Balding Blog

You can have a second hair transplant if the donor area has a reasonable amount of hair left. Failures are usually the result of technical problems at the time of the surgery. If the first surgery was with FUE, the second surgery should not use FUE or you will have balding in the donor area. Your available donor area depends upon your original donor density that you had prior to the first hair transplant. Did your doctor measure it?

What does that mean in terms of my donor area as I had 2000 grafts?

The grafts used from the donor area are lost forever. There is no regeneration of the donor area Most people do not deplete the donor area in a single hair transplant. I would certainly go back to speak with your doctor and ask your doctor why it failed. I can’t give you any explanation other than to say that most failed hair transplants, in the absence of dermatological autoimmune diseases, are technical in nature. A 2,000 graft FUE procedure can be 30 percent of the average Caucasian’s donor supply and 40% percent for Asians as they tend to have less overall hair. From the picture below, it looks like your donor area has been maxed-out and FUE would not be possible going forward based upon what is seen in this picture showing very significant donor site depletion. To me, this reflects that you had a significantly lower than normal donor hair density before this process was started. Your surgeon should have told you this before he recommended FUE. Now with your donor area so depleted and a failed hair transplant and a see-through donor area which will not go away, you don’t have many options. Any more FUEs will only make it worse and this donor area can’t possibly yield enough hair to give you any reasonable transplant result. The only solution to this problem is the use of Scalp Micropigmentation which will make your donor area ‘look’ normal and it also might help the recipient area but you would have to see an expert in this area to fond out more about your options. See here for the limits for FUE surgery defined in one of my previous post in the Hair Transplant Forum: https://baldingblog.com/2017/07/21/many-fue-grafts-many-fues-grafts-one-know-safe-limits/ and here for information on Scalp Micropigmentation: https://scalpmicropigmentation.com/

At 5 days, you have far too many crusts on your beard. What you are seeing is probably the crusting not the Herpes. You should nevertheless start taking your acyclovir because wounds like this tend to bring on the Herpes, possibly in the recipient wounds themselves.Many doctors would have put you on the acyclovir just for having a beard and mustache hair transplant. You need proper washing of your crusts to get them off. See your doctor as you shouldn’t look like this at 5 days, it is poor post-operative management.

My hair is medium-coarse. I had two sessions totaling 5500 grafts. Do you think that it too many grafts from my donor area?

The men who most tolerate 5500 grafts excised from the back of the head are men with a coarser hair. That puts you in this category, so I would worry less, assuming that the FUE was done correctly with good spacing and no donor area shock loss.

An FUE hair transplant depletes the donor area. The greater the number of grafts, the greater the depletion and the see-through look you will develop. Each patient should research this subject before having an FUE with a large number of grafts. 5000 grafts for most people might be a bit too-much but that depends upon the original donor density you have. What is bothering me about the photo is that the surgeon who harvested your donor area went very high, well above the permanent zone which means that some of the grafts may fall out eventually if your balding pattern moves into your crown. More balding will also cause the scars from the FUE to show on your crown. That might imply that the surgeon made his/her decisions based upon their need for money if he/she charged you by the graft, not for your benefit. If you had this done in Turkey, then clearly whoever did your surgery had no clue as to what was permanent hair and what is not.

This is an impressive result; however, I don’t believe that you needed 4500 grafts to get this result. The readership is made to believe that this number of grafts were critical to your balding; however, that is absolutely not the case in my opinion. Your forelock was strong before you did the transplant to it hopefully wasn’t touched. I have had results like this with far fewer grafts.

I had 4500 grafts in Turkey almost one year ago, I see holes in my transplant pattern.

Yes, I see what you are talking about. A session of 4,500 grafts requires a great deal of skill in handling the grafts. Grafts that are out of the body exposed to air for 10 seconds will die before they are put into the recipient area. Quality control therefore is very important. I suspect that the quality control may not be tight. I too would have expected to see much more density present. What is unfortunate, is that your donor area has been depleted by over half and another FUE in the donor area could cause you donor site depletion and a see-through donor area that looks like it is balding. My recommendation is to see a doctor with years of experience who knows how to manage your problem and won’t make you look worse in the donor area.

It doesn’t look like much of it has grown. What should I do now. Should I get PRP and ACell treatments offered by some doctors on the internet?

At seven months, you are seeing less that 50 percent of growth of what you can expect from your transplanted grafts. I would not expect the areas in the center to grow much more. I always tell my patients to go back and speak with their doctor as most reputable doctor will make things right financially. A-Cell and PRP is a waste of your money at this stage.