Is Hair Transplantation permanent?

[67mph]

This is the very number one question i ask my self each time i go on the forums and delve further into my research;-

 

Is Follicular Unit Transplantation permanent?

 

It seems i never get the answer i'm looking for, so i'm posting it here to see what response i get, what do we all think and is there concrete evidence (anywhere!) that HTs last a life time, or at least last for a fair amount of years.

 

Who's the oldest transplant patient, and i don't mean a case of a 94 year old having a HT last week, i'm talking a HT patient who had a HT (in it's earliest form) years and years ago and still has those very transplanted follicles sitting proudly in his head ...etc

 

If this has been answered, can you point me in the direction of 'the best' answer, please!

 

regards,

57mph

[TC17]

This might sound like a cop out, but the truth is that a hair transplant is only as permanent as the donor hair from where the transplanted hair is taken. If you look at older men who are bald ,I believe that you will see a great number of them would be categorized as NW 6's and NW 7's, and many of them have poor donor hair. Essentially, if they went to a doctor for a hair transplant, they would be turned down and told they are not suitable candidates. Of course we don't know what those same men looked like at age 30, 40, or 50, but we can all agree that we see far more extensive loss as men get older, thus those older men with really advanced patterns were one day younger men with minor and moderate hair loss. Although hair loss doesn't necessairly progress through NW levels per se, for many men, hair loss does continue to get worse. Simply because one is showing a clear NW 5 pattern at age 35 does not mean that he will retain that forever. For an example, look at Jason Alexander from Seinfeld. When he was in his 30's he was a clear NW 5, in his 40's a clear NW 6, and now in his 50's, he is fast approaching a NW 7 level. Who knows, in time, his sides may drop lower and his donor may thin.

 

As for who the person who had the transplant the longest time ago, I don't know who that is, but it really doesn't matter. Just because Person A had a hair transplant 50 years ago and it stil lstands the test of time does not mean that Person B will be so lucky. Permanence of donor hair and future balding pattern are unique to the individual, and thus it's irrelevant what happens to anyone but you.

[Sickboy]

I am no expert but this is my understanding of transplanted hair. The donor hair is taken from the back and sides of the head. This is something of a 'safe zone' when it comes to hair. If you look at someone who you would comsider more or less completely bald, you will notice in nearly every case that there is still hair on the back and side of the head, for some reason this hair is not affected by male patern baldness. Only the top of the head is bald. The hair taken from the donor area still holds these characteristics ie it is genetically programmed not to fall out. Therefor the transplanted hair is as good as permanent.......if anyone knows differently feel free to completely contradict me...: o )

[RCWest]

It's permanent as long as you don't develop senile alopecia or thinning of the donor area as you age. Some older men actually thin in the so called permanent zone.

[aaron1234]

TC and RC are correct that donor characteristics can change with age and could affect a transplant years down the road. This is one reason why I preach propecia to be taken not only for the remaining hair on top but also for the "permanent" zone as well.

[ziggy00]

It's difficult to say HTs are permanent because nothing about humans are permanent. Wow, that sounded really gloomy. How about this: a HT will last as long as you need it to last.

[Dr. Michael Beehner]

57mph,

The question you pose is the million dollar question. I'm not sure anyone knows the exact answer, but I'll give you my attempt at honestly answering it.

For starters, I think the permanency of the transplanted hair varies some from one patient to another. There are patients I have seen over a 20 year period (including looking in the mirror every day at my own hair, which was transplanted 29 years ago) and it seems the transplanted hair has thinned more than the remaining donor hair has. There are also a great many patients I have observed over those 20 years from my early days of doing HT who are still very full.

There are a few facts that have been proven and are general knowledge: First of all to some degree, almost all men and women develop what is inappropriately named "senile alopecia." This refers to the gradual thinning of hair everywhere on the head in people as they age. This varies tremendously among individuals, but I do believe everyone does thin from their 40's up and through their 70's and 80's - some to such a small degree that it may not seem noticeable. Another fact that has been proven with research is that the diameter of the resultant transplanted hair in most studies has been measured to be slightly less than when it was originally in the donor area. Thus there is probably less "hair mass" right from the get-go.

The third factor, which I think is important, is that most of us gray, and as the percentage of gray hair increases, especially in Caucasians, the hair "disappears" visually against the background of the scalp behind it. Even when people dye their hair, after a week or so, the roots grow out white so that it starts to look thinner, especially in the part, creases and rear vertex area.

But the good news is that in virtually everyone who has been transplanted, regardless of the technique or graft sizes used, the great majority of the hair does continue to grow and survive and help that individual frame his face and look better than he would if he had never done it. One additional point I would like to make is that a lot of patients change their hair styles during their life, and, if they go to having shorter hair, they are going to lost the valuable overlap and shingling that longer hair provides. This is one of key ways that transplanted hair looks full, since we are never transplanting in the density that originally was on our heads at age 15.

The whole issue of how to wisely use the donor hair in a given patient, given that patient's risk for going on to a Norwood VII is another whole subject for another day. Suffice it to say that you want to select a physician who is a little conservative and has plenty of experience.

Mike Beehner,M.D..

[NEWHAIRPLEASE]

TC and RC are correct that donor characteristics can change with age and could affect a transplant years down the road. This is one reason why I preach propecia to be taken not only for the remaining hair on top but also for the "permanent" zone as well.

 

100% agree with you Aaron!

[fortune11]

Hair thickness and texture is probably more important than worrying about whether donor hair will eventually fall out, in my opinion. People who are blessed with coarse / thick hair need less FUs to get the same look as someone with thinner hair which is a big factor given most of us have limited donor supply.

 

As to the question of how will your specific transplanted hair look/remain 30-40 years from now, is a crapshoot, but I am optimistic that there will be some other solution developed by then (hair cloning maybe?).

 

Growing up outside the US and suffering early hairloss, I had resigned myself to accepting the bald fate of of my father (who was Nw7 by age 30) until I immigrated to this country 10 years ago. The rapid advancement in hair placement technology (the FU based methosd) has made "miracles" possibles for many of us that were near impossible to imagine say 20 years ago.

 

20 years from now, they will probably have found a way to keep the train going.

[Al - Moderator]

I had first HT in 1989 when I was 22. The last one was in 1994. It never looked good. I'm 44 now and I'd say about 30% or more of the transplanted hair is now gone and it continues to fall out. It was not permanent. The total balding area on my head continues to widen. The hairs that are still remaining are thinner than they once were. The donor area in the sides and back (so called safe zone) has been slowly thinning for years. I'm unable to cover the scars no matter how long I grow my hair because the hair just isn't thick enough.

[ziggy00]

Thanks for the post, Dr. Beehner. I learned a lot of good information in there.

[67mph]

Thankyou for the posts so far, each one in their own right has helped, Mike Beehner M.D has raised a few key points to bear in mind when looking into this question.

 

Considering the question i put forward, very few (from the physicians, professionals, big forum posters, the newbies and all that's in between) have come forward to try and answer 'the' very main question impo, i mean, is there a bigger question to ask?

 

i was hoping for more conclusive and 'shots in the dark' posts, and considering the thousands that get follicluar transaction operations each year, i'd have thought these very same people would be tripping over themselves to answer my question, or, atleast tell me what they've found out the case to be so far.

 

Shall i take it that the men and women who have had HTs have gone for their operation not knowing whether their HT will last a few months, let alone years?

 

I know it's not as black and white as we'd wish but some conclusive evidence would help my mind be put at ease.

 

Regards,

57mph

[biscuit]

It's only as permanent as your donor horseshoe. Study some men over 70 and you'll see a wide range of donor conditions. Almost all will have grey hair. Most will have diffuse thinning. Some will have a very narrow band of safe donor hair. There is zero chance of your transplanted hair being "permanent" if you are destined to have severe diffuse thinning in your horeshoe area. The good news is that you could have decades of nice hair before it starts thinning. And, grey hair tends to hide thinning better than dark hair.

 

I would also add a 4th factor to Dr Beehner's excellent post. A lot of guys are opting for a HT strategy that relies on meds. For that strategy to work you have to take the meds for the rest of your life, otherwise you'll quickly lose all of the hair the meds saved. I personally knew that I wouldn't have the diligence to take meds for 20/30/40/50/60 years. So I opted for full coverage with slightly less density. If I had banked on meds the doctor would have placed more grafts in front and none in the crown.

[BlueMan23]

With the advancements of technology, I'm banking on cloning being available in 20 years! There will HAVE to have been some major advancements in hair loss treatments by then! Let's be optimistic!

[Sean]

There are 10% of people who's donor hair does not grow after a transplant. So, there is a chance for some that it may not be permanent.

[Guest JhonPaul]

For sure, FUT transplanting ways of graft hair cells is a permanent process.

[Dr. Michael Beehner]

Sean,

I think you got your facts mixed up. I don't know where you ever heard that 10% of patients don't have growth from their HT's. Rather, in many studies roughly 10% of the hairs are not accounted for at hair counts 8-15 months out from the time of the HT. But there is substantial growth, sometimes near 100%, in virtually ALL of the patients. You would have to have an active autoimmune disease going on to not have growth, and most experienced HT docs are able to recognize conditions such as lichen planopilaris and lupus and not perform a transplant in those situations.

Mike Beehner, M.D..