Not Satisfied With Hair Transplant

I had 1000 fue 13 months ago — 850 in crown and 150 in front middle of my hairline. I have had reasonable results on the crown, but you can still see a bald patch on my hairline. 150 were placed in a small area in the middle of my hairline, but only approx 50 have survived. A slight wind and it looks like a middle part. Do you think the clinic I went to should rectify this?

Any individual clinic is not required to replace what does not grow, but doing so is a good business practice. As you know, a hair transplant is a surgical procedure. There are two causes for non-growth:

1. A technical failure in the hands of the surgeon or transplant team (common when it happens). Team failure is most common because the majority of the graft management is in their hands. A good quality control process is required and many doctors are just not that type of manager. A transplant is only as good as the weakest person on the team. The term for this failure is “H factor” (human team factor).
2. A failure on your side for healing, skin problems, diseases (such as autoimmune disease), poor blood supply (rare but made worse if the surgeon does not use proper judgment in creating the density and matching it with the ‘hole’ size used).

The public tends to think of a transplant as a commodity, offered by various clinics with a marketing program to ‘sell’ and ‘sell hard’ whatever solution to balding and vulnerable patients. I am not against these clinics at all, but realize that a few of them will give you a better quality of work than you may be able to purchase from a doctor who does one or two such surgeries per month. The doctors who dabble in this do not have an organized team, so either they reduce the size of the transplant sessions to match the team, or they develop sub-standard techniques that are not at the state of the art. Some of the larger clinics with many offices, have variable quality of teams (in turn, equals variable qualities of work). I have seen the same national U.S. clinic produce good work from one office and almost malpractice work from another, yet each office publicizes the best sum result of all the offices put together. I have two offices now, one in Southern California (14 years) and one in Northern California (10 years), so quality control has never been the problem for us.