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the_mask

Duration of Hair Transplant over time

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Hello People, 

I want to open this discussion about the objective duration of a hair transplant.

I had various hair transplants during the last few years which I'm not satisfied with at the moment (I always kept the official, high standards, maintaining cure done). I was very much satisfied until a few months ago when I started to notice a consistent hair fall and a shedding of the transplanted area too.

It would be so much interesting for everyone I bet to collect as many (real) information as possible about the stability of a hair transplant over time (I mean at least more than 10 years), especially If performed by top surgeons, so we can exclude the variable of a no well-made operation. 

Any of you have reports, information, a story to share about hair transplant overtime ????

I think it is in the interests of all here (both patients and surgeons who work ethically) to feel safer and more serene to invest (because we all know the financial sacrifice that there's behind) in this kind of hair loss treatment.

Cheers

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I am afraid there are no such reports.  If we had a crystal ball - that would be great. Hair loss is complicated.  It can skip generations, it can come from either side of the family - or both.  And, just because one sibling has it, it does not mean the other one will.  Off hand - family history.  This would, at least, give you a bit of info.  

Much of what happens years later can be attributed to the donor.  The patient is either experiencing retrograde alopecia or is starting to lose hair in the donor.  Transplanted grafts will react the same way as if they were still in the donor area.  Grafts do keep a "memory." So, if the patient is thinning in the donor, transplanted grafts originating from there will also thin out.

Another problem is the native hair because it gets in the way.  Now-a-days the work is so good and natural that most folks can't tell the difference between transplanted hair and the native stuff.  So, the patient moves forward with a procedure, starts to lose native hair....He is going to think the is losing the grafts when in fact it's the native hair.  Medical therapy is HUGE.  And this same medication may also have an impact on the donor.

It's complicated. But, if the donor is intact for a lifetime, so should the grafts.

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I'd be fascinated by this as well.

You occasionally see guys come on the forum after 8-10 years with an unnatural balding pattern asking for recommendations of what to do next from their initial HT's. My greatest fear myself is actually not going bald or thinning (that's just ageing) but being left with an unnatural appearance once all my native hairs fall out and having to reconsider surgery again [as I always thought the goal of a successful HT was to never think about your hair ever again].

I have seen some posting by clinics of patients which cover some history, Konior documented one lasting over 14years, (albeit it was a repair case)  https://www.hairrestorationnetwork.com/topic/50312-raymond-konior-md-chicago-hair-institute-hairline-repair-a-14-year-history/

 

But sadly you don't in much in the way of patient postings (or at least I haven't seen it). I think part of the answer might lie with the fact that HT's themselves have only really hit a critical standard in the last 10-15 years so a long term analysis in this field might not have been realised yet. Another possibility is (and I secretly hope it's the truth) the lack of postings reveal a potential that most of these guys have the procedure done and just enjoy the rest of their lives. So there's no need to return to a forum and share.

Having said all that it's a great idea for a thread and I'd love to see more examples myself ...

 

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7 minutes ago, transplantedphil said:

I'd be fascinated by this as well.

You occasionally see guys come on the forum after 8-10 years with an unnatural balding pattern asking for recommendations of what to do next from their initial HT's. My greatest fear myself is actually not going bald or thinning (that's just ageing) but being left with an unnatural appearance once all my native hairs fall out and having to reconsider surgery again [as I always thought the goal of a successful HT was to never think about your hair ever again].

I have seen some posting by clinics of patients which cover some history, Konior documented one lasting over 14years, (albeit it was a repair case)  https://www.hairrestorationnetwork.com/topic/50312-raymond-konior-md-chicago-hair-institute-hairline-repair-a-14-year-history/

 

But sadly you don't in much in the way of patient postings (or at least I haven't seen it). I think part of the answer might lie with the fact that HT's themselves have only really hit a critical standard in the last 10-15 years so a long term analysis in this field might not have been realised yet. Another possibility is (and I secretly hope it's the truth) the lack of postings reveal a potential that most of these guys have the procedure done and just enjoy the rest of their lives. So there's no need to return to a forum and share.

Having said all that it's a great idea for a thread and I'd love to see more examples myself ...

 

I am just going to chime in and say that you're probably not looking at a "one and done" situation with a transplant option period unless you're either A: already pretty darn bald and getting a large transplant done or B: extremely lucky in that your hair loss has already reached its final form and you don't experience any surgical complications. Otherwise, no transplant is going to be a forever fix, unfortunately.

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Yes I agree completely @Mycroft. Personally speaking I've had 3 done now (around 5600 grafts) so I am just hoping that I do not progress to a higher level NW. I think it mostly comes down to the planning

I believe @LaserCap is a patient with a long history of HT's and apparently was the 1st person to get FUE. I think he said once he was thinking of creating a thread .. might be an interesting read 🤔

Edited by transplantedphil

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I do not provide medical advice, recommendations, all responses are my opinion.

My Hair Transplant Journey

Melvin- Associate Publisher and Forum Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

Follow our Social Media Instagram @thehairtransplantnetwork FacebookPintrest, Linkedin and YouTube.

 

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4 minutes ago, transplantedphil said:

Yes I agree completely @Mycroft. Personally speaking I've had 3 done now (around 5600 grafts) so I am just hoping that I do not progress to a higher level NW. I think it mostly comes down to the planning

I believe @LaserCap is a patient with a long history of HT's and apparently was the person to get FUE. I think he said once he was thinking of creating a thread .. might be an interesting read 🤔

If you've had that many you are a great example for all the other folks out. How severe was your progression?

@LaserCap used to (maybe still does) work in the industry as I recall. I'd be interested to hear some of his stories relating to this.

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hard to say as I believe i was a diffuse NW5-6 when I got my first HT and then continued to thin. Without systemically going through and checking which hairs are transplanted vs native it's almost impossible to know what's going on so i'll let mother time reveal that mystery.

I actually look at @Melvin-Moderator hair as the ideal as we seem to have a similar graft count and maybe even a similar NW. His results are killer (and I believe was almost slick bald when he started his HT journey?)

Conversely I've seen a patient of Shapiro's come on this forum a few months ago with a similar graft count saying his HT's looked great for a few years but once his native hairs shed he was left with an unnatural appearance. This variety of examples seems to suggest a "successful" end result has much more to do with the placement and total coverage of grafts relating to your individual donor characteristics (hair calibre, skin contrast, thinning donor etc) than it does an overall graft count. 

cough cough Lasercap people are interested

Edited by transplantedphil

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I think due to FUE being much more popular these days than in the past there are going to be a lot more cases over the next 10 years of people complaining that their results didn't last as long as they thought it should. I think this will happen due to FUE using grafts from a much larger donor area than FUT does. FUT takes a strip of hair from the area that is generally going to last the longest. Many people will eventually end up with a few of the following: Retrograde hairloss (losing hair from the nape upwards), some thinning above the ears, a larger balding crown area, widening bald area on the sides, and thinning or loss of a frontal tuft for those who have that. If you have FUE, some grafts will most likely be taken from one or more of those areas while FUT takes hair from the area that will last the longest.

 

 

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Great topic OP! And great comments and observations!

I would love to see a quantitative analysis done of the longevity of HT’s....I think it would be fantastic if it was done in the vein of the Norwood scale, with such classification pre and post, current and future timelines.

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2 hours ago, BeHappy said:

I think due to FUE being much more popular these days than in the past there are going to be a lot more cases over the next 10 years of people complaining that their results didn't last as long as they thought it should. I think this will happen due to FUE using grafts from a much larger donor area than FUT does. FUT takes a strip of hair from the area that is generally going to last the longest. Many people will eventually end up with a few of the following: Retrograde hairloss (losing hair from the nape upwards), some thinning above the ears, a larger balding crown area, widening bald area on the sides, and thinning or loss of a frontal tuft for those who have that. If you have FUE, some grafts will most likely be taken from one or more of those areas while FUT takes hair from the area that will last the longest.

 

 

I think you may be onto something 

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I joined the industry in the late 90's.  I had a forelock but little else. Strong class 5A.  I didn't care about it as my grandfather was bald and I wanted to be just like him  So, During the introduction to the industry and training I was told, "Al, you need to have hair...Otherwise how can you talk to anyone about it." They were right of course so I had a 1800 graft case in the front and top.  (I also started the Propecia regimen but avoided Rogaine.  Back then the liquid was the only thing available and I hated the grease).  At the time it was strongly believed that grafts competed for blood supply and a separation between grafts were left.  4-12 mo later you could return and do a 2nd procedure to fill in - which is exactly what I did.  Had my 2nd FUT, again 1200 grafts. About a year later I had another procedure and, by then, I was thrilled with the front and top.  I started working farther back into the pattern, but never placing grafts directly on the crown.  Then came FUE.

It was a big deal.  They invited all the doctors from around the Country to come and observe.  The actually "drilled" the grafts out from my sides where my density is superb, (I've been told that many times).  Did 102 grafts and I had them placed in the mid-back area.  Mind you, I knew 100+ grafts was not going to do much, but the more the merrier. The following year I did the same procedure again.  The same equipment was used.  (It reminded me of a motorized box that is typically used to do spray painting). Another 100 grafts to the mid-back area.

I should point out these procedures were great compared to FUT.  A Tylenol and that was it.  No wrap. (I did look like a mummy on the first two procedures as I was bandaged.  The bandage was removed the next day. Touching anything back then was a no-no.  Had to pour shampoo and poor cups of water to remove the soap. 10 days later you could scrub and sutures were removed in 14 days.

I then flew to Beverly Hills and had another procedure....By then my donor was fairly tight.....

All in all I've done 7 procedures, 3 of which were FUE....Just over 5300 grafts

Many stories to tell in between these procedures...mostly from patients and their reaction once they knew most of my hair was the result of surgery.

I have photos but they're in crates.  If I find them I'll post them and then write a complete synopsis.  

 

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Wow thanks for sharing!!! You once said on another thread that you had 7 procedures and it seemed like a record.

I would hope the separation of grafts did not look too unnatural at the time between HT's (?)

and from your profile pic we will have to assume, addressing the thread, that the transplanted hair and donor has held up these last 20 years

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1 hour ago, transplantedphil said:

Wow thanks for sharing!!! You once said on another thread that you had 7 procedures and it seemed like a record.

I would hope the separation of grafts did not look too unnatural at the time between HT's (?)

and from your profile pic we will have to assume, addressing the thread, that the transplanted hair and donor has held up these last 20 years

When you're conversing with people you typically see their front and nothing else.  Fortunately I had kept a forelock which is what tends to stay put the longest.  So it looked as if I had thinned normally.  That second procedure did help a lot. I also think Propecia contributed a great deal.  

Yeah, 7 procedures but 3 of them were relatively small.  

I think both Propecia and laser have helped a lot.  So much so that my son decided long ago to get on the meds.  He has a beautiful set of hair.  Like many say, "I wish I would have started sooner."

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I'd be fascinated by this as well.

You occasionally see guys come on the forum after 8-10 years with an unnatural balding pattern asking for recommendations of what to do next from their initial HT's. My greatest fear myself is actually not going bald or thinning (that's just ageing) but being left with an unnatural appearance once all my native hairs fall out and having to reconsider surgery again [as I always thought the goal of a successful HT was to never think about your hair ever again].

I have seen some posting by clinics of patients which cover some history, Konior documented one lasting over 14years, (albeit it was a repair case)  https://www.hairrestorationnetwork.com/topic/50312-raymond-konior-md-chicago-hair-institute-hairline-repair-a-14-year-history/

that's interesting! that's a fair result over time! Hope that's real and NOT just an extraordinary case!

Edited by the_mask

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4 hours ago, CosmoKramer said:

Great topic OP! And great comments and observations!

I would love to see a quantitative analysis done of the longevity of HT’s....I think it would be fantastic if it was done in the vein of the Norwood scale, with such classification pre and post, current and future timelines.

It would be revelatory to collect such information...

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9 hours ago, LaserCap said:

I am afraid there are no such reports.  If we had a crystal ball - that would be great. Hair loss is complicated.  It can skip generations, it can come from either side of the family - or both.  And, just because one sibling has it, it does not mean the other one will.  Off hand - family history.  This would, at least, give you a bit of info.  

Much of what happens years later can be attributed to the donor.  The patient is either experiencing retrograde alopecia or is starting to lose hair in the donor.  Transplanted grafts will react the same way as if they were still in the donor area.  Grafts do keep a "memory." So, if the patient is thinning in the donor, transplanted grafts originating from there will also thin out.

Another problem is the native hair because it gets in the way.  Now-a-days the work is so good and natural that most folks can't tell the difference between transplanted hair and the native stuff.  So, the patient moves forward with a procedure, starts to lose native hair....He is going to think the is losing the grafts when in fact it's the native hair.  Medical therapy is HUGE.  And this same medication may also have an impact on the donor.

It's complicated. But, if the donor is intact for a lifetime, so should the grafts.

That I know but if the grafts are super strong because taken from "safe" zones, clearly identified, the hairs should grow for years with that calibre. It's ok there could be some problems throughout the years, but I accept this to happen after 10 years at least.
The thing is that a transplant is proposed as a DURABLE solution from every physician, but if the quality (the appearance) of the results loses after 2/3 years, that's insane, It's a mockery!

Do you agree with me?

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IMO lasercap and Behappy answered your question with donor thinning, native hair loss in the recipient area, and the increased popularity of FUE (which takes hairs from all over the donor rather than FUT which deals exclusively with safest harvesting zones) all being the primary reasons results potentially look worse over time. The only other thing i can think of would be seasonal shedding/resting phases in the hair cycle.

If a physician told you a hair transplant was 100% guaranteed I would believe them to be unethical

1 hour ago, the_mask said:

that's interesting! that's a fair result over time! Hope that's real or just an extraordinary case!

Konior is as real as they come, but he also mentions that patient maintained decent density over time with medications and had extraordinary donor characteristics. 

5 hours ago, CosmoKramer said:

Great topic OP! And great comments and observations!

I would love to see a quantitative analysis done of the longevity of HT’s....I think it would be fantastic if it was done in the vein of the Norwood scale, with such classification pre and post, current and future timelines.

I believe Erdogan claims the donor thins out on average about 10-15% over the course of a lifetime, and so in his use of graft calculators he tries to take this into account? 

I truly wish there were more information available as well.

 

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19 hours ago, transplantedphil said:

 

I believe Erdogan claims the donor thins out on average about 10-15% over the course of a lifetime, and so in his use of graft calculators he tries to take this into account? 

I truly wish there were more information available as well.

 

Yeah, I believe I’ve heard or read somewhere Dr Erdogan making this claim and observation, he also has his own AI donor analyzing robot (KE-Bot) which was used to scan my fully shaved head for 15 minutes to get graft number accuracy I believe, right before and after my procedure.

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I wonder what the 10-15% claim is based on (whether its just an approximation or based on actual studies)

Being that donor strength would seem to be the greatest predictor of the successful HT (excluding graft survival and hair design which would vary from clinic to clinic) that might be the best way to assess a transplant over time; just get guys to have their donors assessed like that on a yearly basis. After 5-10 years on a range of age groups you'd have a greater ability to see the true extent of donor thinning. 

I think Lorenzo uses a similar graft calculator, so either of those doctors probably have the best access to all the information they need to conduct such a study, particularly if they had patients return to their clinics after some years

 

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1 hour ago, transplantedphil said:

I wonder what the 10-15% claim is based on (whether its just an approximation or based on actual studies)

Being that donor strength would seem to be the greatest predictor of the successful HT (excluding graft survival and hair design which would vary from clinic to clinic) that might be the best way to assess a transplant over time; just get guys to have their donors assessed like that on a yearly basis. After 5-10 years on a range of age groups you'd have a greater ability to see the true extent of donor thinning. 

I think Lorenzo uses a similar graft calculator, so either of those doctors probably have the best access to all the information they need to conduct such a study, particularly if they had patients return to their clinics after some years

 

I assume erdogan used some type of data he possibly gathered over time to come up with that claim. I know he used other types of data to come up with the coverage value calculator that some other docs use like you mention. (I believe he/his team developed the coverage value tool).

 

Personally I dont buy much into the 10-15% claim and I think that its a very generous number. This is based solely on observing my dads donor area. At 72, and a NW3V, his donor has thinned out at least 30%. But genetics could be at play here and everyone is different.

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I volunteer at a retirement home from time to time and based on my observations (I cant believe Im secretly looking at old people’s heads now LOL!) id say 10-15% thinning is incredibly generous. 10-15% thinning for women maybe, men seem to be much more. It's rare to see a guy without any signs of thinning at all. But that's mostly for people over the age of 65. I wonder what the average age of an Asmed patient is then for Erdogan to make these claims ...

Genetics/medications are always going to be the personal variables, so i think the goal to all this stuff should always be to left looking natural (which i believe places most of the emphasis with any surgery on the consultation process and planning). 

 

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