What if after the Hair Transplant Hair never grows there ?

[augustya]

One thought that really scares me in going for a HT especially when I am only doing it to lower my hairline, which means I do not have a crown which is bald or my back or my sides nothing this is just to lower my hairline and I came across one case here where the person even after undergoing the HT the Transplanted hair never grew in his case. Whoa !! That's dead scary !! Especially in my case when I am doing it to Lower my hairline, imagine how will it look on me, a certain sq.cm of area on my scalp with some tiny holes, instead of enhancing my look further it will hamper my appearance and put me in minus ? :eek:

 

So what are the chances of this happening Guys ? Any advice ? :confused:

[greatjob]

My personal opinion is that if you are not suffering from mpb you would be crazy to have a transplant. I've seen some people do it many times, I just don't think it's a good idea. You will be planting a very aggressive hairline which could be dangerous if you do start losing your hair, and most people who are advancing their hairlines have much higher expectations than someone undergoing a procedure to treat hairloss and thus a higher risk for disappointment. As to the point of no growth, it's a risk that comes with the procedure. If you go to a top surgeon that risk is greatly reduced, but it's still a possibility.

[gillenator]

Very well stated greatjob. I have seen several cases over the years where the individual had their natural hairline lowered too much and they continued to recede. Some of them had the hair removed later as their adult hairline move up with age.

 

If the individual does in fact have MPB, then placing grafts at an adult placed level is wise advice.

[gillenator]

There undoubtedly have been cases where no regrowth or very little yield was the result.

 

When this occurs it is almost always attributable to the lack of skills with the surgeon and/or his techs.

 

At times the grafts are transected during the dissection process and then the damaged grafts are planted in the recipient area only to die.

 

Or there is a physiological factor(s) involved where the grafts simply do not take. But that is an extremely rare occurrence.

[Spanker]

My personal opinion is that if you are not suffering from mpb you would be crazy to have a transplant. I've seen some people do it many times, I just don't think it's a good idea. You will be planting a very aggressive hairline which could be dangerous if you do start losing your hair, and most people who are advancing their hairlines have much higher expectations than someone undergoing a procedure to treat hairloss and thus a higher risk for disappointment. As to the point of no growth, it's a risk that comes with the procedure. If you go to a top surgeon that risk is greatly reduced, but it's still a possibility.

 

 

I agree with the part about expectations, but I disagree on the sentiment that if you do not have MPB that you should not get a transplant. If you are older and do not have any loss, why not touch up a shape that you are are unhappy with, or if you are a female, why not do something that you want done. I think that we should be careful not to push away people who could benefit from it. When it comes down to it, nobody NEEDS a transplant. I say, just be careful not to be too aggressive, but besides that, if you are in your 30's or even better 40's and have solid hair, then go for it.

[Spanker]

Very well stated greatjob. I have seen several cases over the years where the individual had their natural hairline lowered too much and they continued to recede. Some of them had the hair removed later as their adult hairline move up with age.

 

If the individual does in fact have MPB, then placing grafts at an adult placed level is wise advice.

 

How did they have it removed? Laser? Fue? Was it successful?

[greatjob]

I agree with the part about expectations, but I disagree on the sentiment that if you do not have MPB that you should not get a transplant. If you are older and do not have any loss, why not touch up a shape that you are are unhappy with, or if you are a female, why not do something that you want done. I think that we should be careful not to push away people who could benefit from it. When it comes down to it, nobody NEEDS a transplant. I say, just be careful not to be too aggressive, but besides that, if you are in your 30's or even better 40's and have solid hair, then go for it.

Yeah I understand not everyone will agree with my opinion, I just don't like to see people trying to fix a problem that really isn't there. Everyone is different and has their own opinion.

 

Reality is all relative, so for someone like me who lost a ton of hair before I even turned 18, my reality is that I don't see the point in going through a procedure that really isn't a walk in the park, costs a ton of money and that has the possibility of causing big problems down the line. I understand everyone doesn't share that opinion and that's life, I just want people to be careful and not chase perfection.

 

As for women that is a totally different ball game, since most won't loose hair in the future most of what I have said doesn't apply to them.

[Blake Bloxham]

August,

 

The above replies discussing hairline lowering are excellent, so I won't comment about this issue. However, I did want to state that I think the chances of a modern, state-of-the-art hair transplant - performed by a trusted physician - not growing at all are slim.

[Spanker]

Yeah I understand not everyone will agree with my opinion, I just don't like to see people trying to fix a problem that really isn't there. Everyone is different and has their own opinion.

 

Reality is all relative, so for someone like me who lost a ton of hair before I even turned 18, my reality is that I don't see the point in going through a procedure that really isn't a walk in the park, costs a ton of money and that has the possibility of causing big problems down the line. I understand everyone doesn't share that opinion and that's life, I just want people to be careful and not chase perfection.

 

As for women that is a totally different ball game, since most won't loose hair in the future most of what I have said doesn't apply to them.

 

I see this often and it is understandable. People see folks with minor loss who are at an appropriate age for a HT and tell them that there is nothing wrong with their hair. But, to the person who is experiencing the minor loss, it is not minor to them. Advanced norwoods have a hard time understanding that a NW3 can feel the same way about themselves as a NW6. That is why I support age appropriate transplants for anyone who wants one who has reasonable expectations and who are at a proper age.

[augustya]

August,

 

The above replies discussing hairline lowering are excellent, so I won't comment about this issue. However, I did want to state that I think the chances of a modern, state-of-the-art hair transplant - performed by a trusted physician - not growing at all are slim.

 

 

There was this case here of a person who was operated upon by Dr.Bhatti (Dr.Bhatti is also world class in his own right) and he faced this problem. His Hair Graft never grew, which even left Dr.Bhatti perplexed and then he did some Skin Biopsy or something to diagnose what went wrong. I don't know the exact details but that is what the case was somewhat.

 

People here are confusing that I am planning to do a aggressive hairline, no I do not plan to get done a very aggressive hairline. It is gonna be lowered maybe upto 7 CMS distance from Glabella. But if this thing happens that hair grafts do not grow ? What are the corrective measures to be done then ?

[Blake Bloxham]

August,

 

The "X" factor is something that comes up occasionally on the forums. I was going to bring it up earlier (as a potential cause for why a hair transplant would never grow), but I figured the rarity of the condition didn't justify making you (or any other members) unnecessarily anxious.

 

Essentially, the "X" factor represents an unknown variable inherent in a patient's physiology that simply prevents transplanted hair from growing. In my opinion, it is probably related to something like a lichen planopilaris; which is an inappropriate immune/inflammatory response from the scalp surgery that prevents the grafts from growing. It is quite rare - I found one article that noted 17 recorded cases of lichen planopilaris after hair transplant surgery -, so I'm not certain how concerned you should be (aside from understanding that the phenomenon exists and anything is theoretically possible).

 

Seven centimeters is a realistic hairline height, but it is a value used when rebuilding/recreating a hairline; not lowering an existing non-affected hairline. If the grafts don't grow, then you would likely need to figure out why and try to fix the situation. However, before discussing/analyzing this, I think it may be important to take a few steps back and possibly explain why you want to lower your hairline and provide some images of your current hairline. This will help the community evaluate your situation and offer accurate advice.

[augustya]

August,

 

The "X" factor is something that comes up occasionally on the forums. I was going to bring it up earlier (as a potential cause for why a hair transplant would never grow), but I figured the rarity of the condition didn't justify making you (or any other members) unnecessarily anxious.

 

Essentially, the "X" factor represents an unknown variable inherent in a patient's physiology that simply prevents transplanted hair from growing. In my opinion, it is probably related to something like a lichen planopilaris; which is an inappropriate immune/inflammatory response from the scalp surgery that prevents the grafts from growing. It is quite rare - I found one article that noted 17 recorded cases of lichen planopilaris after hair transplant surgery -, so I'm not certain how concerned you should be (aside from understanding that the phenomenon exists and anything is theoretically possible).

 

Seven centimeters is a realistic hairline height, but it is a value used when rebuilding/recreating a hairline; not lowering an existing non-affected hairline. If the grafts don't grow, then you would likely need to figure out why and try to fix the situation. However, before discussing/analyzing this, I think it may be important to take a few steps back and possibly explain why you want to lower your hairline and provide some images of your current hairline. This will help the community evaluate your situation and offer accurate advice.

 

Thanks Blake for your detailed response, so you are saying the possibility of this is very rare like one in thousand cases, but my worry is what if am that 1 out of 1000 case :rolleyes:

 

So anything one can do to not let this happen before doing the HT and before doing the procedure...

 

I have been on this forum since last 6 months or so I have already shared my pics in my earlier posts people here have suggested that I am maybe Norwood 2 or 3 and that yes, I do need a hair transplant (I mean one could obviously live without it) because it is not a life threatening situation but aesthetically if one feels in my case it is advised.

[Blake Bloxham]

Hi August,

 

Based upon the real lack of published cases in the literature, I'd say 1 in 1,000 chance of known, diagnosed lichen planopilaris may even be a bit high. It's rare. If you are the "1 in 1,000" there is truly no way of knowing beforehand nor can you prevent it, so I'm not certain if you should let it affect the way you seek treatment. I would definitely bring up your concerns with the doctor during your consultation.

 

If you truly are a NW II - III, then you may be a candidate for surgical restoration; especially in the frontotemporal regions.

 

Good luck!

[augustya]

I had this question posted on one another website and one of the HT Doctors happened to give this explanation...

 

"What a great question - and a complex one too!

 

Fortunately, poor hair growth following hair transplantation is not something that happens very often. But when it occurs we need to explore many, many possibilities, including patient factors, physician factors and scalp factors:

 

Patient Factors - including proper care of the grafts. Occasionally, one hears stories of patients scrubbing their new grafts off the scalp at day 1 post surgery. Of course this is unlikely but one needs to think of all things in this category. The other patient factor that is important is smoking. Occasionally, smokers have poor growth for reasons that are not completely understood. Other factors one might think about under patient factors are medications that impair hair growth or cause excessive bleeding.

 

Physician Factors - including overly tight packing of the grafts (too tight, too packed can lead to poor growth) improper depth of grafts, rough handling of grafts by technicians, harvesting of grafts, temperature of grafts. All these things are important. Sounds like your friend was very lucky to have a great and experienced surgeon so these issues are not likely to be contributory. But these are the things to think about in the "Physician Factors"

 

Scalp Factors - this is one of the most important categories. Some scalps (because of excessive sun damage or other factors) may take up grafts less efficiently and this leads to poor growth. Some scalps bleed more than others are this can rarely impact growth due to post operative "popping" of grafts. Infection post surgery can impair growth as well. And finally some patients have scalp diseases that are either present before the surgery (but could not be detected) or some patients develop new scalp diseases after the surgery that impairs the growth of the grafts. This is rare but in a busy practice, it is something that is seen from time to time. For example some individuals rarely develop alopecia areata or rarely develop scarring hair loss problems after their hair transplant. These scalp issues can impair growth partially or completely. A scalp biopsy is sometimes needed to diagnose these problems.

 

As you can see there are many, many possible reasons and only with a careful evaluation and a bit of "detective work" can the reason usually be figured out. Your friend will want to meet with his surgeon to review all the possibilities and possibly have a biopsy if the surgeon thinks it would be helpful."

[xtatic5]

"Sounds like your friend was very lucky to have a great and experienced surgeon so these issues are not likely to be contributory."

Who's your friend?

[augustya]

"Sounds like your friend was very lucky to have a great and experienced surgeon so these issues are not likely to be contributory."

Who's your friend?

 

Lol ! No one, this Dr I thought I was asking on behalf of someone since in the starting of my thread I mentioned I have come across one case where...

[gillenator]

It is possible to have a complete blood work prior to surgery noting any deficiencies in the auto-immune system, and the like that could possibly negatively impact the regrowth. But chances are, you would have other symptoms or it would have possibly been detected from prior health physicals.

 

But the chances are, as was said from having the so-called X factor in highly unlikely. Poor regrowth many times is more attributable to the surgeon's lack of skills or the techs' high transection rates as they are dissecting the strip.