question