There are times where you would be thinking about your friend spending lot of money on hair transplantation, even then the results are not 3.

Why Hair Transplant Fail?

September 16, 2018 by Dr. Sandeep Bhasin0

Reasons, Why patients Do Not Get Good Results After Hair Transplant?

There are times when you would be thinking about your friend spending a lot of money on hair transplantation, and even then the results are not 3.

Let me share with you, why the results were not observed. From my experience, the most important factor in the entire transplantation process is, how the grafts (hair roots) are extracted from the donor area, stored & implanted in the bald area.

The results are usually good when all the above processes are carried out with care.

Let’s Explain Each One of Them One by One

When the grafts are extracted or taken out, we need to consider the size of the punch

Previously, various surgeons would use a punch size of 1.2mm, with greater technology and technological innovation, it came down to 1mm, then 0.9 mm. In the present scenario, surgeons use a punch size of 0.8mm.  The smaller size of the punch creates lesser scarring, which increases the number of grafts being extracted.


The handling of an FUE hair transplant machine to remove the punches or bursts. For this, we need to keep in mind the angle, direction, and depth of the probe. When this is done, surgeons receive a greater number of follicles per graft.

For example, a graft contains 3 follicles. If the surgeon’s technique is perfect, the success rate of getting 3 follicles per graft would be above 90%. But, if a surgeon uses an incorrect technique, then they would receive only 1 or 2 hair roots. This is called a partial transaction.

The partial transaction can be outlined as a graft that is not totally damaged, but out of the three roots, one or two roots may get cut off. This means a surgeon and the patient will only get a single graft, or a lesser number of follicles, rather than the complete set of follicles.

Now, let’s say a person named Harry wants to undergo hair transplantation with 1000 grafts. Each graft has 3 follicles. There are two clinics performing the transplant.

Clinic A follows all the best practices and receives 1000 grafts with 3 follicles each. It is also implanted by the surgeon in the clinic in the perfect way. Thus, Harry would receive 2700 – 3000 hair roots coming out of all the grafts.

Whereas the surgeon at Clinic B charges less amount for hair transplantation surgery but, does not follow the best practices & usually has a high transaction rate. Due to this, the patient will only receive 1 or 2 follicles per graft, thus receiving only 1500-2000 follicles or even lesser with the same 1000 grafts.

Once the grafts are extracted, how do surgeons store the grafts in the clinic also contributes to the quality of grafts

In my clinic and under strict supervision, we store our grafts in a proper solution known as Graft Holding Solution which improves the lifespan of grafts. Vitamins and minerals are also added to the solution and the solution is kept at 40C. This creates minimal damage to the graft.

The next thing that needs to be taken care of is – when the grafts are being implanted they should always be kept hydrated or wet. In my clinic, I have assigned one or two assistants with the task of keeping the hair hydrated whilst the transplant is going on.

If the surgeon uses 3 or 4 assistants to handle various tasks, the cost would go up considerably, but the results would be exceptional whereas surgeons transplanting hair with a single assistant will not be able to provide the desired results.

Implantation Technique

It is good practice for surgeons to make the holes closer. If the holes are closed, the density increases. The angle of the holes needs to be 300, and the holes need to be very close to each other. If the angle of the probe is 900, then the hair would actually stand up like spikes, which would expose the scalp in between.

No. of Grafts per Sq cm

If a surgeon implants 30-50 grafts per square cm, the results would be excellent in comparison to implanting 15-20 grafts per square cm.

Benefits of No Root Touch Technique

One more thing surgeons need to consider is the process of implanting grafts. If a surgeon uses a single forceps, the graft survival rate is less than 50%. If double forceps are used, then the graft survival rate is 70-80%. Using the no-root touch technique, the survival rate of the graft is 90%.

Thus, it is very important for surgeons to use the right technique for graft implantation. The no-root touch technique or using two forceps is the most ideal way to implant the grafts. The single forceps technique should not be followed at all.

So, these are a few important practices and techniques I follow to perform hair transplantation for my patients. These techniques garner excellent results for my patients.

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Dr. Sandeep Bhasin

Dr. Sandeep Bhasin is a highly skilled cosmetic surgeon and the owner of Care Well Medical Centre in Delhi. With extensive expertise in cosmetic and plastic surgery, he is dedicated to providing exceptional care and transformative results to his patients. Dr. Sandeep Bhasin obtained his MBBS and MS in General Surgery from Aligarh Muslim University (AMU) and served as a consultant at Bhaktshreshtha Kamalakarpant Laxman Walawalkar Hospital, Diagnostic & Research Centre. Specializing in various procedures such as face-lifts, rhinoplasty, liposuction, breast augmentation, hair transplant and many others, Dr. Sandeep Bhasin is committed to enhancing his patients' natural beauty and self-confidence.

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