mcr7777

3 hours ago, dobler said:

Hmmm no, for both of your questions.

Ah ok - it might not be frontal fibrosing alopecia in your case but could be any number of other things. Might be worth consulting with a dermatologist hair specialist/considering a biopsy to rule out other conditions.

9 hours ago, Egy said:

I have read that many cases of FFA, (Frontal Fibrosing Alopecia), are often reported right after hair transplant surgery, and is basically, a special form of LPP (lichen planoplilaros)

“Frontal Fibrosing Alopecia is a progressive disease and without effective therapy in its stable form: therefore the interventions must be aimed at safeguarding vital hair, with classic therapies and regenerative therapies of the scalp (PRP, HC, PDRN in primis).”

Yes I've heard this too. I'm actually wondering if people often get hair transplants without realising they have frontal fibrosing alopecia.  And the disease then starts working away at their hairline again.  They just don't realise they have it until afterwards - it might explain some of the cases of losing grafts after 15 months or two years.

9 hours ago, pradeepbr said:

I am taking medication (finasteride and minoxidil). I myself feel that 25% of grafts  have shed. So i agree with your assessment, hair from safe donor is also affected by bald gene to some extent. I plan to do acell or prp every year to maintain the hair, apart from medication.

Do you have any pigmentation/skin discoloration on your forehead - is part of your forehead more pale (usually towards the hariline)? This is a sign of frontal fibrosing alopecia/lichen planopilaris.  Also have your eyebrows thinned over the past 5 years- another sign? 

6 hours ago, dobler said:

Happened to me as well. And also to Wayne Roonie (you can look up for his photos after hair transplant, and now). Had 2900 grafts on frontal third back in 2016. Then follow up to fill crown in 2017 with another 2800 grafts (total 5700, Im NW6).

Results were great, I remember that in 2018 I had a thick full hair and I weren't even thinking about my hair loss anymore, thought I was done with this.

And then suddenly in 2019 (like end of 2019) I started thinning again in my frontal 3rd. 

Now I look almost as same as before the first HT. I don't know why is it.. Maybe FUE is just not as safe as you may think, as many grafts are taken from the nape, or from the thinning parts of the sides, which include hairs that were supposed to miniaturize anyway in the future. That may cause only part of FUE transplanted hairs to survive in the long term.

You can see the related post I had back then: 

 

Can't really see from your photos - but do you have any unusual pigmentation on your forehead (more pale and white at the top of your forehead towards your hairline)?  This is a classic sign of frontal fibrosing alopecia.  Also are your eyebrows thinner now than they were 5 or 7 years ago? Another classic sign. 

I'd definitely recommend getting a biopsy before considering any future transplants.

I have also read stories about scarring alopecias like frontal fibrosing - which can be confused with MPB.     This is where the body's immune system attacks hairs - including implanted hairs (nothing to do with DHT).

Dermatologists say frontal fibrosing diagnosis is increasing rapidly.  It is mainly diagnosed in women but I have read experts think it may be undiagnosed in men due to it looking somehwhat like MPB. 

Wondering if some cases of losing transplanted hairs could be due to frontal fibrosing that hasn't been diagnosed?

Do you have any pics before the surgery?  

Have you noticed any eyebrown thinning?  If yes, you might want to consider if it could be a scarring alopecia like frontal fibrosing (mainly affects women but men get this too- it can easy to misdiagnose as MBP).  I believe these types of alopecias can cause grafts to fall out. Have been reading a lot about it myself recently....

Thanks for these comments - very helpful.

Raphael 84 - it's great advice to have the surgeon see me beforehand - this is what I intend to do. My scalp doesn't show signs of scarring/bad work from the HT but I would like it examined properly. I'm 41 and on fin for 1 year which seems to be working.

Really interesting that you mention scalp condition.  I have been suffering from an intensely itchy scalp on and off (no dandruff) for over a year and half now - maybe longer - well before the first HT.  The itching comes and goes but at times it's felt like burning  and feels very tender  e.g. in the shower when water gets  on it. I had put the itching down to MBP itch or dermatitis.  After researching more, two weeks ago I mentioned it to my my GP and she ordered a test for Tinea Captis (ringworm - which is not actually a worm but a fungal infection).  She said the actual results may take a few weeks and in the meantime prescribed me Betascalp steroid drops (bethamesanone) and the itchiness has stopped and it's not tender and inflamed anymore.  Strangely, my hair loss accelerated significantly around the time the itching condition got bad  a couple of years ago.  In retrospect I wish I'd researched the condition (and clinics!) before the HT - I was in too much of a rush at the time.

Nevertheless I'm still thinking my disappointing result is mainly down to the clinic using too few many grafts in my case.  However, there is also a nagging doubt now about my scalp condition and whether that could have interfered at all.

I'm thinking of getting a full biopsy before my next surgery just to rule out any scalp condition.

I've also read about scarring alopecia (lichen planopilaris) and seen some horrible results with HT.  I'm pretty sure I don't have scarring alopecia but the tinea captis would explain a lot. 

Really interested if anyone else has any experience with  intense itching/burning scalp and tinea captis out of curiousity?  I haven't seen it mentioned much on these boards.

I'm considering a 2nd HT to add density to the front where I feel the first HT is lacking somewhat in sdensity.

Is DHI or pre-made slits a better/safer to minimise shockloss and transection risk? 

I think I've read DHI is better - but grateful for views on this.

On 11/1/2020 at 11:34 PM, JohnBob said:

Yea, very strange. What would have caused that?

But note that on the 12th day his implanted hairs were looking pretty good already: https://foro.recuperarelpelo.com/viewtopic.php?f=16&t=78822&start=30

 

It appears the patient was diagnosed with scarring alopecia (autoimmune disease)....

see here :

https://foro.recuperarelpelo.com/viewtopic.php?f=16&t=78822&start=615

 

Yes Unbald Eagle - I think too few grafts were used on both of us. Not really wanting to lower my hairline - so curious as to whether doctors would place grafts just in front of the hairline and not really lower it or just transplant in between hairs.  Temple points would need to be strengthened. I'm most worried about them placing grafts in between existing hair as I don't want transection.

I have heard shaving the recipient area is best and some docs mandate this. Although really not looking forward to that (I didn't have to shave completely last time).

Thanks Melvin - yes I think it will need more grafts to get me happy.  Shaving the recipient area and shockloss will be the hardest part.... Dr. Reddy seems solid but I understand he is booked well into next year. I'm looking at options in Europe (not Turkey though).

photos before ht attached. Yes I think not enough grafts were placed.  Another clinic has quoted 1200-1500 grafts to create a dense result.  
 

But I am concerned about losing existing hairs due to permanent shock loss. Has anyone had experience of adding density in between existing hairs? Success or otherwise? 
 

I am waiting for a face to face consultation with the uk clinic so don’t want to name them until that has happened. 

The HT was at a UK clinic (not recommended on this site). I had 1200 grafts implanted into the area as shown in the first photo.  I think a big part of the problem is not enough grafts were planted.  However, I'm concerned about shock loss and permanent shock loss to existing grafts and looking worse if I go for a 2nd HT.

On fin for 1 year and seems to be working.

Photos attached. First one of showing the day after my HT.  

Others are showing the result after nearly 10 months under harsh lighting - i have tried to highlight the issue rather than hide it away for the purposes of this post. 
 

when my hair is arranged properly the gaps in density can sometimes be relatively hidden or harder to spot - as in the final photo taken outside with no product.  Essentially my native hair can help hide the problem. But under harsh lighting it is nearly impossible to hide. 

any advice from people who have had a 2nd transplant to add density in the front -  and if it helped or not - would be especially helpful to hear.

Hi Seb1928 - is there any update on how your 2nd hair transplant is progressing? I am considering getting a 2nd hair transplant to add density. I am concerned about shock loss- especially permanent of grafts from the 1st transplant.

Have your shock loss grafts recovered? How are you feeling about the 2nd procedure?  

Has anyone had any success or failure with a second HT to add density?  Mine is the frontal area - temples and forelock. I am concerned about permanent shock loss of hairs transplanted in the first HT. 

?  Did you have shock loss of hairs from the first HT or not?  Did shock loss hairs grow back?   Interested if people are satisfied with the result - or has it barely improved or made things worse?  

There seem to be few examples of these cases on the forums (although seem to be plenty of examples where people are unhappy with density after the first HT!)
My background:
First HT was in January 2020 of just under 1200 FUE grafts to fill in temples and at front. I'm convinced not enough grafts were planted - result is see through in many lighting conditions unless I keep my native hair longer to cover.

I have been quoted 1200-1500 grafts by another doctor to add density.  

Also considering FUT after my first FUE although don't know if it would be worth it for 1200 additional grafts.

Thanks for any advice.