Risk of damaging transplanted follicles during a second hair transplant?

[SeanT1]

Hi everyone, hope you are all doing well.

I was just wondering what the risks are of having a second transplant on the same recipient area as the first.

Can this cause damage to the originally transplanted follicles?

What other risks are involved?

Thanks.

[zerocool]

Yes.

I had my 2nd HT 5 weeks ago. There's a significant area where the previously transplanted hair is not growing, possibly due to shock loss. Not sure if this is temporary for me, but definitely not feeling happy about it.

[sl]

For an experienced surgeon then to give a second pass over an already transplanted area is not a problem. Assuming the transplanted grafts already in are good and correct angels then placing more and matching angles as needed to add density is not an issue. The problem is when there are poorly placed grafts with bad angles and then the surgeon if he were to do correct angles can run the risk of transection etc...But for the most part then adding is not a problem and shock loss is more down to the injections and surgery trauma, use of epinephrine etc..A doctor with skill and magnification should not have an issue and we do it a lot also. Shaving can help for the field of vision etc and seeing the hair angles, although not popular for some, it is worth it and especially if the case is a repair case to also be aware of any skin irregularities etc..

 

All the best!

 

 

 

[RTC]

32 minutes ago, sl said:

For an experienced surgeon then to give a second pass over an already transplanted area is not a problem. Assuming the transplanted grafts already in are good and correct angels then placing more and matching angles as needed to add density is not an issue. The problem is when there are poorly placed grafts with bad angles and then the surgeon if he were to do correct angles can run the risk of transection etc...But for the most part then adding is not a problem and shock loss is more down to the injections and surgery trauma, use of epinephrine etc..A doctor with skill and magnification should not have an issue and we do it a lot also. Shaving can help for the field of vision etc and seeing the hair angles, although not popular for some, it is worth it and especially if the case is a repair case to also be aware of any skin irregularities etc..

 

All the best!

 

 

 

so if a doctor places new grafts in around crappy angled ones, he risks transecting the old grafts?

getting worried now, I had new hairs implanted around my ugly, poorly angled grafts to camouflage them..

Edited July 20, 2022 by RTC

[asterix0]

Generally speaking the first surgery will always have the best yield. You want to give yourself more time to heal before you get your second one, I guess in theory a year would be fine but probably you want to wait longer than this, maybe 18 months.

 

[Gatsby]

I like to think that a year is best to wait for a second pass. My reasons are that after the trauma of a first surgery you really want the scalp to recover fully before undergoing more trauma in that area. The second reason is that you really want to know what areas you need to work in. There's no point placing grafts in an area that may still sprout and you also want to wait to see how much more area requires filling. the best example of this is the crown where it can take up to 18 months to fill in. All the best!

[sl]

Think of parking cars in parallel and as close and you can to not knock the car next to you as an analogy. The more parallel the closer you can get. So, if you have grafts at poor angles then by cutting sites  at totally different angles and next to them then you can transect what is nearby, so there is skill in understanding this and angle changes etc throughout the scalp and knowing the give and takes on repair work. If you have gone to a good repair doctor. (Dr.Mwamba is) then you should have little to worry about and I am sure they can discuss the plans they had. For the clinic they cannot match poor angles but need to take into account the previous work and not to transect it if it is staying in situ and density and other factors also will play a part.  I would not worry unduly but trust the clinic who did the repair. Risk of transection is not only for repair but also working around native hair and why matching hair angles, magnification and shaving short can help in all this. 

Edited July 20, 2022 by sl

[LaserCaps]

2 hours ago, SeanToman said:

Hi everyone, hope you are all doing well.

I was just wondering what the risks are of having a second transplant on the same recipient area as the first.

Can this cause damage to the originally transplanted follicles?

What other risks are involved?

Thanks.

Many surgeons are under the impression grafts compete for blood supply. They'll leave a separation in between the grafts and explain they are placing a foundation to which they can add grafts at a later time.  A year later you can return to do more.  It may even take an additional visit to achieve fullness.  This is also number dependent.  

It is typically recommended you wait at least 6 months before considering a 2nd transplant into the same area.  The doctor wants to be able to see where the first set of grafts were placed.

What medical therapy are you doing to help you with retention of the native hair?

You may want to research Fellowship trained doctors.  Some can achieve density in a single procedure.  

 

[asterix0]

I think this is why I'm always amazed at dense packing results, that I thought generally you need to wait and do 2 passes to get optimal density especially on the hairline, because you can't squeeze in enough grafts in one pass without compromising blood supply and yield.

 

[sl]

I don't think for most blood is an issue and especially on virgin skin and placing strategically and as good use of multiple haired units etc to give more the illusion needed.

One issue can be popping and raising up of grafts as you place and collagen and skin elasticity come into play, how wounds heal or  when placing at higher density, or at the angles needed as others can pop up but we don't go ourselves for a multiple pass approach on virgin skin as such. Second passes are usually but not exclusively from poor growth the first time and then by definition it is not a virgin scalp and then other challenges are there. It is important as said above to give time for firstly the growth from the initial surgery and all the healing time needed and not to rush into anything. 

[Antlor]

There are trade offs to 1. dense packing at the first pass vs 2. sparse implantation and a second pass. 

1. pro: virgin scalp, con: competition for blood floor so some hair might not survive

2. pro: more hair survival and easier to implant at second pass, con: lower density and putting up with poor hair appearance from first HT and scarred tissue so poorer vascular activity from second HT.

 

Generally speaking, I think Dr Zarev employs second method.

[Jackdaniels]

If the existing hair are transplanted, the risk of shock loss to them is low. If a surgeon implants between existing hair that are native hair which are weaker, then the shock loss can happen much more easily to them, since the native hair that are affected by DHT are weaker and less strong than the transplanted hair which are very strong and can survive and withstand difficult situations.

Edited July 20, 2022 by tesco