How Can You Tell If a Hair Transplant Has Failed? Signs, Causes and Correction Options

How Can You Tell If a Hair Transplant Has Failed? Signs, Causes and Correction Options

Looking in the mirror months after a hair transplant and thinking "something has gone wrong" can be both disheartening and confusing. This is because hair transplant results take time to settle, and much of what you see in the early stages is actually normal. In this article, we explain how to distinguish a genuine problem from normal healing, the possible causes of failure and the options for correction.

Check the timeline first: Is it still too early?

You need to wait at least 12 months before assessing the results of a hair transplant; if the crown was treated, this can extend to 18 months. Many things you may notice before then are temporary: shedding of the transplanted hair in the first few months (shock loss), no noticeable growth until month 3–4, and the first new hairs being fine and uneven are all expected stages. You can find out what is normal each month in our hair growth timeline.

However, some problems can be spotted early. If there is no new hair growth in the transplanted area by the sixth month, the shape of the hairline is clearly wrong from day one, or there is obvious damage to the donor area, it is advisable to speak to your clinic rather than waiting until month 12.

Based on the signs you notice

The causes listed in the table are possibilities; only an examination can establish the exact cause. Particularly where thinning is concerned, it is important to distinguish between a problem caused by the transplant and ongoing hair loss unrelated to it.

Why do hair grafts fail to take?

Grafts failing to take may not have a single cause. The causes fall broadly into three groups.

The first group relates to the procedure. Damage to the roots during extraction, grafts being left outside the body for too long or drying out, crushing during implantation, and placing grafts too densely in a small area can all adversely affect graft survival.

The second group relates to the healing period. Pressure or knocks to the transplanted area in the first few days, forcibly picking off scabs, not following aftercare instructions, infection and smoking can damage grafts. We explain what to watch out for during the first two weeks in our first 14 days guide.

The third group relates to individual factors. Continued loss of the natural hair surrounding the transplanted area can leave the overall appearance thin, even if the transplant itself is successful. Certain scalp conditions and your general health can also affect the result.

Is correction possible?

In most cases, yes, to some extent; but the remaining capacity of the donor area determines the limits of correction. The methods used depend on the problem: the main options include an additional transplant for insufficient density, softening an unnatural front hairline with single-hair grafts, removing incorrectly placed grafts and reimplanting them in suitable positions, and camouflaging donor-area damage or scars with micropigmentation. When the donor area is insufficient, transplantation using beard and body hair may also be an option; we discuss this in our article on a depleted donor area.

Corrective procedures are generally more difficult than the initial transplant: the area has already undergone surgery, the donor area has been partly used, and working with incorrectly placed grafts requires care. For this reason, ask the doctor you consult for correction how often they have performed this type of procedure. We explain how long you should wait before a second procedure in our article on a second session.

Document it first, then discuss it

If you think there is a problem, the first step is to document the situation. Keep your pre-operative photographs, monthly follow-up photographs, contract, invoice and correspondence with the clinic together. Then contact the clinic that performed the procedure first, in writing; many clinics commit to correction or a top-up under certain conditions. We explain how to interpret the guarantee coverage in your contract in our written guarantee guide. If you cannot reach an agreement with the clinic, you can find the avenues available to you in our article explaining your rights.