Why might a HT fail?

[bonkling]

Hey all,

I'm sure we've all seen the cases in which, for whatever reason, a transplant doesn't work. 

The grafts don't grow, the person may be incompatible, and so on. Does anyone know the most prominent reasons for a transplant not working?

Considering this, would it be potentially smart to start with an FUE, instead of the recommended FUT, in case if doesn't work, and then scarring would be less potentially?

I know both scar, and FUE can have terrible scarring, but it is usually easier to hide than a strip.

Thanks all.

[Wendell]

Thats interesting brother. I have read that grafts dont grow after a HT because they are incorrectly hasvested  (traumatized) but I dont know any other reasons

[Sean]

Improper extraction of grafts, improper tools, improper surgical protocol.  Improperly trained staff.  Too much saline injections and etc.  list can go on.

if it is a physiological issue as some might add then that is what consults and in person screenings prior to surgery can detect.  

What i can say is life is living hell when you are a person that has had his scalp screwed by trusted surgeon and continue to be repair as a result of uninformed damage to scalp.   I wish no one has to go through repair or be in a situation where you are stuck.  I hope more doctors can stop lying and be more ethical and straightforward.  Some act as if they are doing you or did you favors when you are in the situation you are in due to their actions.  

Then you have doctors that do not communicate and rely on their agents to communicate when something goes awry.   Lot of unethical folks out there.  

Then You have doctors that blame another doctor that takes part in repairs and vice versa.  Its funny how someone can go from colleague to it is due to him and damaged he caused.  

At this point, i am looking to try to get out of a nightmare situation by those that worked on my scalp.  

Edited May 1, 2019 by Sean

[LaserCap]

Interesting indeed.  I do know of a doctor, in particular that did work and grafts did not grow. Every case! Would then do a repeat case at no cost and that too, did not grow.  Incompetent?  I don't think so.  But something was causing the issue.  Staff? Perhaps.  Time of harvesting?  Were the incisions made too deep or shallow? How about placement?  Many points to make but the most important, the patient was truly screwed. No donor left.

It is imperative when you consider this subject, that you do the research.  Ask to look at photos.  HUNDREDS of them, not just a handful.  Consistency, results, density...what will the doctor be doing?  What will the staff be doing? ASK.

 

[Dr Blake Bloxham]

Good post thus far. 

I think this is an important topic, albeit one that many do not want to discuss. I don't think anyone wants to go into any medical procedure thinking it may not "work" as expected, but this is even more true for an elective and cosmetic procedure. Although it is elective, it is important to remember that it is still surgery; there will always be variables and human physiology is unpredictable. 

Thankfully, hair transplant surgery is an EXCELLENT procedure. When you compare it to the entire gamut of cosmetic surgery, it is probably the most consistent, effective, and natural when performed by an experienced team using modern techniques (IE: true follicular unit grafting, appropriate dense packing, small tools and proven placement protocols, et cetera). However, it still can "fail" or not work as well as we would hope. And I think it is important for all patients to understand and truly accept this before "taking the plunge." There is always an aspect of "risk" in life, and the results of an elective procedure are no different. 

A lot of very good reasons for sub-par growth are listed above. A few important ones that come to mind: 

-Inappropriate graft handling

This includes the grafts being physically mishandled during removal, preparation, and placing, and grafts sitting out for too long. This is typically avoided by using a clinic that has highly trained in-house technicians who have performed a LOT of surgeries together. 

-The wrong procedure for the wrong patient 

I do not want to turn this into an "X vs Y procedure" situation, but some patients are simply not as well suited for FUE. Certain follicles are just more fragile and less resilient than others, and they will not do as well with the FUE process. 

- Inappropriate surgical technique or too much delegation 

Making recipient sites using too large of tools or putting them too close together  in certain patients (inappropriate dense packing) can overwhelm blood supply and result in poor or no growth; making recipient sites too small or not trimming grafts properly and trying to place "chunky" grafts into small slits can do the same. Handing important aspect of surgery off where they should not be handed off can play a role as well. 

-Physiology 

This one is likely the "hardest pill to swallow," but some people simply grow better or worse compared to the average. The good news is that touch-ups typically take care of this. 

[Westview]

If a doctor says he's never had a failed transplant, or that he rarely has failed transplants, he is lying.

Even the best clinics will have about a 5 to 10 percent failure rate.

In addition there are also many cases of partially failed transplants where only about 2/3rd or half of the grafts grow

Edited May 4, 2019 by Westview

[Sean]

I agree with your points, but I think for most not all, the failure rate is probably more than 10%.  I say this because the number of messages I received for failed and harmed patients from trusted surgeon(s) was an eye opener.  Lots of folks had yield issues, donor issues, and other issues.  This is something that many people do not reveal online.  What you see online is a minor pool of results and even so you see failures posted or hidden from view.  

 

A lot of docs fail to inform in many aspects.

[Raphael84]

Lots of great points have already been raised and discussed on what can only be labeled as an extremely useful thread.

One thing to remember or at least consider, is that for any data analysis you must have some kind of specific data to analyse.

To simply ask, "do you believe that surgery "x" was a success" is purely objective and not genuinely valuable moving forward unless the "judges" are consistent and highly regarded and respected.

It is necessary to be specific on such things as graft survival/transection rate, agreed density, donor scar/donor area, graft count, healing, design etc...

Just as elated individuals are likely to sing the praises of their Dr, some patient with less than optimal results will absolute sabotage the reputation of their Doctor (however justly or unjust). But remember that there the middle range of these extremes probably represent 80% of patients.

Nothing is guaranteed but your choice of surgeon is paramount!