Is transplanted hair permanent?

[gillenator]

The following is my reply to a patient experiencing this phenomenon on another forum. I thought to post my reply to him in this community as well because there are undoubtedly others experiencing this as rare as it is. My following opinions are based on the past three decades of observation in HT patients.

 

You may very well be experiencing a phenomenon that some patients do unfortunately experience. I am and have been actually doing a research project on this phenomenon. Thank goodness it is the exception and not the rule!

 

I do not know how your doc confirmed the fact that you are "losing" your past transplants other than simply looking at what was once there and how much is left. In other words, comparing past photos post-op when everything from your past procedure grew in.

 

IMHO, the best way to determine if you hair is diffusing or being lost is by closely examining the individual transplanted hair shafts under a scope with at least 30X empowerment. I use a densiometer because it has a light meter built in. It's a hand held instrument that can be purchased at Radio Shack for approximately $20 US. Believe it or not, you can even use a magnifying glass to monitor and compare the differences in "hair shaft diameter". So to make my pount clear, you are comparing differences in hair shaft diameter to confirm the diffusion.

 

You simply take small individual hair samples in any zone that you notice diffusing going on. You then take "terminal" hair samples from the donor zones (sides and back zones, parietal/occipital). Compare hair shaft diameter between the diffused hair samples to the terminal hair.

 

You can even mail the samples to me and I will examine them for you providing that you acknolowledge by reply email that I am not a licensed physician nor making any clinical representations and/or any formal certifications. You are getting my lay opinion, nothing else.

 

But I have been doing this on myself and some other younger men who are just beginning to notice the effects of MPB. I use the same approach to informally confirm if finasteride is working to stabilize the loss of hair shaft diameter. I am also as I said conducting my own research on past HT patients who feel they may be losing their transplants. I can say that most of the participants are at least 5 or more years post-op.

 

It is extremely rare to see the loss occur at such a soon interval as you are experiencing. I would say the average has been between 10 and 15 years post-op. Let me also say it is rare for this phenomenon to occur. Clearly, this is not the norm and I have tried to get more feedback from several HT docs. But what I have found is that many of them are uncomfortable discussing or confirming that is in fact a potential part of the risk in HT surgery.

 

My premonition is that this is occuring more than we realize and why I am doing the ongoing research project.

 

I will need your written release and cooperation if you would like to participate and why we need to talk further. You can also forward to me ongoing digital quality pics of the thinning zones, again for comparison purposes only. Your case and file is strictly confidential with me.

 

It's the "why is this occuring" question that we are trying to answer with a scientific conclusion.

 

Now, if you want my opinion to date as to why this phenomenon is occuring, here it is: I believe the main reason why any patient may lose their transplants at a future date is because some of the donor hair is in fact DHT receptive. In other words, I am realizing more and more, or better stated, I am becoming more convinced with time that terminal hair is not a black and white issue.

 

Just because it was harvested from the occipital zone does not necessarily imply that it will last forever. Some of it will last for decades and some will not. There is no way of telling strand by strand because an extremely high percent of HT patients are doing the procedure when most of their donor zones appear as terminal hair without exception. I am finding that there are in fact exceptions. Those zones do not show very much miniturization if any at younger ages. It begins to show as we age. That's why it is easy to be mistaken.

 

Here's the key folks! This is the most critical statement I can state on this issue. If You have donor zone thinning in your family history on either side of your family (maternal or paternal), then there's a real possibilty that you will experience it as well. So if donor zone thinning is in your cards, then it is very possible that some of your transplanted hair is in fact DHT receptive!

 

One last statement. One of the similarities between the participating patients have in common is guess what? Donor zone thinning in their family history! That's is the only real evidence that supports the answer to this phenomenon. I do not include individuals who are on meds with hairloss as a potential side-effect nor people with diseases that can also cause hairloss like Lupus for example.

 

To date, I cannot find any other source or reason as to why the permanency of transplanted hair fails other than some of it is DHT receptive to begin with.

I began to come to this conclusion about 3 years ago and why some of you have noticed that I began to warn and inform new patients to reconsider HTs "if" and I repeat "if" they have histories of donor zone thinning in their families. At the same time, I began to warn new patients to not consider "nape hair" for donor use "if" they have donor zone thinning in their families.

 

I have been criticized for this opinion elsewhere in the past, yet as time rolls on, there are more patients like you experiencing this dilemma.

 

Again, IMHO, it is something for every patient to explore and consider before they ever step into the OR room!

 

I truly hope this has been helpful to you and any others who may be experiencing the same thing.

 

Let me know if I can be of any futher help. See what I mean by the amount time it takes to type all of this?

 

Best wishes to you my friend!