A second hair transplant: when, how, and why?

You got one already, so why not do it again? How many hair transplants could you get in your life? How many do you really need? The answer is relative. Getting only one hair transplant may be enough to meet your expectations in terms of restoring hair to areas affected by alopecia. However, some patients choose to get a second one because either they want to increase density in the same area (or a different one), or they would like to repair a previous procedure.

Why undergo a second hair transplant?

Here are some scenarios where you could consider the possibility of undergoing a second hair transplant:

1. Satisfactory results. When we experience something that we like, we always want more. As early as six months after your first procedure, you may start thinking about the possibility of improving your appearance even more with a second transplant. This second procedure can be performed in an area different from the first procedure. For instance, patients who get the transplant on their hairline may consider transplanting hair to their crown, or even their beard, mustache, or eyebrows.
2. Advanced androgenetic alopecia. Over the years, in many cases, patients continue losing native hair (not the transplanted hair), so, eventually, these areas which did not receive the proper care end up looking bare. 
3. Complications from the first procedure. It is very rare for patients to experience complications following their procedure that keep a certain number of follicles from thriving. This can happen as a result of unexpected scarring patterns, not following post-op care instructions, or even choosing clinics that do not have the necessary tools to guarantee a good procedure. In these cases, a second hair transplant is recommended in order to fix and restore hair density.

When is the best time for it?

It is always a good idea to talk to a specialist about when is the best time to undergo a second hair transplant. At Kaloni, we want to be there by your side every step of the way. Remember, you can always come back for a free evaluation. In fact, once you have attended all your follow-up consultations for 14 months after your procedure and you are discharged, we recommend that you come for a check-up at least once a year in order to see if your alopecia has advanced or you need to strengthen your native hair.

The best time to get a second hair transplant is whenever you choose. When you go to your follow-up appointment at Kaloni after the six-month mark, you can talk to your specialist about this. Your donor site will have healed completely by this point, so it would be possible to extract follicles from this area without causing any damage.

If you are thinking of getting a second procedure in order to increase density in the same recipient site as the first transplant, you will have to wait for one year, at least.

General guidelines for a second hair transplant

Some patients undergo hair transplant procedures without being properly evaluated beforehand, so they get the procedure even though it was not the most effective course of treatment for their type of alopecia. Because of this, the patient is not happy at all with their results. In situations like this, we recommend that they come to Kaloni and receive a proper diagnosis. In this way, we can look for other alternatives, such as intensive treatments or capillary prostheses. We will talk about these options shortly. 

The first and most important thing is to have a serious and honest conversation with your specialist, so that you create realistic expectations. The specialist will then consider the following aspects in order to determine whether or not you are eligible for a second procedure.

Type and degree of alopecia

As we mentioned earlier, some patients have mild cases of androgenetic alopecia that affect only one part of their head. For these patients, a single procedure would yield the results they want. Meanwhile, patients who have moderate or advanced alopecia could talk to their specialist about the possibility of a 2-stage design. In these cases, it is also important to evaluate the quality of the skin on the recipient site.

As for patients with cicatricial alopecia or autoimmune alopecia (like alopecia areata, for instance) the chances of a hair transplant not turning out right are very high. Therefore, the best thing to do would be to consider the risks involved and look into other options. 

Density in the donor site 

Did you know that hair is a non-renewable resource? In other words, if your hair follicles die or they are over-extracted (for the transplant), there is no way to get them back. Some hair transplant clinics get carried away and extract too many follicles in order to cover a mild alopecia case. Then, when the signs of alopecia begin to appear in other areas, the patient does not have the necessary follicles to perform a second procedure. For this reason, at Kaloni, we extract follicles very carefully from the donor site. This way, we can preserve the area for after the procedure, guaranteeing natural results, and opening up the possibility of another procedure in the future.

Your hair’s color, texture, and width

The results of your hair transplant will depend on your specific hair type. If your hair is very straight and fine, or it is blond or very light brown, you might look like you have less hair density, and the treatment areas will be more visible. The best way to prevent this situation is to perform a trichological exam that allows us to calculate the transplanted hair’s growth pattern and distribution. In these cases, opting for a second procedure would help darken this part of the scalp by inserting small grafts close to the larger ones.

Your age

Most people make the decision to undergo a hair transplant around the age of 35, when there is a visible hair loss pattern, and we can tell how their androgenetic alopecia will evolve. Usually, though, 10 to 15 years later, they come back for a second procedure, since their alopecia will have progressed. In these cases, we restore density to the areas most affected by hair loss.

Hair care routines

As we mentioned before in another blog post, there is no cure for alopecia. It is more like high blood pressure: you stabilize it and keep it there. For this reason, getting a hair transplant is just as important as caring for it afterwards. 

Taking care of your hair means maintaining proper hygiene and talking to your specialist about the possibility of undergoing some form of intensive growth stimulation treatment for your native hair, which may be vulnerable to DHT and fall out eventually.

It is also important that you provide your hair with the nutrients it needs to grow healthy and strong. This includes eating a healthy diet and, if need be, taking dietary supplements or a vasodilator treatment that helps nutrients reach the follicles. If you do not follow these indications, you may have to come back to the clinic for a second hair transplant one day.