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3 Hair Transplant Failures + Why and How Often do they happen?

hair-transplant-failures

When it comes to medical operations, such as hair transplant surgeries, there is no room for failure.

But it happens.

Once in a while, you’ll hear from people around you or just read from the internet about someone who had his 3rd hair transplant because the first two were unsuccessful.

Such cases should not exist and can be avoided easily by expert physicians and responsible patients who know what they’re doing.

In this article, I’ll go over:

Hopefully, by the end of this article, you’ll know everything to ensure hair transplant success.

Let’s start by answering a question we’ve already answered, but in more detail:

Is it possible for a hair transplant to fail?

Yes, hair transplantation can fail.

And in fact, based on your perspective, every hair transplantation fails to an extent.

After every hair transplant surgery, you lose a certain amount of the planted grafts. So we need to define “success” and “failure”:

What makes the whole operation a failure or a success is the graft survival rate after 6 months to a year. You can consider your hair transplantation a success if the majority of the planted grafts survived and your hair looks the way you wanted it to be; natural.

And of course, if the majority of grafts didn’t survive after the surgery, and your hair looks the same as or worse than before, it can be considered a failure.

What is the failure rate of hair transplants?

From my experience, I can say that on average, 5% of hair restoration surgeries fail, with unnatural hairlines and low percentages of surviving grafts.

However, this failure rate goes down to 1% in clinics that use high-tech equipment and appropriate techniques with expert surgeons and staff.

And on the contrary, it can go up to around 10-15% in hair transplant clinics with inexperienced staff and outdated methods.

So you actually determine the risk you take when you’re choosing the clinic you’re going to have your hair restoration surgery in.

What causes a failure in hair transplantation?

As I’ve said, your hair transplant’s success or failure will depend on the grafts that survive after a while.

And the survival rate of the planted grafts is determined by 3 main actors in all types of hair transplant:

hair transplantation failures
3 main reasons behind hair transplant failures

1- Patient Eligibility

Are you eligible to get a hair transplant?

Not everyone that loses hair is eligible for hair transplantation surgeries, yet, some clinics are either unable to determine eligibility or just ignore it to do the operation and get paid.

If you’re not the right candidate for a hair transplant, the result of your hair transplant surgery will most likely not be the way you’d expect it, and there’s a high chance your planted grafts will fall out.

Here are some situations where the patient isn’t eligible to have a hair transplant surgery:

  • The balding area is too large, requires too many individual follicles,
  • The donor area is too small, limits the number of hair grafts that can be harvested,
  • Patients with active scarring alopecia,
  • Younger patients with early, evolving balding (if the hair loss is not stable, a second hair transplant surgery would be needed soon after the initial surgery.)
A hair transplant patient with a large balding and limited donor areas
A hair transplant patient with a large balding and limited donor areas

2- Physician and/or the Clinic

Suppose you own a business targeting low-segment customers. And, you know that new techniques enhance the quality of work by 10-15%, but they also increase the cost by 30-35%. What would you do?

The low-cost clinics cut everything to reduce costs, ignoring patients’ ultimate well-being. Next time you think about having a hair transplant think about what is more precious;

  • 1000$?
  • Time?
  • Health?
  • Limited Donor Area?

To reduce the price, It is common for clinics to employ inexperienced physicians with sometimes no medical background to do hair transplant surgeries.

And it is also common for these inexperienced physicians to adopt out-of-date or simply wrong and harmful medical procedures.

After a surgical procedure full of unhealthy practices, it’s almost inevitable for you to lose many of the planted grafts and even have an unnatural hairline or visible scars.

Some failures that are caused by the hair restoration surgeons and the clinics are as follows:

  • No doctor involvement in the surgery: Technicians conducting the operation without supervision can’t deal with complications.
  • Transection rate: Transection is the amputation of single or multiple hair follicles. Transection rate is % of follicles that are transected during the operation.

    The rate depends on the experience of the operator. The least skilled one can have transection rate between 20-50% meaning almost half of the precious and limited grafts are amputated.

    Some clinics use bigger punches to extract grafts to reduce the transection rate without decreasing the surgery speed (speed is essential for “hair mill” clinics), extending the healing period and leaving scars.

    A skilled dermatologist surgeon has a transection rate of 1-2% and transplants most grafts successfully.
hair transplant transection rate: amputated grafts
The probable hair follicle damages in FUE. A: Total transection., B: Partial transection., C: Paring., D: DP injury., E: Bulb injury., F: Fracture., G: Telogen. (Source)
  • Trying to plant too many grafts: Which causes trauma on the scalp and increases the chance of inflammation, necrosis, hair transplant rejection, and future hair loss.
  • Inefficient use of tools: The graft harvesting and plantation process should be done carefully by a well-educated, experienced team with physician supervision. In some clinics, for example, the punching tools used to harvest grafts can be bigger than they’re supposed to make the process easier for the applier, leaving scars over the donor area and increasing the chance of failure where it’s planted.
  • Ignoring the latest technology: New technologies for hair transplant surgeries are invented every year to increase efficiency and hair transplant success rate. Most clinics ignore these technologies and keep going through the process in outdated methods to cut costs.
  • Unnatural insertion of the grafts: Physicians might insert grafts in the wrong direction, resulting in an unnatural look.
  • Too deep or too shallow insertions of the grafts: Physicians, when inserting grafts, might go too deep or too shallow. In either case, the success rate decreases significantly.

Deep insertions may cause Vascular Injury, which is the most vital complication.

Vascular damage can cause necrosis, reduce graft survival rate, and harm existing hair. These may result in regional hair loss.

  • Bad planning of the hairline and the insertion of grafts: Physicians might not consider the best post-op cosmetic possibility before and during the operation because of their lack of experience. This can result in an unnatural-looking hairline.
  • Bad storage of grafts: This may sound like a simple thing but believe me, it is not.

    Live hair cells are taken out from the body and left without blood supply; no glucose and oxygen supply. They are exposed to different outer pressure forcing cells to use energy sources to counterbalance to remain intact.

    Even if they are implanted in 6 hours to recipient zones, they are not connected to blood vessels for 4 or 5 days. So they are susceptible in this period and require special treatment.

    Most clinics make graft storage mistakes: They use extracellular storage solutions such as saline and Ringer’s Lactate and reduce the temperature to around 4°C. The cell metabolism reduces and can’t produce enough ATP to balance the external pressure. Thus, cell swelling occurs, causing scalp swelling, edema and pain for days.

At UnitedCare we use intracellular storage solutions and safely reduce the temperature to slow the cell metabolism. These solutions are very similar to the hair cells and make cells stay alive even for 5 days outside the body.

The intracellular storage solutions are extremely expensive (One Liter is over 1000$) and used in other organ transplants (E.g., kidney transplantation).

That is why just a couple of clinics are using them in Turkey (Koray Erdogan is one of them).

The image below shows the cell recovery difference between intra- and extra-cellular storage medium after cold storage. The difference between cell survival and metabolism rates is exceptionally high.

the cell survival rate difference between traditional isotonic storage media and intracellular storage solution
A: Traditional isotonic storage media, B: Intracellular storage solution. (Source)

3- You (pre & post-operation care)

In cases where the patient was eligible for a hair transplant, and the experienced physician had a successful operation, the patient most likely causes failures.

After a successful operation, the planted hair follicles will stay in your scalp as healthy hair follicles, as long as you don’t give them another reason to fall out.

For example, the success rate of hair transplants is significantly reduced in the patients who practice heavy smoking and excessive drinking after their surgery. If you want to improve the chance of your success, you’ll need to give your body everything that it needs to make the planted grafts survive.

A proper diet full of healthy proteins and staying away from everything that can cause hair loss should be enough to maximize the survival rate of your new grafts and promote further hair growth.

You can use our Care Assistant to learn about everything you should and shouldn’t do after a hair transplant surgery.

Hair Transplantation Personalized Pre- and Post-Care Instructions on Care Assistant
Hair Transplantation Personalized Pre- and Post-Care Instructions on Care Assistant

3 common ways hair transplantations can fail

So you’ve chosen a clinic without an expert staff, or you don’t know if you’re even eligible for a hair transplant.

What can you expect if you’re unlucky?

Here are 3 of the most common ways hair transplants can end up being failed:

1- Losing the planted grafts

In most failed cases, the patient loses the planted grafts after a short or long period.

If the physician doesn’t approach the patient’s condition with a holistic approach and performs a poor operation on the planting area, planted follicles will be lost after a while.

Why can this happen?

  • Treating patients with early, evolving balding (Wrong patient selection)
  • Trying to plant too many grafts (Inexperienced Physician and Clinic)
  • Too deep or too shallow insertions of the grafts (Inexperienced Physician and Clinic)
  • Unhealthy habits such as excessive smoking and active drinking (Poor post-operation care)

2- Unnatural hairlines that look odd

The whole point of going through with a hair transplant surgery is to restore your natural looks, maybe even improve it.

Nobody wants a full head of hair with a twist of an unnatural-looking hairline.

Poor planning and poor practices can result in hairlines that look bad.

Why can this happen?

  • Bad planning of the hairline (Inexperienced Physician and Clinic)
  • Unnatural insertion of the grafts (Inexperienced Physician and Clinic)
Unnatural hairline after failed hair transplant
Unnatural Hairline after Hair Transplant

3- Visible scars in the donor area

In a hair transplant, the front section of your head shouldn’t be the only part you care about.

The back of your head, generally, is also a subject of the operation, grafts that will be planted on the front of your head are harvested from here.

An inefficient harvesting process can result in permanent scars in this area.

Why can this happen?

  • Overharvesting donor hair due to large balding area (Wrong Patient Selection)
  • Ignoring the skin tissue of the patient (Inexperienced Physician and Clinic)
  • Inefficient use of harvesting tools (Inexperienced Physician and Clinic)
  • Use of the FUT Technique
    (Which results in linear scar marks)
overharvested donor area after hair transplant
Overharvested Donor Area

Going for success: how do I make sure my hair transplantation doesn’t fail?

Now that we’ve seen all the reasons for hair loss and the results, let’s discover how to maximize your hair transplant success rate.

Of course, it all starts with the big choice:

Triple-check the experience and expertise of your clinic

Don’t hold back.

Make sure your clinic is experienced in hair and skin disorders, especially hair transplantations.

Ask for social proof, consult past patients, and check the clinic’s legitimacy online. Ask questions learn how the process works.

If anything makes you doubt the clinic and can’t address these doubts, look for another clinic.

And make sure your physician knows what they’re doing.

Speaking of the physician:

Work with a Dermatologist

Not all hair transplant surgeons can be called “hair transplant doctors.”

Let me explain:

Dermatologists specialize in skin and hair disorders, and they’re the ones who should be doing hair transplantation surgeries for a successful outcome.

As a dermatologist, I can assure you that there is always room for doubt if the physician you’re working with isn’t a dermatologist. Likely, they won’t be able to understand the reasons behind

Here’s why a dermatologist is your best option for hair transplant surgeries.

Be ready to change a few habits

As I’ve said, if your hair transplant surgery went great, you’ll be the one that determines the success of the hair transplantation.

You need to give your body everything it needs to help it keep the transplanted hair follicles.

These include:

  • Avoiding harmful habits such as excessive smoking and drinking,
  • Eating balanced meals with plenty of raw vegetables and fresh herbs,
  • Start regular exercising, even if it’s light.

Go with FUE (DHI is a modified FUE )

Most patients with scarring on their scalp after a hair transplant surgery have unfortunately gone through a FUT surgery.

Follicular Unit Transplantation will take less time and is mostly cheaper, but the risks of having huge scars on the back of your scalp are significantly high.

Instead, prefer the FUE method, where the surgeon must be more precise with the harvesting and implanting process to treat male pattern baldness.

Why UnitedCare?

We’ve started our dermatology clinic as two dermatologists who wanted to provide patients with a better way to restore their natural look.

In contrast to other clinics, cheap or expensive, we approach each patient with a holistic approach only applicable by dermatologists to understand the reasons for their hair loss, how we can help them with hair transplantation, and what they should do following the hair restoration procedure to improve their success rates.

Affordable hair transplant costs, a holistic approach, experienced dermatologists on-site, waiting to provide you a permanent hair transplant...

Read more about how we take hair transplantation to the next level at UnitedCare, or contact us for a free consultation: 👇

Maximize the success rate of your Hair Transplantation.

Restore your natural look with a Dermatologist:

Frequently Asked Questions (FAQs)


Why would a hair transplant fail?

Hair transplantation can fail due to 3 main reasons: selection of ineligible patients, indifference or ignorance of the physicians and/or the clinics, or the patient’s lack of self-care before and after the surgery.


What happens if a hair transplant fails?

A hair transplant failure means that most of the grafts planted didn’t survive and fell out. In this case, hair loss still remains visible and another hair transplantation would be required.


Do Hair Transplants last forever?

The transplanted hair follicles are usually much more long-lasting than your regular hair since they keep their DHT resistance property in the newly transplanted area. So yes, a successful hair transplant is a permanent solution that lasts forever if the operation and the follow-up are done right.


Does stress affect transplanted hair?

Stress is a factor that highly contributes to hair loss in the first place, so it would be natural to assume that high levels of ongoing stress, especially right after hair transplant surgeries, would affect the success of your hair transplant.


What age is good to get a hair transplant?

Anything above 25 years or older is perfect for getting a hair transplant if your alopecia has settled, meaning it isn’t aggressively progressing at the moment. Medications and remedies are suggested for patients younger than 25 or who have aggressive alopecia since hormone levels are not settled yet at that age.


Do hair transplants look natural?

If an experienced surgeon executes the hair transplant procedure, it will look natural, and even experts couldn’t understand the existence of transplantation. However, it also depends on the method used. If you’re going for the DHI, a modified version of the FUE (Follicular Unit Extraction) technique that’s much more advanced and precise, you may end up with natural results, but the maximum number of transplanted grafts is limited to 3000-3500 in a session. However, going for FUT (Follicular Unit Transplantation) might decrease the natural appearance of the result since it leaves wide scars on the donor area.


Are body hair transplants successful?

For hair transplant procedures that use body hair instead of hair from the scalp, the success rate might go lower than normal, simply because the donor grafts are not the exact match of your scalp hair.

Dr. Utkan Kiziltac

Utkan Kızıltaç, MD

Chief Physician and Dermatologist Hair Transplant Surgeon of UnitedCare, a dermatology clinic helping patients become the best version of themselves.

2 thoughts on “3 Hair Transplant Failures + Why and How Often do they happen?”

  1. i had a hair transplant in the 90s and the hair did well ,it was the fut and i did have scare on the back of my head. i was in my ,early forty when i had my hair done and i was happy with the result . i still had bald area in back but the front was natural and look full . i am now 70 and the hair in the front has become short and thin a great deal in the last year . i have male patteren baldness ,but i am concern why my transplant are now thin and not growing . i though possible hypothyroid because my eye brow also were thin on the ends. i did not get thyroid test at fist ,started taking kelp for hypo thyroid , started rogaine which at first was helping then it appear to make it worse,,then started rogaine with finterside topically and even did prp on my self , 3 time . use to do blood in the office and i still had a centerfidge so i took my own blood and injected the platlet in to my head about 5 time over a 3 month peroid and see no results and i think the rogaine is making it worse. i did a blood test but my new doctor only does tsh,i had to get him to do tsh ,t3,4 reverse t3,sed rate and thyrogloblin antibody . test were with in normal range . not sure if kelp help my thyroid and improve reading or not. i was on lisinopril for years stop that.i am at a lost . i still have thick hair on the sides , my question to you why is rogaine making it worse ,PRP i really think this is more for a special group of peaple and not worth 2500,00 . can hair be transplant from side of hair now, and is there another reason medical cause the transplant hair all these years to stop growing and thin out . wayne

    1. Hello Wayne,

      The transplanted hairs are DHT sensitive, even if sensitivity is quite low compared to hairs on the front, mid-scalp, and crown. So, they can shed.

      Also, aging occurs in the skin and causes hair loss. If we all live for 150 years, everyone will go bald. So it doesn’t have to be an internal disease; aging alone may cause serious hair loss.

      Get your biotin, iron, and zinc levels checked and Complete Hemogram Test. No further test is required.

      40-50% of Minoxidil users answer to its active ingredient. So if it’s not working, quit and try finasteride.

      I recommend you take oral supplements and try mesotherapy along with PRP (at least 7-8 sessions).

      Of course, another hair transplantation can be done. I need to see the donor area. A part of the side hair can also be used as a donor if necessary.

      You need to share your photos so that I can evaluate your situation. You can reach my clinic and send your photos.

      Best.

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