Before Hair Transplant Frequently Asked Questions
Will I have to take any medication for life after hair transplant surgery?
No, it is not necessary to take any medication after hair transplant because transplanted hair is permanent. However, if you still have active hair loss, the doctor may recommend anti hair loss remedies like Minoxidil, Rogaine, Propecia or Low level Laser Therapy to help maintain your existing hair.
Will I need a second hair transplant in future?
This entirely depends on your rate of hair loss, stability of your hair loss and the available donor hair after the first hair transplant.
Is transplanted hair permanent?
Yes it is. The transplanted hair will permanently grow for life.
Will the results look natural?
Yes, Dr. Civas designs a solution that goes well with your face and looks natural; this includes position and shape of the hairline, density as well as the graft selection. It will be difficult for anyone to tell that you had a hair transplant. Check our results on the hair transplant results page
How much does the surgery cost?
The cost of the surgery is 1.5€ per graft. The total cost depends on the number of grafts transplanted. More information on the hair transplant cost page.
Are there any discounts?
Sometimes we offer discount in summer. To find out more about discount, visit the hair transplant discount page.
Will there be permanent scars after FUE?
FUE has very tiny scars that are not visible within existing hair. You can only notice the tiny dots on the donor area if you shave your hair to level 0.
Can I speak to some of your former patients to learn about their experience?
Our reviews are all over the internet and you can see some of them on our hair transplant reviews page. Yes on request, we can give you contacts of some patients who agree to be contacted.
How are the extracted grafts selected and transplanted?
Grafts are selected by the number of hairs per graft. A few hundreds of 1Follicular Unit (FUs) grafts are implanted on the front part of the hairline, behind the hairline 2s FUs are implanted and on the frontal hair to the crown 3s and 4s FUs are implanted. This gives a natural soft hairline and dense look. For more info, look at the hair transplant procedure page
From what countries do your patients come from?
Our patients come from all over the world. Most of our patients come from Europe (UK, Germany, Finland, Norway, Sweden, France, Italy, Spain, Portugal, Malta, Romania), USA, Canada, South America, Australia, Middle East and China.
Do you do hair transplant for women?
Yes, 10% of our patients are women. Most women come for hairline lowering and re-design and also female pattern hair loss patients. For more information, take a look at hair transplant for women page. We also do eyebrow hair transplant for women and men.
Do you do hair transplant for African hair type or curly hair?
Yes we do hair transplant for African type hair and curly hair. Even though extraction of grafts by FUE is difficult, our team has experience and have successfully carried out FUE hair transplant for African patients. Take a look at afro-type hair transplant page
Do you have an English, French, Spanish, Arabic, Russian speaking staff in the clinic?
Yes we have foreign employees in the clinic who speak native English and Russian, we can also organize for French, Spanish and Arabic Translators.
How many months in advance are you booked out?
We are booked out 3-4 months in advance. You have to book your surgery as early as possible. For consultation, fill in the form in the hair transplant consultation page and indicate when you want to come for the hair transplant procedure.
The Hair Transplant Procedure Frequently Asked Questions
Does Dr. Civas do the surgery?
Yes, he will do the surgery together with a team of 3 other people, 2 leading hair transplant specialists (university graduate trained nurses), and 1 other medical assistant; all fully trained and specialized for hair transplant. Dr. Civas has worked with the same team since 1999. He has 19 years experience; the lead technicians both have 19 years experience while the other assistant has 8 years experience in hair transplantation. Each team member has specialized in their specific roles. Dr Civas is in charge of design and implantation, the lead technicians do both extraction and implantation, while the medical assistant does graft sorting and counting.
Are there any complications that can occur in the surgery?
Hair Transplant is a dermatological surgery that rarely has any complications. The only thing that can make the surgery difficult is over bleeding, tight skin and hard skin which only affect the duration of the surgery but not the results.
Is the procedure painful?
No the surgery is not painful. On a scale of 1-10 the pain level is 2 at most. Only the first few anesthesia injections are uncomfortable. More hair transplant procedure
What hair transplant method do you use?
Is the extraction manual, motorized or robotic?
Grafts are extracted manually, by micro motor or combined. More hair transplant procedure
What size of punches do you use?
We use 0.6mm, 0.8mm and 1mm punches depending on the size of graft being extracted. More hair transplant procedure
Do you implant the grafts immediately after extraction?
Extraction takes place in the morning and implantation is done in the afternoon.
What solution do you use to store the grafts?
Grafts are placed in special tissue (organ) transplant solution that keeps the grafts alive and healthy.
Do you implant long hair?
The donor hair has to be shaved in order to extract the grafts. The recipient area can be shaved or unshaven.
Do you do unshaven hair transplant?
Yes we do unshaven hair transplant. For more information, check unshaven hair transplant procedure.
What is the maximum density you can transplant?
In the front area and hairline, the density varies from 60-80 grafts per cm squared, which looks like natural hair density.
What is the maximum number of grafts you can transplant in one session?
The maximum grafts we can transplant in one session is 4000 grafts. An average session takes 3200-3600 grafts. To learn how many grafts can be implanted, fill in the hair transplant consultation form and attach pictures
Do you do 2 sessions in 2 days
No we do not do 2 consecutive sessions on one patient because big sessions can have adverse effect on the patient like poor slow healing, over harvesting of grafts hence visible scars and poor graft survival. Its best to do an average session then the patient can come 1 year later to do a second session.
Can you take grafts from the beard, chest or armpits?
No we do not transplant grafts from body hair because the results do not look natural. Body hair has different characteristics from scalp hair with regards to length, growth rate, thickness, color and degree of curliness. Body hair does not grow as long as scalp hair. So a mix of both hairs will not look natural. Secondly very few grafts can be extracted from the body and have poor graft survival on the scalp. So we risk scarring your body for not much value.
How many hair transplant patients do you take in one day?
We take only one hair transplant per day.
I would like 5000 grafts to be transplanted, is it possible?
Big sessions can have adverse effect on the patient like poor slow healing, over harvesting of grafts hence visible scars and poor graft survival. We advise patients who need a second session to do it 1 year after the first session. To learn how many grafts can be implanted, fill in the hair transplant consultation form and attach pictures
After Hair Transplant Frequently Asked Questions
What after care is needed after hair transplant?
- Do not hit or scratch your hair for 2 weeks after hair transplant
- Do not smoke or drink the first 1 week after surgery
- Wash your scalp once a day and apply the given antibiotic medication.
- Spray on the recipient area frequently for 1 week after the surgery
- Avoid heavy sports, swimming and sauna for 3 weeks after hair transplant
- Avoid directly exposing the transplanted area to the sun for long hours during the first 3 months after surgery. Wear a cap whenever you go outside in the sun.
- Do not use any styling hair products or dye for 3 weeks after hair transplant.
When can I do heavy sports after hair transplant?
When can I go for swimming and sauna after hair transplant?
When can I shave my hair after hair transplant?
When can I dye my hair after hair transplant?
When can I stay in the sun for long without wearing a cap?
When do the crusts/scabs start coming out?
When can I start drinking alcohol or smoke?
When can I have sex after hair transplant?
When is the best time to go back to work after hair transplant?
You can go back to work after 1 week- 2 weeks after surgery
When does the transplanted hair begin to grow?
2-3 months after the surgery.
When can I see the final results of the hair transplant?
How will the donor hair look after FUE hair transplant?
When the donor area heals, it looks normal, almost like before, as if grafts were not extracted from there.
How much donor hair will remain after hair transplant?
In one session a maximum of 30% of the donor hair can be extracted. So you are left with sufficient hair density at the donor area.
Does the transplanted hair grow naturally?
Yes, the transplanted hair grows back normally. You can keep it long or short or style or dye it however you want.
My forehead and under the eyes is swollen a few days after the hair transplant, is that normal?
Yes it is normal to swell within the first week after hair transplant. Apply ice pack whenever you have a chance to reduce the swelling. Swelling reduces within 3 days.
My donor area feels painful and sore, is that normal?
Yes, as the donor area heals, it may feel painful and sore. If the pain is unbearable, you can take painkillers.
My donor area feels itchy, is that normal?
Yes, the donor area may feel itchy during the first months after hair transplant. You can take antihistamine pills to help against the itchiness.
I still have redness a few months after the hair transplant, is that normal?
Yes redness gradually fades within the first 3 months.
I have lost all my transplanted hair, is that normal?
Yes within 1-2 months after the hair transplant, the transplanted hair sheds off before new hair starts to grow. No need to worry, the hair will grow back.
I have pimples on my scalp after hair transplant. Is that normal?
Yes, this is a result of ingrown hair. You will be provided with medication to heal the ingrown pimples.
The recipient area is dry and has dandruffs, is this normal?
Yes it is normal to have dry flaky skin after the crusts come out. Use Nizoral shampoo 2 times week.
My recipient area is numb a few months after the hair transplant, is that normal?
Yes, you will regain sensitivity gradually 1-3 months after the surgery.
Are there any risks of hair transplant surgery?
There are no risks of hair transplant
What are the side effects of hair transplant?
There are temporary effects related to healing like shock loss, itchiness, dry scalp, numbness that disappear within the first 3 months.
How long does the surgery take to heal?
It takes 1 week for the crusts to dry and fall out, 2 weeks for the scalp to be clear of traces of the surgery except redness.
Have you had any unsuccessful hair transplants or bad results?
There is no chance to have bad results for healthy patients. Only patients with alopecia related skin conditions that can have poor graft survival.
After about 8 months post op, I am experiencing a lot of hair shedding, what can I do?
Experiencing massive hair shedding within the 8-12 months after hair transplant is normal. Hair growth has phases growth phase, dormant phase and shedding phase. After hair transplant, synchronization during growth and shedding phases can cause a massive hair shedding to occur. The hair grows back after 3 months latest. Transplanted hair is permanent for life and cannot be lost unless you develop alopecia related skin infection. In the mean time you can use Minoxidil/Rogaine or a laser cap to prevent further shedding. It will also be advantageous for you to take multi-vitamins for a few months.
When can I come for a second hair transplant?
1 year after the first surgery
How does hair transplant really work? What is Hair Transplant?
The basic concept is permanently transferring hair follicles that are genetically unsusceptible for hair loss to the balding areas. Androgenetic hair loss occurs in a specific pattern, so there are areas where hair loss will occur and areas where hair growth is permanent. Most men lose their hair from the hairline, temples and crown area while the back and the sides remain stable. So during hair transplant, follicles are taken from the back and the sides (donor area), and transplanted to the bald areas on the hairline, frontal, temples and vertex areas (recipient areas). The transplanted hair is permanent for life.
The 2 main techniques used to obtain the follicles (grafts) from the donor area are FUT strip technique (Follicular Unit Transplant) and FUE (Follicular Unit Extraction). In FUT, grafts are taken from a thin strip of skin extracted from the scalp at the donor area. The surgeon has to cut out a strip of scalp skin at the back; dissect grafts from the thin strip; then implant the grafts on the recipient area. In FUE, grafts are extracted one by one from the donor area using special instruments. FUT leaves a visible thin linear scar on the donor area. FUE leaves tiny round scars that are almost invisible. Both methods are equally effective.
The procedure is safe with no major risks or side effects; the patient heals quickly within 1-2 weeks after the surgery and can even resume his duties 3 days after the procedure. The transplanted hair then begins to grow about 3 months after the surgery. By 6 months, the patient has good coverage. Full results can be seen 1 year after the surgery.
Hair transplant is suitable for patients with good quality donor hair that can potentially fill up the whole or a big part of the bald area. Hair transplant can also be done on scarred scalp, beard and eyebrow areas. Even bikini hair transplant is becoming a normal thing
Are hair transplants worth it?
Do you feel uncomfortable with your baldness? Is it bothering you? Have you lost confidence in yourself? Do you wish you could do anything to change it? Do you look older than your age mates because of baldness and it upsets you?
If your answers to these questions is ‘yes’, and you have quality donor hair with a considerably sized bald area, then hair transplant is worth it. If you are a suitable candidate for hair transplant, you should definitely go for it. Why, because with hair transplant, you will regain:
- A natural hairline
- Thicker hair density in the thinning areas
- Good volume and coverage of the bald areas
- A much more youthful look
- Psychological boost that will make you feel more confident
- A more well defined facial frame that will make you more attractive
In some careers, having hair is very important. People who have to constantly interact with the public, whose public image is very important, are the most affected when they experience hair loss. For instance, actors, footballers, musicians need to maintain a physically attractive look, so hair transplant would be highly advisable. Additionally, people who directly interact with customers, their appearance highly affects their performance; for instance bankers, real estate agents, customer care and sales professionals. Hair transplant is highly recommended in such cases.
What is the most suitable season for hair transplant?
You can do hair transplant in any season. However you must note that exposing the transplanted area directly to the sun for long hours can have adverse effects on your healing and graft survival. For this reason, it is advised to wear a cap and use sun screen whenever you stay in the sun for long hours. This should be applied also in spring and summer. In winter there is nothing much to worry about with regards to the sun. For aesthetic reasons, if you do not want your freshly transplanted hair to be noticeable in the early stages, winter is better for you because you can easily wear beanies and hats without question from outsiders.
What is a suitable price for hair transplantation?
This is a question whose answer varies from country to country. It depends on the tax requirements on medical procedures and the cost of living in that country. So, there can never be a flat rate of hair transplant that applies in all countries all over the world. However we can do a country to country average rate. The leading destination for hair transplant in the world is Turkey. In Turkey you can get a good hair transplant on the price of 1–3€ per graft. This is why there are so many international patients that travel to Turkey for hair transplant. It is common to see many bandaged heads on the streets of Istanbul and in the airport. Last year there was an average of 300–500 patients coming to Turkey for medical tourism, despite the political instability.
However, you need to be very conscious of the choices you make. In Turkey, there are so many options with a wide range of prices. In Istanbul you may find an offer of 1500€ for 5000 grafts. This is too good to be true, don’t be fooled by price alone. Make sure you do a good research of the doctor who will do your surgery before you accept any crazy discount offers. In many cases quality and price go hand in hand. If someone offers you a price that is way below this range, think twice. Below is the hair transplant price per graft range in various cities:
- Istanbul 1€-3€
- Ankara 1€-3€
- New York 5$ – 15$
- Los Angeles 5$ – 15$
- Washington DC 5$ – 10$
- Florida 5$ – 10$
- Vancouver 5$ – 10$
- Toronto 5$ – 8$
- Sidney 5$ -12$
- London 5£ – 10£
- Paris 5€ -10€
- Brussels 5€ -10€
What age is most suitable for a hair transplant surgery?
For genetic reasons, people start losing hair at varying ages. So the most suitable age varies from person to person. Generally Androgenetic hair loss can start from as early as 16 years to as late as 35. The most suitable age for a person to have a hair transplant is when their hair loss has stabilized; this is the age when you notice that you no longer have active hair loss, and that your balding pattern is evident. Once hair loss is mature, the doctor can plan your hair transplant in a way that naturally covers a good percentage of the bald area. The main disadvantage of doing a hair transplant early is that years after getting that good coverage from the first hair transplant, you keep losing your original hair the un-transplanted areas. This creates an island of regions of high and low density on your scalp; so you have to keep updating your hair transplant to cover the newly balding areas. But what if you no longer have sufficient donor hair? Then you won’t stand a chance…
Are hair transplants reliable?
Yes, if hair transplant is done by a qualified and experienced practitioner, then it is reliable. In my experience it is possible to get 99% graft survival. It all depends on how well the surgery is done and how well patient takes care of the transplanted area after the surgery. Very good natural looking results can be obtained from a hair transplant and there is evidence for that all over the internet. The transplanted hair grows on for life and can be cut, styled and dyed just like your original hair. The downtime of doing a hair transplant takes only a few weeks then you will almost never have to worry about your hair; however the downtime of solutions like wigs, toupees, wearing hats, hair fibers is much more. Take a look at some of our before and after photos.
What is hair transplant? Is hair transplant possible?
Hair transplant is a scalp dermatological surgery where hair follicles are transferred from a stable region to a bald region. Transplanted hairs then permanently grow on the transplanted area. Currently, there is no technology available to regenerate miniaturized follicles. There are some treatments that can postpone or prevent hair loss, but they are not permanent solutions; for instance use of Minoxidil, finasteride, lasercap and PRP. So hair transplant is the only permanent solution to baldness.
Can patients with alopecia areata have hair transplant?
Alopecia areata is an autoimmune disorder where the immune system attacks and causes damage to the hair follicles. White blood cells normally attack the hair follicles, shrinking them hence slowing down hair production. Varieties of alopecia areata are Alopecia Areata; patchy hair loss on the scalp, Alopecia Totalis; loss of all hair on the scalp and Alopecia Universalis; total loss of body hair. Since the damage to the follicles is not permanent, the disease causes a repeated cycle of hair growth and shedding as the hair usually grows back after a few months; but eventually falls off again. The symptoms can be thin hair, smooth round bald patches or short stubs of hair. In some cases permanent hair loss occurs.
Physical examination such as pull test and microscopic analysis; as well as blood tests are necessary for diagnosis. Medical and family history should also be examined. Treatment can be done by injecting corticosteroids into the scalp, applying Anthralin and contact immunotherapy with Diphencyprone (DPCP). Use of minoxidil can also be an added advantage to improve the hair regrowth.
Long term follow up of an eyebrow transplant patient suffering from alopecia areata was done. In the initial stages, both his transplanted eyebrows and his original eyebrows re-grew; causing a cosmetic problem of double eyebrows. In the later stages, the disease re-activated and the patient lost both his original and the transplanted eyebrows; taking us back to where we started from. For this reason we conclude/believe/think that hair transplantation is not a suitable treatment option for alopecia Areata patients.
Hair transplant for alopecia areata?
An experiment was done with a patient with alopecia areata with hair loss on the eyebrows. The patient was followed up for a few years to determine the progress of the treatment. In the initial stages, both his transplanted eyebrows and his original eyebrows re-grew; causing a cosmetic problem of double eyebrows. In the later stages, the disease re-activated and the patient lost both his original and the transplanted eyebrows.
Alopecia areata is an unpredictable disease. After hair transplantation for therapy resistant alopecia areata of eyeborows original eyebrows can re-grow and can cause cosmetic problem of double eyebrow appearance. Long term follow up of the patient disclosed the loss of transplanted and original eyebrows leading us to the starting point. Therefore, hair transplantation is not a suitable treatment option for alopecia areata.
Can patients with Trichotilomania have hair transplant?
Trichotillomania is a mental disorder where patients feel a strong urge and eventually pull out their own hair, resulting in permanent hair loss. The main symptom is the patient constantly pulls out their own hair from the scalp, body and facial hair. The urge to pull the hair is irresistible; in the end they feel relieved after they have pulled it out. It can be noticed by patchy and thinning hair loss on some parts of the scalp, eyebrows and other body parts. The causes are still unknown but it may be linked to psychological, genetic and environmental factors. Stress and tension often aggravate the disorder. Trichotillomania can be reversed by psychotherapy, medication and training. If the disorder is treated earlier before the follicles are permanently damaged the hair can re-grow back. Hair transplant is a possible treatment and can only be effective if the disorder is under control. The patient must no longer be having the urge to pull out his hair for at least 1 year and his scalp must not be severely damaged. The presence of scars may result in poor graft survival. The patient should have sufficient and healthy donor hair and should be medically and psychologically healthy. The main risk lies in the possibility that the patients may eventually pull out the transplanted hair.
Women who had the bikini and armpits hair waxed or permanently removed by laser are now doing bikini hair transplant to bring back the natural bush. The trend is common in the UK and Korea. In the 80s and 90s having pubic hair under the arms and bikini area was frowned upon; however, things are changing as women have begun to embrace their natural pubic hair. Celebrities like Miley Cyrus are openly showing pride in their bushy pubic hair. In S. Korea, pubic hair is considered a sexual strength and attraction signifying fertility and health. In bath houses in Korea, women without pubic hair are looked down upon. The S. Korean women… more about bikini hair transplant
Im a 25 year old male. I ve been losing my hair since the past 2 years and can also see the usual bald pattern showing more and more. I would like to enquire about how many grafts could be transplanted. Please see attached my picture showing current hair loss.
From your photos and also your age, the hair loss you have experienced right now is still at early stages as you have not lost a lot of hair. Your hair is still dense and there is no sufficient baldness to qualify for a hair transplant. You are going to experience more hair loss in future and after about 5 years you may need a hair transplant. If we use your donor hair now on your crown, you may not have enough donor hair for your hair line in the future. The best thing to do now is to wait for your hair loss to advance further; around 3 years, monitor the hair loss level and if it is more advanced, then we can do a hair transplant.
Since hair transplant surgery is done under local anesthesia, it is not painful at all. The first two injections might be slightly uncomfortable but not unbearable. The second day after surgery, there might be some discomfort or pain that fades away gradually in a few days as the donor area heals. In the first washing after bandage removal, there is some slight sting on the donor area as the tiny wounds are still open. However when you wash the second time, there won’t be any pain.
Hair transplant is basically a dermatological operation that does not affect any major body organs; this makes it safer than other invasive surgeries. But like other surgeries, there can be a slight risk, especially if the patient has bleeding problems. To prevent any risk you need to observe the following before the surgery:
- Do not take aspirin one week to the operation
- Do not take antidepressants and blood thinner pills one week to the operation
- Do not smoke one week after the operation
- Do not take any alcohol 3 days to the operation
- Do not take multivitamins or herbal medication 1 week to the operation
There are no permanent side effects of hair transplant. However, there are some temporary effects of the surgery that gradually fade away after surgery. The most commonly experienced are:
- Swelling of the face and under the eyes:-This happens in about 10-30% of the patients. It lasts about 3-5 days after the surgery. It can be reduced by applying ice bag on the forehead for the first 3 days after surgery. Additionally, you need to sleep facing upwards for the first 5 days after surgery.
- Pain and itchiness in the donor area:- Some patients experience pain or discomfort in the donor area 1-2 week after surgery. You can take pain killers as prescribed by the doctor. For itchiness, you can take antihistamine tablets as prescribed by your doctor.
- Drying crusts:-Crusts form on the recipient area during the first week after the operation. These crusts easily fall out by themselves with time. However you can soften them by applying olive oil in the area, and washing the hair after about half an hour.
- Dryness of the recipient area:– Your doctor can prescribe a moisturizing spray which you can use to keep the recipient area moisturized.
- Redness of the recipient area:– As the recipient area heals, it turns red and gradually goes back to its original color within the first 1-2 months.
- Shock loss:– 1-2 months after the hair transplant surgery, you will lose your transplanted hair and probably some of your existing hair. Due to the stress from the surgery, your hair goes into the resting (telogen) phase. Telogen effluvium is when stress causes hair follicles to prematurely go into the resting phase.This is definitely not permanent. Hair starts growing back 2-3 months after surgery.
- Ingrown hair:– When new hair starts growing after 2-3 months, patients observe tiny red pimple like bumps forming on the scalp. This is a result of dead skin clogging the hair follicle, thus the hair is forced to grow inwards under the skin causing the Ingrown hairs in some patients can be itchy and uncomfortable. Your doctor should prescribe some medication to treat this.
- Allergic reaction to Minoxidil or Rogaine:– Skin rash and itching may occur in some patients. If this occurs, you should stop using the medication and observe if there any changes.
Yes. Transplanted hairs grow. If the patient observes care during the post surgery period, almost all the transplanted hair will grow. Factors that may hinder growth of new hair are:
- Hitting or scratching the transplanted hair the first few days after hair transplant
- Wearing tight head gear after the surgery may pull out the grafts
- Drinking alcohol or smoking too much a few days after the surgery
- Exposing the sensitive recipient area to the sun
Any lose cap or hat would do. Do not wear anything tight on your head after hair surgery.
Yes at Civas Hair Transplant Center, we have at least one hair transplant repair in a month. Some of the procedures we perform during repair are:
- Correction of an unnatural hairline
- Extraction of grafts that were transplanted too low on the forehead
- Redistribution of unevenly placed grafts
- Increasing the density of the frontal and crown area
- Improving the density of the hairline
- Revision of the FUT scar
- Correction of the old punch grafts pluggy look
Hair transplant prices vary with different surgeons and in different regions too. The prices in most cases are charged per graft, however some centers charge standard prices on some range of number of grafts. The cost of hair transplant in USA may range from 3-15$ per graft, while the prices in Europe range from 2-10€ per graft and in the UK up to 15£ per graft. Hair surgery in Turkey ranges from 1500-6000€ per surgery depending on the center. Many hair transplant clinics in Istanbul and other cities in Turkey charge very cheaply, but the quality of the surgery could be questionable. In our clinic, we charge 1.5€ per graft standard price, however we have some offers especially in summer where the cost can be as low as 1.2€ per graft. You need to fill in the consultation form including your pictures, to find out the estimated cost of your surgery.
Yes we do. Hair transplant for afro hair patients can be challenging as the follicles are curved. This poses a difficulty in extraction. In many cases, we may not be able to harvest as many grafts as the straight hair patients in one session. African patients may need to come for a second surgery because of this.