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dobler

3 years after 2 hair transplants. Lost hair and receding sides

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Hey,

So my case is complicated. I am 31, NW6. Had 2 successful hair transplants - in 2016 and 2017. First - 3000 grafts (all from head) on frontal 3rd, Second - 2800 (about 1000 from beard) on the crown area (had almost an empty crown). Not on meds since 2016 (And will never get back to them). My crown is still very thin, but at least not empty.

In the last 6 months I started seeing transplanted hair falling from my frontal 3rd area.. It's much much less dense than 1 year ago. Such that it is already noticeable if I grow my hair a little bit. Even my hairline, which was very dense, looks thinner.

 Also, in the last 2-3 months I am starting to see my left side hairs (the upper area of the left side) receding. This is noticeable from certain angles only. The right side has remained the same (so far).

So that's it? Am I going NW7 and am going to lose my sides? Is it possible to lose my transplanted hairs after 3.5 years?

I feel like I am heading back to my initial point before my 1st ht back in 2016.

What are my options now?

 

Attached photos:

1 from October 2018

1 from December 2018

2 from October 2019

6 from February 2020 (today)

 

* added 2 from December 2016 (prior to 1st ht) - just so you can see how it looked before.

 

*Don't have photos of my crown from 2018, so hard to compare, but it had much more density

 

1 from October 2018 (2 years after 1st ht, 1 year after 2nd ht:

October2018.jpg

 

 

1 from December 2018 (2 years after 1st ht, 1 year and two months after 2nd ht:

December2018.jpg

 

 

2 from October 2019 (3 years after 1st ht, 2 years after 2nd ht:

October2019_1.jpg

October2019_2.jpg

 

 

6 from February 2020 (today) (3.5 years after 1st ht, 2.5 years after 2nd ht:

February2020_1.jpg

February2020_2.jpg

February2020_3.jpg

February2020_4.jpg

February2020_5.jpg

 

February2020_6.jpg

 

 

2 from December 2016 (prior to 1st ht) - just so you can see how it looked before:

December2016.jpg

December2016_2.jpg

Edited by dobler

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5 minutes ago, duchaine said:

are you using any kind of medication to prevent hair loss?

Hi, as I have already mentioned in my post - no. I stopped using Fin after 6 months back in 2016. Not gonna be back on it ever again (destroyed my body).

About minoxidil - I have used it for 7 years, and stopped in 2016 as well.

Edited by dobler

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9 minutes ago, dobler said:

Hi, as I have already mentioned in my post - no. I stopped using Fin after 6 months back in 2016. Not gonna be back on it ever again (destroyed my body).

About minoxidil - I have used it for 7 years, and stopped in 2016 as well.

I think it is really hard you can hold hairs on your scalp if you don't use DHT blockers (fina or Dutasteride) and uses other stuff to increase growth factors and anagen phase.
My 2 cents tip is: start ASAP-

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I don't think it's just a matter of treatment, I think that hair transplantation is not for life, much depends on our vascularization in the receiving area, but nobody gives it due importance, and unfortunately it's a genetic thing.  We cannot know if where we put the hair, underneath we have more or less blood vessels willing to nourish more or less the new grafts ... our predisposition is fundamental ... trying is already a demonstration of so much courage.

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It doesn't look that bad mate. A touch of toppik and you'd see a further difference 

It's not ideal but without meds that's life 

 

 

 

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Have you been in touch with your surgeon? When your donor area was examined, what was the view of your surgeon? You mentioned you were on meds until 2016 and had your first procedure the same year. Don't know if you were on meds at the time of your procedure but if you were, just wonder whether the meds were keeping hair in your donor area going and when you came off them, they started to miniaturise. 

Obviously your hair loss pattern had clearly formed when you had your first procedure but if you were destined to head to be a NW7 and hair was extracted from the sides that was being propped up by meds, maybe coming off them has resulted in the transplanted now being vulnerable to miniaturisation and eventually dying. Obviously all guesswork but something to maybe consider.

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28 minutes ago, Egy said:

I don't think it's just a matter of treatment, I think that hair transplantation is not for life, much depends on our vascularization in the receiving area, but nobody gives it due importance, and unfortunately it's a genetic thing.  We cannot know if where we put the hair, underneath we have more or less blood vessels willing to nourish more or less the new grafts ... our predisposition is fundamental ... trying is already a demonstration of so much courage.

Egy,
you are right but miscovascularization is just a piece of the puzzle.
Anyway, some treatments are directly related to vascularization and blood flow (minoxidil, PRP, Dermorolling)
other indirectly affect vascolararization (5ar inhibitors, anti androgen, estrogenic and progestinic, PG agonist and antagonist).
So, imho, it is a big mistake not doing anything after ht.

Edited by duchaine
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4 minutes ago, Fozzie said:

Have you been in touch with your surgeon? When your donor area was examined, what was the view of your surgeon? You mentioned you were on meds until 2016 and had your first procedure the same year. Don't know if you were on meds at the time of your procedure but if you were, just wonder whether the meds were keeping hair in your donor area going and when you came off them, they started to miniaturise. 

Obviously your hair loss pattern had clearly formed when you had your first procedure but if you were destined to head to be a NW7 and hair was extracted from the sides that was being propped up by meds, maybe coming off them has resulted in the transplanted now being vulnerable to miniaturisation and eventually dying. Obviously all guesswork but something to maybe consider.

I agree. From macroanalysis, I can say his safe donor was really small. For sure, not big enough to support 2 HT to cover that big area.

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Hello @dobler

If you lost transplantef hair over time its likely that hair was extracted outside the Safe doner zone. You are doing the right thing in keeping your hair short as it suits and dosent show the thinning areas as much. 

Like myself, you have used beard grafts for your HT. There is no reason why you can't use them again . This approach will help to fill thin areas and create more density.

Paddy

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I don’t see a big difference to be honest, you may be losing additional hair in the crown. I don’t see significant thinning on the sides. I see your hair is a lot shorter, it could be that your hair looks thinner because it’s shorter. Remember length is required for the “illusion” of density.

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6 hours ago, duchaine said:

Egy,
you are right but miscovascularization is just a piece of the puzzle.
Anyway, some treatments are directly related to vascularization and blood flow (minoxidil, PRP, Dermorolling)
other indirectly affect vascolararization (5ar inhibitors, anti androgen, estrogenic and progestinic, PG agonist and antagonist).
So, imho, it is a big mistake not doing anything after ht.

Yes yes @duchaineI know, in fact I will do some prp treatment this time.

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8 hours ago, duchaine said:

I think it is really hard you can hold hairs on your scalp if you don't use DHT blockers (fina or Dutasteride) and uses other stuff to increase growth factors and anagen phase.
My 2 cents tip is: start ASAP-

Probably, but there are things that are more important than hair. When I was on Fin for 6 months, my body was completely messed up. Brain-wise, semen-wise, hormon-wise. I felt like crap, and this was a nightmare. I am never going to take it again.

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7 hours ago, Fozzie said:

Have you been in touch with your surgeon? When your donor area was examined, what was the view of your surgeon? You mentioned you were on meds until 2016 and had your first procedure the same year. Don't know if you were on meds at the time of your procedure but if you were, just wonder whether the meds were keeping hair in your donor area going and when you came off them, they started to miniaturise. 

Obviously your hair loss pattern had clearly formed when you had your first procedure but if you were destined to head to be a NW7 and hair was extracted from the sides that was being propped up by meds, maybe coming off them has resulted in the transplanted now being vulnerable to miniaturisation and eventually dying. Obviously all guesswork but something to maybe consider.

I stopped taking meds 4-5 months before the 1st HT.

And yea you are probably right, many hairs have been taken from the sides, and those hairs turned out to be weak and destined to miniaturization.

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7 hours ago, duchaine said:

I agree. From macroanalysis, I can say his safe donor was really small. For sure, not big enough to support 2 HT to cover that big area.

You are probably right. By the age of 28-29, and after losing a big area in the crown, I thought I have already gotten a clear picture of my balding status, but it is never too late to lose hair I guess.

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6 hours ago, paddyirishman said:

Hello @dobler

If you lost transplantef hair over time its likely that hair was extracted outside the Safe doner zone. You are doing the right thing in keeping your hair short as it suits and dosent show the thinning areas as much. 

Like myself, you have used beard grafts for your HT. There is no reason why you can't use them again . This approach will help to fill thin areas and create more density.

Paddy

Beard grafts are tricky. They look weird when grown up, and they are also consist of single folicullar unit (as far as I know). So you need tons of them to cover a given area, compared to scalp hairs.

I might use them again, but I wonder if I am able to cover all future bald areas at all.. whether it's with beard hairs or not.

My donor is very limited right now, and I am afraid it will be over harvested.

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5 hours ago, Melvin-Moderator said:

I don’t see a big difference to be honest, you may be losing additional hair in the crown. I don’t see significant thinning on the sides. I see your hair is a lot shorter, it could be that your hair looks thinner because it’s shorter. Remember length is required for the “illusion” of density.

I actually started to cut it short because it appeared thin when I grew it up. Not the opposite. If I grow it again, it will look bad.

What path should I go now?

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I say just ride it out and see how the thinning progresses.  The other alternative is to try body hair grafts, but that is probably not ideal for large area.
 

Would it be possible to shave or is there a bad scar in back?

Edited by BadHairDay

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15 minutes ago, BadHairDay said:

I say just ride it out and see how the thinning progresses.  The other alternative is to try body hair grafts, but that is probably not ideal for large area.
 

Would it be possible to shave or is there a bad scar in back?

That's probably what I will do. I will not do any other HT before I see where it goes

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Hair stays in the growth phase between 2-6 years so what you may be experiencing is the hair entering a resting phase. This is why a lot of people complain years later that they have 'lost ground'. 

I have a slightly weaker hairline on one side, most probably down to this phenomenon. No big deal though. 

As mentioned by others it may be exacerbated but some unsafe hairs taken from the donor. 

Minox might be able to improve density by causing hair to stay in the growth phase longer. 

Edited by 1978matt

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10 hours ago, dobler said:

I stopped taking meds 4-5 months before the 1st HT.

And yea you are probably right, many hairs have been taken from the sides, and those hairs turned out to be weak and destined to miniaturization.

I'm sure that finasteride might have given you a sense of false donor supply. Get in touch with your surgeon, but for a large HT you might be better off with FUT. You are right about the medication. Don't go on it again for the sake of hair. I mean hair is awesome, but not that awesome to lose your manhood. 

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On 2/2/2020 at 4:53 PM, dobler said:

<<In the last 6 months I started seeing transplanted hair falling from my frontal 3rd area.. It's much much less dense than 1 year ago.>>

 

2 from December 2016 (prior to 1st ht) - just so you can see how it looked before:

December2016.jpg

December2016_2.jpg

 

How do you know that it's the transplanted hair that is falling out and not the native hair?  Your hairline from pre-op looks like a NW6.  Meaning you were set up to lose the rest of your hair up front.  Between your first surgery and now those would have fallen out since you are not using meds.  It's normal.

Let's be honest, 5,800 grafts is not going to make up for that amount of balding.  As it is you look decent and better than from before you started, the crown included.

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19 hours ago, AB2000 said:

 

How do you know that it's the transplanted hair that is falling out and not the native hair?  Your hairline from pre-op looks like a NW6.  Meaning you were set up to lose the rest of your hair up front.  Between your first surgery and now those would have fallen out since you are not using meds.  It's normal.

Let's be honest, 5,800 grafts is not going to make up for that amount of balding.  As it is you look decent and better than from before you started, the crown included.

Because I see thinning in the sides. It never happened before.

Also - my crown is getting wider and wider, so I assume NW7 it is.

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So guys, what do you think.

Assuming I am going NW7 and already had 5800 grafts (obviously some of them died by now), is another HT a viable option for me? If I am gonna have lower sides and wider crown, how many more grafts will help me get a decent look with no "islands"?

I also have beard hair to donate...

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1. How many grafts do you think I need more, considering my condition.

2. How many safe grafts (hair + beard) do you think I can get? 

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