Those of us w/ diffuse thinning often wonder is it worth having the procedure done considering the risk's of permanant shock loss and the chance of a 0 sum gain? what are the %'s of this type of thing happening? Obviously I would welcome all opinions and not just the doc's!

Thanks for asking this. I asked this too and I'm hoping to see some professional opinions from the surgeons on this board.

I'm a diffuse thinner and had a very pleasant experience with a doctor from this website. I had 2000 grafts done in a narrow strip from the front of my scalp to the back. Most of the grafts were placed near the front. It's been 10 months since the operation and I'm thrilled with the results. The doctor that did my operation shaves the recipient site. I'm also on finasteride , rogaine foam 2x/day and use the lasercomb 4x/week. If you have any questions email me at walkerg11@hotmail.com

dakota,

Great question.

In my opinion, diffuse hair thinners are some of the BEST hair transplant candidates simply because they are most likely "one and done" procedures assuming hair loss has been controlled with medication.

Keep in mind that the risk of permanent shock loss only exists for native hair that is currently in a weakened state due to hair miniaturization (or if the native hair follicles are transected, but this is rare in the hands of a qualified surgeon). This means that this hair would have eventually fallen out and leave you bald anyway. Temporary shock may occur due to scalp trauma but will return.

In my opinion, there is a very low risk of a diffuse hair thinning only acquiring a 0% gain. But the good news is, even if it does happen, at least susceptible hair has been replaced by permanent hair and subsequent surgeries can add density. After all, most patients go for multiple surgeries before they are complete anyway.

Best wishes,

Bill

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Thanks Bill!

Bill,
I was under the impression that after several years the effects of Propecia wore off and eventually I would lose it all anyway. So the 1 and done idea while sounding wonderful may not necessarily be true right?

Bill: Thanks for your response.

Would you also be able to direct some surgeons to provide their professional medical opinion on this important question?

Thanks,

CG.

great question!

I am a diffuse thinner & have always been confused whether or not to go under the knife! The reason being shock loss. I dont want to end up looking worse than what I was before surgery.

Although I have decided to go with H&W I still am very confused whether to go ahead or not.

The problem is with the native hair. Unlike the normal MPB pattern I do have a lot of native hair which I don wanna lose due to surgery!

On the bright side as Bill said diffuse thinners make excellent candidates! going by what I have seen on this forum & my personal case I dont think my scalp would need tooo many grafts to make a significant cosmetic difference. Even lesser number of grafts placed fairly widely apart would give me very nice coverage ( assuming my native hair does stay after surgery). This hope makes me take the necessary steps towards scheduling my surgery but again! the killer called shockloss!

Everyones goal is different and the experience of the Doc is vital to know what's in the best interest of that individual patient depending on ALL his/her particular factors. Placement is key and appropriate density its key - Shock loss is attributed to trauma and poor placement - In the right hands the patient will only benefit from a session into a diffuse area as long as the Doc performing it knows how to benefit that patient and has his/her best interest at heart - many do not and want a fast buck$$$$$ or ????????????.

Its artistry, precision, experience, planning, strength of native hair, meds involved, stabilised pattern, continuing pattern etc etc etc etc etc etc etc .NO 2 people are the same, different loss pattern, donor supply, goals, age, existing hair, strength of hair etc etec etec etc etc etc etc ........



All the variables are processed by the doc and discussed with that INDIVIDUAL on the day of surgery or at the point of a consultation - and a potential plan of action in the best interest of the patient will be discussed , agreed upon, or not.



Shockloss is something that can be experienced when transplanting into existing hair although highly unpredictable. Shockloss occurs when the native hair is weak and isn't strong enough to resist the trauma thats going on around it. More often than not the hair that has gone into shock will grow back but after 3/4 months - after the resting phase
Hair that goes into shock and doesn't return is hair that was inevitably on its way out anyway and wasn't strong enough to return.
Increased trauma to a localised area will increase the chances of shockloss
Shockloss is unpredictable and there is no hard and fast rule to avoiding it - especially if you are transplanting into existing hair.

There are risk factors that either heighten or lessen someone's risk. Diffuse thinners seem more prone to shockloss than receders because the hair in a diffuse area is often less stable than that of a receder. Very often, a lot of the hair in a diffuse area is "on its last legs" and in the latter stages of the miniaturization process.

Hope this helps

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SPEX

Consultant for Dr. Feller, Coalition Member and Dr. Lindsey, Coalition Member.

I am not a medical professional and my words should not be taken as medical advice. All opinions and views shared are my own. "Research-Research-Research"

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The term, "diffuse thinner," can refer to two different types of patients.
One group - and the more common one referred to this way - is the man with homogenous thinning throughout the typical male pattern baldness area on top (horseshoe-shaped), in whom there is some degree of miniaturization going on with some of the follicles/hairs, allowing someone to see the scalp through the hair.
The second group are those who have the acronym diagnosis, D.U.P.A. - which stands for "diffuse unpatterned alopecia. These men, though usually much thinner on top, also have diffuse miniaturization throughout the donor area also. Many of these men present for transplantation in their 20's and it is difficult to tell them they are NOT candidates for hair transplantation. If you look around in a crowd of older men, you can spot some of these. They have hardly any hair on their head anywhere. It is a somewhat rare diagnosis fortunately. The reasons for not transplanting them are twofold: One, the "donor" hair is of uncertain quality and will not last that many years in all likelihood. Second, because the sides and back are thinnish, a donor scar would easily be seen and would draw attention to itself. Basically, a surgeon is raising false hopes and stealing the patient's money in such situations.
With the more commonly described "diffuse thinning" patient, in whom there is an equal degree of thinning throughout the top, the patient certainly should be told that he will eventually lose all the hair contained within that area, unless he is in his 50's or 60's at the time of examination. Even medication, such as finasteride and minoxidil, will not prevent it from eventually being lost. It may delay that day by 10 years though. If they are transplanted, the advantage for the patient is that the hairs that remain on top help serve as camouflage while the patient is recuperating and healing those first couple of weeks and makes the whole process more undetectable. It certainly is possible that some of those more vulnerable, miniaturized hairs will be "shocked" and possibly lost forever; but it's a minor point, since only 4-5 months later the new transplanted hair will be gradually growing and dominating the area on top.
I will try and attach a photo of a young DUPA patient, confirmed with 30x power magnification exam of the scalp showing a significant percentage of miniaturized hairs.
Mike Beehner, M.D.

Photo showing Diffuse Unpatterned Alopecia attached.
Mike Beehner, M.D.

Attached Images

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