Failure is not binary
A procedure can technically grow hair yet still be a clinical failure - if the hairline looks artificial, density is uneven, results look good at 30 but unnatural at 45, or the donor zone is visibly depleted with no grafts for correction.

Surgical causes
Incorrect implantation angle
Hair grows at specific angles. Grafts at wrong angles grow outward or sideways. This is a direct function of surgeon skill.
Graft damage during extraction
Over-aggressive punch tools or rushed technicians transect follicles. Transection rates above 5% associate with poor density outcomes.
Poor graft storage
Grafts stored too long or improperly have reduced survival. An infrastructure and protocol issue patients cannot assess pre-surgery.
Design failures
The most common long-term failures are design-based: hairlines set too low, too straight, or without planning for future recession. These emerge over years. See Hair Transplant Turkey | Dr. Arslan Musbeh | How to choose a clinic

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