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Will I need more than one hair transplant?

  • 6th January 2023
  • 12 min read
Jeremy Profile 2021
Written by Jeremy
Medically reviewed by Arran Isherwood on 8th February 2023
Next review due on 8th February 2024

Hair transplants are revolutionary procedures that can help restore your confidence as well as your hair. While a hair transplant from a reputable clinic will be almost risk-free, sometimes a candidate may require more than one procedure. This can be for a variety of reasons but not limited to: extent of your hair loss, desire to achieve a level of density not achievable from a single stage treatment, poorly executed surgery first time around, a post operative complication due to poor aftercare. This should all be assessed during your consultation at your chosen clinic. 

Because of this, one of the most common questions many hair transplant physicians get asked is whether or not a single surgical procedure will be enough. Luckily, in most cases, only one session is required to achieve good results. However, some patients will benefit from having a second or even a third hair transplant to improve the overall density, clarity and appearance of their surgery. 

To help you understand more about multiple hair transplants or if you’re wondering whether you’ll need more than one, we’ve answered some of the most common questions in detail. 


The goals of the first hair transplant

The goal of any hair transplant is to increase the scalp's overall hair density, provide  coverage to thinning and balding areas of the head and restore/improve the hairline of patients. 

However, while the goals of a hair transplant are usually the same, everyone is unique and experiences hair loss differently. For this reason, your physician will examine your head and hair loss and will choose the best option for you. The right method for you will depend on the level of hair loss, your desired results, and the characteristics of your hair. The two main methods for hair restoration procedures are FUE and FUT transplants. 


Follicular Unit Extraction (FUE) is where individual hair follicles are extracted from your donor areas which are typically found at the back or sides of the head. These will be implanted one by one in the recipient site. Due to the precise method of this procedure, scarring and downtime are often minimal and the results are exceptionally natural. 


Follicular Unit Transfer (FUT) is where a narrow strip of tissue from the back of the scalp is removed and donated to the recipient site. This strip will contain an abundant quantity of follicular units to donate. This method is recommended to patients who may not be suitable for FUE due to their hair characteristics or who wish to pursue a more discrete method of hair transplantation as their is no need to shave the donor area. .. 


Why would I need a second hair transplant? 

In the majority of cases, a single hair transplant procedure will be enough for the patient to see satisfactory results that they’re happy with. However, on some occasions, the desired density or definition of the scalp and hairline may not be reached during the first procedure. If this is the case, a second hair transplant is recommended for a fuller finish and more satisfactory results. 

While an individual's personal preferences and desired look can be the reason why they might get more than one hair transplant, in some cases, it isn’t that simple. Here are some examples of more complicated and uncontrollable reasons why someone might need a second or even a third hair transplant. 


Hair transplant surgery won’t stop the progression of hair loss

Hair loss in the form of male pattern baldness is caused by the hormone dihydrotestosterone (DHT). Hair follicles that are vulnerable to this hormone are often found at the top of the scalp. These follicles are attached by DHT which will cause miniaturisation (thinning or balding) and eventually lead to hair loss. Hair follicles often resistant to DHT are often located on the back and sides of the head, which is why these areas are often used for donor grafts. 

Unfortunately, even after a hair transplant, the top area of the scalp will remain vulnerable to attacks from DHT. While the transplanted hair won’t be lost and will remain with the patient forever, any hair that was present at the start of the surgery could still thin and fall out. While it won’t affect everyone, it does mean that a ‘top-up surgery’ may be required in the future. Many don’t think about the future complications of this additional hair loss. 


The cost can be spread over many surgeries 

Hair transplants are an investment, and while payment plans can sometimes be put in place to pay off the procedure, for some people, this won’t be a viable option. To tackle this issue, some patients will split their treatments into two or three FUE implantation sessions over time. These sessions will usually take place 6 to 12 months apart, breaking up the overall cost of the procedure and making it easier to pay off. 

While this can benefit you financially, it can also improve the aesthetics of your hair transplant. Multiple sessions will allow you to review the number of grafts that you need from area to area during each visit. This ensures that not too many or too few are implanted during a single treatment. Multiple sessions are also great for those who don’t want to draw attention to their hair restoration. 

Thankfully, at FUE Clinics, we provide options for payment plans to ensure that any suitable candidates can financially support a hair transplant. Learn more on our pricing page.


The first surgery wasn’t carried out correctly 

Mistakes are often a reason why someone will need a second or third hair transplant. If the first surgery wasn’t carried out correctly, the results are likely to fail to meet the needs and expectations of the client. In some circumstances, people won’t carry out the correct research before they get their surgery and will opt for the cheapest option, which will often lead to rushed procedures and undesirable results.  


How many hair transplants can you have?

With all of the above information, you may be thinking about how many hair transplants can you have. If you suffer from significant hair loss, you can have two or more procedures, provided you have a suitably rich donor area. Donor hair follicles are a finite resource — the density of hair follicles and the size of the donor site will determine your total yield.

It’s crucial, therefore, that you don’t remove too many hair follicles at once or have more procedures than your total yield can handle. If you don’t, you risk ‘over harvesting’, which will result in bald patches in your donor area, as not enough hair was left to regrow.

When considering multiple procedures, the real thing to ask is how many grafts can a person have. With an FUE procedure, a graft is equal to a single follicle (which contains 1-4 hairs) and over a person’s lifetime, it’s possible to implant a maximum of 6000 to 7000 grafts. The average size grafts are as follows: 

  • 800-2500 for your hairline
  • 1000-2750 for the crown
  • 5000+ for the entire head 
  • 1000-3000 for an entire beard 

During a single session, you can get a maximum of around 3000 grafts for an FUE procedure and 3750 with a strip of tissue if you go for FUT. The graft numbers quoted are based on a patient with optimum donor density — the number of hair follciles per sq/cm. If you have two patients, Patient A with a donor density of 100 FU’s per sq/sm and Patient B with a donor denity of 70 FU’s per sq/cm you would not expect to be able to achieve the same graft yield with the same amount of tissue being harvested.


Things you need to know before additional hair transplants 

If you’re looking to undergo a second hair transplant, it’s important to remember that surgeons will recommend that you wait a minimum of 9-12 months before you get your second procedure. This will give you enough time to recover and begin to see the results of your first transplant. During the first year, you’ll start to notice a sufficient amount of growth of your transplanted hair which will offer you a better insight into how the final results will look. 

Over time, your new head of hair could become denser, increase in diameter, length and texture, and can even be cut and styled. This will have a huge impact on how you feel about the results of your hair transplant. However, if you or your surgeon are still unhappy with the results a year or so later, then you can sit down and discuss the potential of a second hair transplant and if you’d be a good candidate for another procedure. This will be determined by:

  • Your scalp’s laxity 
  • The volume of hair available for extraction 
  • The reason for your second transplant


When a hair transplant isn’t recommended 

In some cases, whatever the number or method, a hair transplant won’t be recommended to a patient. Some people who may not be suitable for a hair transplant include:

  • Men under 25 years old - they’re often advised to try oral or topical pharmaceutical treatments for 6-12 months instead of going for surgery. However, there are circumstances where the degree of premature loss permits hair transplant surgery in Men under the age of 25.
  • If there isn’t enough high-quality donor hair available - the results are unlikely to be worthwhile and will be compromised from the start. 
  • When hair loss isn’t sufficient - if you don’t have much hair loss to start with, then surgical intervention will be unnecessary and medicical treatments will be considered the preliminary option.

Every individual is different and something that may not be suitable for one person will be suitable for another, and vice versa. If you’re unsure about whether or not you’re suitable for hair loss treatment, we have an in-depth guide on whether you are the right candidate for a hair transplant that could help you. 


How to avoid extra restoration procedures

Fewer people require multiple hair transplants compared to people who do. As long as they’ve done the research and are sure that they’ve found the best clinic and surgeon for them, the success rate of a hair transplant will be exceptionally high. For peace of mind, there are additional things you can do to avoid extra hair restoration procedures, such as:

  • Using an experienced, specialist surgeon who has the right certifications and qualifications and who you feel comfortable with. The surgeon is key to the best results. 
  • Listening carefully to any instructions given by your physician like prepping for the surgery, how to look after your scalp during the initial healing period and information regarding recovery. 
  • Following a recommended treatment for your kind of hair loss rather than going for a preferred option that may not give you the best results.
  • Attending any follow-up appointments and continuing the ongoing aftercare to prevent baldness around the implanted grafts.  

Finding a hair transplant clinic can be stressful and hard work, especially if you’re not sure what you’re supposed to be looking for. To help you get started, we have put together this guide on the top 10 tips for finding the right hair transplant clinic, so you can find the best place for your specialist procedure. 


Learn more about hair transplants 

If you’re interested in hair loss treatments, then our frequently asked questions on hair transplants should help you understand more about the process. Alternatively, if you have any pressing or specific questions about this subject, please feel free to reach out and contact us or book a free, no-obligation consultation.

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