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Physician Answered Q & As

Looking To Get Repaired After Receiving a Bad FUE Hair Transplant Procedure

In November of 2007 I traveled to another country to have an FUE hair transplant by a supposed world renowned hair transplant surgeon. I was impressed with his website and with his credentials and he told me on the phone that he was the first in North American to perform this type of surgery and that no one else has perfected it to his level. He said he could guarantee that I would have no scaring and undetectable results. Since I was told the he was board certified in FUE, and he was the president of a couple of organizations, I thought that I would be big good hands. Unfortunately for me, this was not the case. The entire experience was a disaster! I have practically zero growth and my donor area is severely scared after this supposed surgeon removed 2000 FUE grafts from the back and side of my head. I was told that I would be able to close crop my hair, which is now impossible, and I look MUCH worse than when I went in to see him. I put my trust in this doctor and all I have to show for it is less hair, a scarred head and thousands of dollars less in my bank account. I have attempted to contact his office on several occasions but the doctor has stopped returning my calls or answering my e-mail. I have to try to get this mess fixed and move on with my life. Are there surgeons who can fix someone who has had bad FUE with zero growth? Do you think it is possible to come out of this looking normal again? Thank you for any information you can provide me with. I feel very desperate after everything that this “doctor” has put be through

I sympathize with your problem and can understand your frustration with having expended the money you did and not having the results you thought you would obtain from the procedure. I know I don’t have the “magic answer” you might be looking for or the exact cause of why this happened to you, but there are a few points I think are worth making and may be of some help.

First of all, usually 12-13 months is sufficient time to be able to judge if transplanted hair is going to grow or not. I have seen two cases in my 20 year career, both in females, in which growth at one year was disappointing and sometime during the second year, luxurient growth occurred. So there is that rarest of possibilities.

As you may be aware, the FUE procedure is a relatively new one and has continued to enjoy limited popularity because of a few unique features. First of all, a horizontal surgical scar is not necessary. Also, the small circular cut-outs heal amazingly quick, often within a few days. It also gives the hair surgeon the possibility of harvesting hairs in the higher and lower regions of the donor supply that one could never touch with a strip harvest. On the other hand, there are a couple of negatives and many unknowns. One negative is that, when all is said and done, the FU graft is literally yanked out of the small hole that has been made. There is a certain “ripping” that occurs and it often does not yield a perfect FU with normal surrounding tissue encasing it all around. The bulb and follicle are often denuded, making handling by the placers difficult. This could result in poor growth, especially if the assistants doing the placing are not experienced. This is especially true if a doctor has a lot of staff “turnover”. Also, if enough FUE grafts are taken, there will eventually be a slight “moth eaten” scarring appearance to the scalp, especially with short haircuts. And being able to wear the hair short is one of the prime reasons many men seek out FUE over strip.

So back to you and your perceived poor growth. It is important to compare photos of your scalp before the surgery and presently to be certain there has not been significant growth. Did you have any “shocking” of existing hair on top following the procedure? Occasionally the amount of hair lost from shocking will equal the growth of new transplanted hair and the whole process appears to be a “wash” with no new gains, when in fact the transplanted hair did grow. This also is more common in females. If you had 2000 FUE grafts planted in one day, that should be around 4000-plus hairs, which should be pretty evident on your head if even 75% of them grew. If all the grafts were harvested the same day, that is a very large case. Questions of fatigue on the part of the doctor or the staff, or “over-delegation” of surgical tasks sometimes can play a role in a poor result. However, I need to emphasize that every single hair surgeon I have ever met has had cases with poor growth. Sometimes it is mysterious and we just don’t know why. When I have been confronted with this in my career, I usually will do some “test grafts” to make sure that hair does in fact grow on a given patient’s scalp.

When a patient selects a hair transplant doctor, it is important that you trust that individual and that there is a bond between you in which you feel certain this doctor will see things through to the end and make sure that you are happy in the end. Did you see photos of other patients like yourself who were transplanted with FUE? Did you talk to any of them? In most practices when there is obviously poor growth, the doctor almost always offers to do some free or greatly reduced-price work to “make good” for the patient and achieve satisfaction.

One problem with FUE transplantation is that no one, to my knowledge, has done a good survival study on FUE grafts as compared with strip-harvested grafts. Is it realistic to expect near-100% growth and survival. I am skeptical that that is possible with FUE grafts, but am happy to be proven wrong.

So what would I do if I were this doctor? First of all, I would want to see you or at least some very high quality, close-up photos to verify your claim. Then, if it was indeed near-zero growth and I was certain that I and my staff did each step in the proper fashion with no short-cuts, I would probably entertain rare conditions such as Diffuse Alopecia Areata and “zebras” like that. I would also suggest some test grafts and wait 8-9 months to see what grows. If they did grow, I would offer you a free second surgery and try to convince you to let me do it with FU grafts harvested from a strip. That way each graft can be perfectly cut out under the microscope and will have tissue surrounding it so that it can be safely placed in the recipient site.

I wish you the best with your dilemma and hope that somehow the lines of communication can open up again with your surgeon and that the two of you can begin to try and sort this out and make you a “happy camper.” Good luck.


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