Men and Women's Frontal Hair Loss? Why Hair Density Drops After Hair Transplant and Requires Revision - Hair Transplant

Many men and women who have undergone hairline transplant surgery often find that the density of newly grown hair in the frontal area decreases, leading them to undergo revision surgery. The fundamental reason for this is that the doctor who extracts the follicles from the back of the head and the doctor who implants them into the hairline are different, or each lacks the relevant expertise.

When extracting follicles (the small pouch-like tissues from which hair grows) from the back of the head for implantation into the hairline, if the physician fails to carefully extract follicles of varying thicknesses—such as fine, medium, and thick hairs—without damage, they might either implant too few follicles or unnecessarily extract too many.

Additionally, since each follicle grows in different directions, angles, and depths, failing to match these conditions during extraction can result in damaged follicles that cannot be transplanted.

For instance, fine hair follicles grow at an angle, so extracting them as one would for regular hair can cause damage. The extraction tool must be angled accordingly. Similarly, when transplanting follicles, each must be implanted according to its individual growth angle, direction, and depth.

Moreover, follicles must be extracted with the surrounding supportive tissues intact to ensure stable engraftment and healthy hair growth at the hairline. While extracting delicate follicles without damage is challenging, securely extracting them along with the surrounding tissues requires extensive experience, often gained through thousands of procedures.

Before implanting the harvested follicles into the hairline, a slit design is created. Tiny holes are made according to the conditions of each follicle, and the follicles are then implanted into these holes. This process must not be done mechanically.

For thick follicles, larger slits are required, while for thin and short follicles, the density of the slits needs to be increased. Additionally, the angles at which the hair lies on different parts of the hairline must be adjusted to create a natural gradient of hair density and thickness in the hairline.

However, each customer has different characteristics in their harvested follicles. Some have predominantly thin and short follicles, while others have a balanced distribution of thick and thin follicles. Some may have follicles that grow at an angle, or have a lot of curly hair.

Since the characteristics of individual follicles can be accurately identified during harvesting, a detailed plan for the slits and implantation that reflects these characteristics is established at this time. Therefore, the doctor who harvests the follicles should not be different from the doctor who performs the implantation. If different doctors handle the extraction and implantation, they may not fully consider the various variables and conditions, leading to decreased hair density or unnatural results, similar to frontal hair loss after hairline correction surgery.

Furthermore, the skin types of the scalp where the follicles are harvested and the hairline where they are implanted also vary between individuals. These detailed factors must be considered to adjust the depth of the punch during harvesting and be reflected in the slit design for implantation.

At Mo & Line Plastic Surgery Clinic, we consider the detailed differences in the characteristics of each customer’s follicles, even if they are thin.

Hairline correction requires meticulous adjustment at every step and must be carried out with extensive expertise. It is safest to undergo surgery at a specialized hairline correction clinic where one director is responsible for the entire process, from the careful examination of the occipital area before surgery, to harvesting, slitting, implantation, and post-operative care.

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