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Would a transplant now cause a lot of shockloss?

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  • Regular Member

Hi, apologies for the long message but wanted to try to include everything.


I received a transplant 3 years ago where I got around 2,100 grafts to the front of my head by Dr. Pathomvanich. He left the area or tuft to the front centre of my head which was a bit stronger than the surrounding areas and felt there was no need to work on that as it could be affected by shockloss. The temples were filled in and the area behind and surrounding the tuft was thickened. I was very happy with his work but feel I would like to have this centre front area filled in more as it has since become thinner. It is see through in sunlight and under lights. I need to use Toppik and would like to not have to use this anymore to conceal my thinning.


I contacted Dr. Pathomvanich about this but he thinks that the area is not thin enough yet for a transplant and that working on this would be too dangerous for shockloss. I fully respect his decision as he is obviously someone who knows about the effects of shockloss. I am just seeing what others think and how they think the shockloss would affect it. Has anybody ever got a transplant on a similar looking area?


I am wondering how dense do you think my hair is? I would guess that it is near 40 hairs per cm2, though many may be minituarized. I have zoomed in on the pictures and used a ruler in some pics. I have some pics with wet hair and hairs in the thin area spread out to get a good view of the thinning.


At what stage would you think I could get a transplant on the hair so shockloss would be less likely? When it reaches 25 hairs per cm2? I feel that if I was to have a transplant with my hair at 40 hairs per cm2 then I would lose more than if I had one when my hair has thinned to 25 hairs per cm2 as the hairs are a bit denser. However, would it not all be the same as I would be starting out with more? I'm assuming I have 40 hairs per cm2 but obviously it may be more or less that. Here are the 2 hypothetical scenarios:


1) transplant when hair is at 40 per cm2 - lose 50% to shockloss (20 hairs per cm2) - end result from shockloss is 20 hairs per cm2


2) transplant when hair is at 25 per cm2 - lose 20% to shockloss ( 5 hairs per cm2) - end result from shockloss is 20 hairs per cm2.



So although I lose more in scenario 1, I had more to start with so I would still have the same amount after the shockloss and before new hair grows. These are all just hypothetical figures but you get the idea. I am also aware that shockloss is unpredictable but that it is more likely when hair is denser.


In short,I am wondering is there a density threshold for when it is safe from major shockloss?













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  • Senior Member

I think it also depends a lot on the doctor, if I were you I would get enough down time to shave the area and then if FUT go with Dr. Konior who places the grafts himself or FUE with Lorenzo (?) or other doc who individually places the grafts.

This will give you the best chance of avoiding shockloss, along with also making sure not to suddenly start/stop meds prior to surgery and up to 6 months post-op.

go dense or go home


Unbiased advice and opinions based on 25 plus years of researching and actual experience with hair loss, hair restoration via both FUT & FUE, SMP, scalp issues including scalp eczema & seborrheic dermatitis and many others


HSRP10's favorite FUT surgeons: *Dr. Konior, *Dr Hasson, Dr. Rahal

HSRP10's favorite FUE surgeons: *Dr. Konior, *Dr. Bisanga, Dr. Erdogan, Dr. Couto

(*indicates actual experience with doctor)

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  • Senior Member

You have to respect the concerns of your doctor because many would just take your money and do the procedure anyway.


I agree with hrsp and just wanted to add that shock loss is more related to the corresponding trauma of the recipient incisions, the fluids injected into the scalp, etc. There can even be shock loss in the donor area which is again related to the trauma.


Overall, the more incisions that are made, the higher level of trauma and potential level of shock loss that can occur. The less invasive the instrumentation used to create the recipient incisions, the less overall trauma. Not always but true in principle.


Shock loss is still a phenomenon that is not well understood or more importantly, the differences in how each and every individual responds to the related trauma from the procedure.


For the most part, it's unpredictable. Native hair or weaker debilitating hair is more subject to shock loss than one's transplanted hair. Again in general terms.


If you were to add some density to what you have, it's possible IMHO based on your pics but like hrsp stated, it would be wisely advised to shave down the recipient area first to avoid transection of the hair that is already there.


And approaching it with a lower density pass is also wise rather trying to dense pack that particular zone...;)


Independent Patient Advocate

I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice, but are my own views which you read at your own risk.

Supporting Physicians: Dr. Robert Dorin: The Hairloss Doctors in New York, NY

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