A: The answer depends upon the patient’s baldness. If they are very bald, the first session will be the most noticeable, since going from no hair to hair is much more dramatic than going from some hair to more hair. In addition, if someone is very bald, the first session is generally the largest, with less hair being transplanted in the second.

The situation is different if someone has had a hair transplant with only a limited amount of hair loss. In this case, the first session may be small (since that is all they need at the time) and the second session, performed after the person has lost additional hair, may be significantly larger.

In addition, while the impact of the first session was lessened by the progression of the person’s hair loss, the second session was superimposed on existing, permanently transplanted hair and may be more dramatic.

A: Generally in a second procedure, a patient can expect less swelling post-up although the reason for this is not known.

There will also generally be less shedding in the second hair transplant session since the weak miniaturized hair that will be shed is often lost in the first session and the previously transplanted hair is generally more resistant to shedding.

In a second session we generally, but not always, transplant fewer numbers of grafts.

If the old scar in incorporated into the new incision, then there will be slightly less hairs per graft since the density in and around the scar will be slightly altered.

For those who are bald, the second hair restoration is sometimes less dramatic than the first since the second is used for fine tuning rather than taking the person from completely bald to having hair.

A: Yes, it is typical for hair in the crown to grow more slowly than the front and top of the scalp and the second procedure generally grows more slowly than the first.

A: This condition is often referred to as pitting and occurs when grafts are placed below the surface of the skin. It is more common with large grafts rather than small ones and is almost never seen in Follicular Unit Transplantation (FUT).

In general, visible holes can result from mini-micrografting hair transplant procedures where the grafts (and thus the recipient sites needed to hold them) are larger than approximately 1.2mm. Recipients sites smaller than 1.2 rarely leave any mark. In follicular unit hair transplant procedures, the grafts will fit into sites smaller than 1.2mm so surface changes are generally not seen (even if the grafts are not placed flush with the skin).

It is difficult to fix the holes directly with the methods you listed as fillers do not fix well defined holes and laser-abrasion and dermabrasion may destroy the surrounding hair.

A properly performed second procedure that places follicular unit grafts in the area should correct the problem.

A: It is possible to lower the hairline with a second hair transplant, but the doctor must be certain that you have enough donor hair so that the transplanted pattern will look natural long-term.

Unless there is some pressing reason that you had to have a second session sooner, I would wait a minimum of 10-12 months between hair restoration procedures so that you can see the full cosmetic impact of the first session.

As a hair transplant matures and thickens, the hairline will look lower as the eye doesn’t see as far into the scalp.