losing transplanted hair

[johnny 05]

2 1/2 years after HT(choi in ATHENS)start losing transplanted hair. I have found dr.FELLER`S answer to someone that`s happen but dont know why. If that`s true why all surgeons claims that transplanted hair stay for life. Is there anyone with same problem?

[Arrie]

What was Dr. Fellers answer? I really hope this isn't the norm. Could it be possible the doctor who did this procedure went outside of the "safe zone"?? I hope what I paid for stays for life...

[Dr. Alan Feller]

Fortunately most HT hair does in fact stay for "life". However, there is a small percentage of the population that continues to lose hair in the donor area as they progress in age. It then stands to reason that such people will lose the hair when it's transplanted. Fortunately this is not common.

 

Another rare varient are patients who've had a successful HT procedure and enjoyed a couple of years of thick growth. Then seemingly out of no where the transplanted hair begins to thin. This has happened with at least 2 of my pateints in the past that I know of. In this case the best treatment is to implant more hair to make up for the volume difference.

 

One of my patients who posts on the forums by the name of Dai Vernon was an excellent example of this phenomenon. We did 2 procedures on him that looked excellent for almost 3 years. Then, the HT hair miniturized or thinned out. The way we treated it was by packing in more hair between the existing HT hairs. That did the trick and his final result was excellent. I'll dig up the links to his photos and post here later today.

[Arrie]

Thanks for the reply doc, am a big fan of your work. Being how busy you are with your professional life, how do you stay so active in this online community, kudos?.?. One more thing you don't have to answer, in your patient with the loss of his HT hair, since its a rare phenomenon did you charge the pt for the additional surgeries? Sorry one more and does this phenomenon with the transplanted hair usually happen from the donor hair on the sides or does that not matter? Once again you don't have to answer the $ question but I was just curious.

[Dr. Alan Feller]

Here is a link to another thread that shows Dai Vernon before and after:

 

http://hair-restoration-info.com/eve/forums/a/tpc/f/346...121019863#7121019863

 

Thanks for the kudos. It doesn't take much to be active on the forums. I tune in whenever I get a few minutes and keep up on what's going on. At first it's hard, but once you get into a routine it's no more of an effort than brushing your teeth-you just do it without thinking.

 

All variations of miniturization are possible throughout the donor area and that includes a signficiant differential between sides and back. No doubt about it.

 

Of course I will answer your question as to whether or not I would charge for more HT work should a patient fall into this catagory, and the answer is yes. I think any surgeon with a heart will offer somewhat of a discount, but I would certainly charge him.

 

Don't worry about this phenomenon too much, it's actually quite rare.

 

Dr. Feller

[HairTodayGoneTmrw]

This is why it is important to wait till you know what your hairloss pattern will be. will you be a NW7, NW6, or a NW3? Will your donor area stay thick?

 

If you go in too soon for a HT and and your donor area you think is gonna be ok turns out to be in the non-safe zone 5 years down the road, your transplanted hairs might fall out too.

 

Not sure if this is related, but thought it was at least worth mentioning

[bald bull]

I was told to take propecia/rogaine/both after getting the HT procedure done to prevent any further hair loss. This would probably cut the risk of the already rare occurance of the donor areas falling out and thus the transplated hair from falling out. If I'm wrong, correct me.

[johnny 05]

QUOTE;

This is why is important to wait till you know what your hairloss pattern will be.

................................................

When you said wait to see what your hairloss patern will be,I am confused a bit. When we will know what our hairloss pattern will be? In our 30`s, 40`s,50`s. I was 33 when I had my HT done.I didn`t want to wait to get in my 60`s or 70`s to get HT.

[Bill - Seemiller]

Bald Bull,

 

For the most part, you are correct. Propecia can help minimize the risk of future hair loss (including donor hair thinning). There have been a number of cases where men have strengthened their donor area as a result of taking Propecia.

 

johnny05,

 

It's not that you have to wait until you lose all your hair to consider hair transplantation, but very young patients who just started losing their hair have no established hair loss pattern yet, which make it more risky to proceed with surgery. That's why surgeons who work with younger patients if they are candidates at all, should be conservative to reserve donor hair for the good possibily of subsequent surgeries.

 

I hope this helps.

 

Bill

[nm76]

Originally posted by HairTodayGoneTmrw:

This is why it is important to wait till you know what your hairloss pattern will be. will you be a NW7, NW6, or a NW3? Will your donor area stay thick?

 

If you go in too soon for a HT and and your donor area you think is gonna be ok turns out to be in the non-safe zone 5 years down the road, your transplanted hairs might fall out too.

 

Not sure if this is related, but thought it was at least worth mentioning

 

People with mpb continue to have this for the rest of their life don't they? So how long do you wait before you determine what your hair loss will be? - eventually wont all mbp'ers end up being nw7?

[Bill - Seemiller]

mm76,

 

The simple answer is that hair loss continues to where the genes have programmed it to. Hormone levels of course, contribute to the liklihood of further loss which is why it can be slowed down or even stopped by using Propecia.

 

But no, not everyone will end up a norwood 7. Otherwise, everyone suffering from male pattern baldness would be completely bald.

 

Best wishes,

 

Bill

[nm76]

Originally posted by Bill - Associate Publisher:

mm76,

 

The simple answer is that hair loss continues to where the genes have programmed it to.

Bill

 

Thanks for the reply. "where the genes have programmed it to" - we have no means of finding out what this is do we?

[Bill - Seemiller]

mm76,

 

Not that I know of my friend. There is a genetic hair loss test by HairDX, but I think that only tells you if you are susceptible to male pattern baldness - not how far it will progress.

 

Family history of hair loss can be used as a guide, but it's not absolute.

 

The mysteries of hair loss - frankly, I'm disappointed in the advancement of available non-surgical hair loss treatments. When I was young and before any hair loss, I swore that by the time I was old enough to lose my hair (of course, hoping I wouldn't), that there'd be a cure by now.

 

Bill

[nm76]

Yeah I kind of figured it would not be possible. It would be great, though, to know - it would really help in planning a HT.

[Arrie]

Informative great thread. Once again thank ylu Dr. Feller you are one of the VERY few I would ever let to touch my scalp Bald bull love the pic brings back a lot of memories.

[htloss]

I am another transplant recipient who is experiencing loss of transplanted hair. Needless to say, it is very worrisome. I had two scalp reductions and a lot of work done by Dr. Dorman in the early 90's. I have had two " touchups" done by Dr. Hasson early this decade. The hair grew beautifully at first and I was thrilled with the results. About two years later I noticed the thinning. The most noticeable area where I am losing hair is the right forehead. This is solely transplanted hair and it is becoming increasingly difficult to conceal. This is the area that needed the "touch up". I discussed this with Dr. Hasson but he seemed to think I was imagining it. Well, the continuing loss indicates I must have a vivid imagination. I don't relish yet another transplant session that may last just a few years as well. Where do I turn?

[htloss]

I should add that I am 59 years old and I take Propecia. It does not seem to make any difference. I was over 40 when the original transplants were done. Much of my hair is not grey yet.

[VictimofDHT]

htloss, I see that you haven't been online for a while. I just found out I have the same problem. I'm losing my transplanted hair after 5 HTs over the past decade. I'm wondering if your loss has worsened or stopped. I'd appreciate it if you let me know. Thanks.

[htloss]

Hi victim

 

I am sorry to hear that you are also losing transplanted hair. It is so frustrating and maddening to lose hair that cost you a great deal of money and in my case at least, considerable pain and suffering. I think it is mostly the transplants that I had in the early 90's that are dying off. The newer ones that I had after 2000 ( I had two "touch -ups" done then ) seem to be doing better ( I cannot be completely sure of this). The odd thing about it was that the fallout began in front of my head on the right side and spread to the left gradually. I still have one small patch that is thicker, although the right side is definitely thinner. I am hopeful that most of the fallout is over, but I cannot be sure. It helps that my hair tends to be coarse. It helps to make things look more thick. If I had fine hair, I would be hooped.

I chatted with two other guys a few years ago who were having the same problem. One believed that this problem was not uncommon and that it was the transplant industries "dirty little secret".

I spent over $18000 on hair transplants, including two scalp reductions. Scalp reductions are no longer done. My transplant surgeon told me that they stopped doing them because they were barbaric. The real reason is that they don't work. The scalp just stretches out again. We were used as guinea pigs for an unproven procedure !

I now have thin hair on most of my scalp and a growing bald spot on my crown. The back of my head is a mess of horizontal scars that make getting my hair cut tricky. I certainly cannot get it cut short as it looks just awful. I recently discovered that when I had to switch to a new barber and he forgot what I had told him about my scalp.

I would be very interested to hear your story.

[bill4488]

this has happened to me TWICE! With two different doctors. I had a transplant in 2009 and after less than a year later, I began to lose transplanted hair. I consulted with a second hair tranplant specialist who told me the donor site for the first tranplant was "too low." I underwent a 2,300 FUE transplant with him in 2011. Now that transplanted hair has begun to fall out, just a little over a year after the transplant. I do not believe these doctors who make the comment that this is "rare." I suspect it happens often, but it is not in their best interests for anyone to knowabout it. I have been on testosterone therapy since September 2009, shortly after receiving the first transplant. I asked both physicians if this could cause the loss of transplanted hair and both answered in the negative. Again, it would certainly NOT be in their best interests for their middle-aged and older male patients to think the only choice they have is between a normal hormone level OR a full head of hair, but NOT both!

[htloss]

I am surprised that the doc told you the transplanted hair had been taken from a donor site that was too LOW. Usually they say that the site was too high and therefore contained hair that would have fallen out of your scalp given time. My hair continues to thin, especially on the front left side where I already have had the two "touch ups". I try not to worry about it but it does concern me. There is now a broad swath of thin hair running from the crown to the front of my head ie where the transplants and scalp reductions were done. If the original surgeon who did this work was still alive ( Dr. Dorman ) I would be seeing a lawyer to investigate the possibility of a lawsuit. The transplants were supposed to last a lifetime. This statement was in his brochure which I still have.

I do not take propecia any more and I am aware that this increases fallout of non-transplated hair. I feel that messing with my hormones is not something I want to do anymore. I know the hair transplant industry says Propecia is safe for the vast majority of men, but I don't trust them at all.

I don't know why anyone would have a hair transplant these days. I would wait and see what new treatments are possibly going to be available in a year or two . I am hoping that the hair transplant industry will be made obsolete by new treatments which are currently under development and testing. Then the transplant doctors can go back to being regular doctors.

BTW, I have noticed that when my transplanted hair is going to fall out ( it goes in phases ), the scalp gets itchy and there is sometimes a burning sensation. This is especially noticeable at night and may wake me up from sleep. Have you noticed this?

We certainly are not alone in this and I agree that we will probably never know what is the percentage of men who have had this problem with hair transplants.

Edited September 10, 2013 by htloss

[bill4488]

Thanks for your response htloss. my first doctor is still alive and making money from transplants. I doubt a lawyer would do much good, because no cosmetic surgery is ever really guaranteed. that is their universal "out." Your case and mine have some eerie similarities. I too was a steadfast user of Propecia but discontinued for a short period of time due to all the cited concerns of resultant sexual dysfunction from prolonged use. I am again, however, using it, as well as saw palmetto. My most recent transplant loss, like yours, was also accompanied by an itching and/or burning sensation of my scalp. and some noticeable small "bumps." much like what I would imagine psoriasis would feel like. although I have never suffered from this. I wonder if this represents the body's rejection of the new or transplanted grafts? I feel certain that most transplant recipients fare well with their procedures, but it would be gratifying to see either the creators of this website or transplant doctors respond to those of us who have not. I suspect, however, they do not want to even acknowledge us. Bad for business, you know. My testosterone therapy is a very mild dosage (1.5 ml) every two weeks. But i intend to attempt some experimentation with it by reducing the dosage (or perhaps suspending an injection or two) to see if any of my hair grows back. Although, based on what I've learned of the effects of DHT, I don't hold out much hope of that. I agree with you that waiting for the "silver bullet" cure mite be a viable alternative to hair transplantation for someone else who is considering the procedure.

[bill4488]

thanks for your response htloss. I too suffered from itching and burning at the site of the loss of my transplanted hair. perhaps the body's rejection of the grafts? I also was a user of Propecia, but suspended its use for a short time due to cited concerns of sexual dysfunction. I have, however, resumed its use. It would be gratifying to see either the creators of this website or transplant doctors respond to those of us who have lost transplanted hair. I doubt they will, however. bad for business, you know. I intend to experiment with my testosterone dosage, which is quite low anyway (1.5 ml every two weeks) by either reducing it or suspending an injection or two. just to see if my transplanted hair will grow back. I don't hold out much hope, tho.

[mabbers]

Hi Dr Feller,

 

I believe that I am one of the rare cases where transplanted hair begins to miniaturize and fall out around the 2.5 to 3 year mark. I have been losing HT hair pretty consistently for a year now and estimate that I have lost around 3-4K grafts. I have 2 questions:

 

1) Did the patients that had the same problem as me ever have their hair loss stabilize before the new procedure? I find this important so I know that I wont just be throwing more grafts at the problem only to find bald spots in another year.

2) What is your recommendation with propecia and Rogaine use while this occurs? During these sheds my scalp is very sensitive and I would rather not use rogaine but will continue if you think it may help.

 

Thanks and I look forward to your reply.

[mabbers]

I actually experience the same pain/ burning sensation as well. Sometimes its terrible at night and during the day. Did anyone lose all of their hair or did it eventually stop or slow down.

 

thanks