Hair Transplant Shock Speed loss of native hair?

[misterv]

I am a candidate for a hair transplant but i dont want to use finasterade or minoxadil. A surgeon told me that the transplanted hair would create a shock loss to my existing hair and speed up hair loss to existing hair. Is this true? What happens in shock loss? Is there any way to mitigate shock loss without finasterade or minoxadil? 

[duchaine]

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[147break]

As far as I understand... Yes it can cause shock loss to the native hairs around the transplanted area. Finasteride will help reduce shock loss. If the native hairs are already thin due to miniaturisation then it's possible that they will be permanently lost, but they were dying anyway.

[LaserCap]

3 hours ago, misterv said:

I am a candidate for a hair transplant but i dont want to use finasterade or minoxadil. A surgeon told me that the transplanted hair would create a shock loss to my existing hair and speed up hair loss to existing hair. Is this true? What happens in shock loss? Is there any way to mitigate shock loss without finasterade or minoxadil? 

If you're a candidate for transplants it means a number of things.  You have hair loss somewhere, front, top back. Please post photos of your entire head to answer properly.

If you've lost the front, there would be no native hair to shed.  If the loss is elsewhere, how much native hair is left?

If you've shown the propensity to lose, you will continue losing.  Forget shedding for a minute.  Say for example you want to add grafts to the crown.  You fill in the circle.  Looks great.  A few months later you lose all the hair around the circle.  Now you're left with an island worth of hair and nothing around it.  We call this chasing the pattern.  Eventually you lose all you donor and then lose the hair in the front.  Now you have nothing to work with.

It is important to understand the donor area is finite.  If we had a wheel-barrel full of hair, great.  But we don't.  It is imperative you keep as much of the native hair as you can so you can get close to achieve a "fuller" looking set of hair.  

If you choose not to use Finasteride or Minoxidil, perhaps a laser is in order.  There is also PRP which, by the way, can help reverse miniaturization and can bring the grafts in sooner.  

Now let's answer your question.  Yes, a procedure can cause shock loss of the existing hair.  So what? That hair typically returns along with the transplants.  And it's not so much shock.  Typically, when the doctor is making recipient sites, he is using a very sharp instrument.  Inadvertently he can cut the native hair.  Just gave you a hair cut.  That hair will continue growing - as it always did.

Lastly, this all refers to shedding.  That's normal.  Hair loss is different.  Hair loss refers to the miniaturization of the strand.  Eventually the hair dissipates until you can no longer see it.  Once gone it never returns.

If you are not going to do meds, and I do respect you for it, DO NOT move forward with transplants.  

[misterv]

https://www.hairrestorationnetwork.com/topic/55830-thinking-of-getting-a-hair-transplant-fue-how-many-grafts-would-i-need/?tab=comments#comment-528169

Hi, thanks for the advice. I  had posted some pics in the link earlier. I just wanted some hair in the front hairline, some reinforcement in the front center and front sides. How long would you suggest being on finasteride after the transplant? thanks

[gillenator]

Shock loss occurs as a result of the trauma induced to the scalp from the procedure...it's the thousands of incisions that are made along with numerous fluids that are injected into the scalp that causes the high level of trauma.

[duchaine]

On 2/16/2020 at 3:47 PM, misterv said:

https://www.hairrestorationnetwork.com/topic/55830-thinking-of-getting-a-hair-transplant-fue-how-many-grafts-would-i-need/?tab=comments#comment-528169

Hi, thanks for the advice. I  had posted some pics in the link earlier. I just wanted some hair in the front hairline, some reinforcement in the front center and front sides. How long would you suggest being on finasteride after the transplant? thanks

you entire life

[Hair4Days]

On 2/14/2020 at 9:42 AM, LaserCap said:

If you're a candidate for transplants it means a number of things.  You have hair loss somewhere, front, top back. Please post photos of your entire head to answer properly.

If you've lost the front, there would be no native hair to shed.  If the loss is elsewhere, how much native hair is left?

If you've shown the propensity to lose, you will continue losing.  Forget shedding for a minute.  Say for example you want to add grafts to the crown.  You fill in the circle.  Looks great.  A few months later you lose all the hair around the circle.  Now you're left with an island worth of hair and nothing around it.  We call this chasing the pattern.  Eventually you lose all you donor and then lose the hair in the front.  Now you have nothing to work with.

It is important to understand the donor area is finite.  If we had a wheel-barrel full of hair, great.  But we don't.  It is imperative you keep as much of the native hair as you can so you can get close to achieve a "fuller" looking set of hair.  

If you choose not to use Finasteride or Minoxidil, perhaps a laser is in order.  There is also PRP which, by the way, can help reverse miniaturization and can bring the grafts in sooner.  

Now let's answer your question.  Yes, a procedure can cause shock loss of the existing hair.  So what? That hair typically returns along with the transplants.  And it's not so much shock.  Typically, when the doctor is making recipient sites, he is using a very sharp instrument.  Inadvertently he can cut the native hair.  Just gave you a hair cut.  That hair will continue growing - as it always did.

Lastly, this all refers to shedding.  That's normal.  Hair loss is different.  Hair loss refers to the miniaturization of the strand.  Eventually the hair dissipates until you can no longer see it.  Once gone it never returns.

If you are not going to do meds, and I do respect you for it, DO NOT move forward with transplants.  

Why wouldnt you move foward with a procedure if you chose not to take medication? Clinics like Feller and Bloxhams objective is to design and transplant without depending on medicine, because genetics always win in the end, and you have enough donor to achieve full coverage front to back.

[LaserCap]

But, what if?

I think a lot of this depends on the age.  If you're on your 50's, 60's perhaps as the pattern has declared itself.  But in your 20's? No way.  Think of a 22 year old with a full set of hair who is just starting to mature his hairline.  Eventually he has a procedure.  No meds.  in his early 30's he starts thinning the crown.  Eventually he is going to be a class 6 and will dip in the donor.  He starts losing the grafts that were transplanted in the temporal areas.  Why? Because the grafts were taken from the area where he was destined to lose the hair.  So, thinking of transplants too early is not a good thing.  This is one of the reasons why many doctors want to wait and avoid having issues with the patient down the road.  In the eyes of the patient - it is then the doctor's fault.

If we had a hair crystal ball.........

 

[Hair4Days]

12 hours ago, LaserCap said:

But, what if?

I think a lot of this depends on the age.  If you're on your 50's, 60's perhaps as the pattern has declared itself.  But in your 20's? No way.  Think of a 22 year old with a full set of hair who is just starting to mature his hairline.  Eventually he has a procedure.  No meds.  in his early 30's he starts thinning the crown.  Eventually he is going to be a class 6 and will dip in the donor.  He starts losing the grafts that were transplanted in the temporal areas.  Why? Because the grafts were taken from the area where he was destined to lose the hair.  So, thinking of transplants too early is not a good thing.  This is one of the reasons why many doctors want to wait and avoid having issues with the patient down the road.  In the eyes of the patient - it is then the doctor's fault.

If we had a hair crystal ball.........

 

You run no risk of Losing transplanted hairs if they were taken from the center of the donor via FUT strip. A 22 year old can do a procedure if his pattern calls for it. We all have anywhere between 5-8000 grafts available so this particular person would have enough to address his hairline and then whatever thins in the future 

[LaserCap]

10 hours ago, James C said:

You run no risk of Losing transplanted hairs if they were taken from the center of the donor via FUT strip. A 22 year old can do a procedure if his pattern calls for it. We all have anywhere between 5-8000 grafts available so this particular person would have enough to address his hairline and then whatever thins in the future 

Agree, in most cases and when done properly.  "We all?" Disagree.  Most? ok.

"would have enough to do whatever in future" Disagree as well.  This will depend on many factors including what hair loss he has, if he does meds or not, elasticity etc.

[Hair4Days]

6 minutes ago, LaserCap said:

Agree, in most cases and when done properly.  "We all?" Disagree.  Most? ok.

"would have enough to do whatever in future" Disagree as well.  This will depend on many factors including what hair loss he has, if he does meds or not, elasticity etc.

I’ve never heard any professional in the industry claim anyone has less then 5,000 available grafts for harvesting. What does taking meds have to do with if he can extract grafts in the future to address thinning? Are you referring to taking propecia to strengthen donor hair? What happens when someone decides they can no longer tolerate meds, or they stop working. It’s best to design a plan to obtain maximum  coverage through surgery alone, without depending on meds.

[LaserCap]

Plenty of people out there with global thinning.  

No one has donor to allow for a full set of hair, particularly in an advanced pattern.  Depending on the goals of the patient, it is always recommended they try to keep as much of the native hair as possible to allow for the best outcome.

Meds will not strengthen donor.  It can help retain and enhance native hair elsewhere.

Not sure what you mean by tolerate meds.  If you are going to have a side effect you'll know immediately.  Side effects to not surface years after taking/using meds. And, if they work, they'll continue working for as long as you do them.  Rogaine does lose some of its effectiveness at about 7 years - but the patient should continue using it otherwise they'll see more fall-out.

When you say, "stop working" are you referring to the visual change? So, when you see hair fall out, in the shower, sink, pillow...do you think this is hair loss? So, no fall-out - the meds are working?

 

[Hair4Days]

7 minutes ago, LaserCap said:

Plenty of people out there with global thinning.  

No one has donor to allow for a full set of hair, particularly in an advanced pattern.  Depending on the goals of the patient, it is always recommended they try to keep as much of the native hair as possible to allow for the best outcome.

Meds will not strengthen donor.  It can help retain and enhance native hair elsewhere.

Not sure what you mean by tolerate meds.  If you are going to have a side effect you'll know immediately.  Side effects to not surface years after taking/using meds. And, if they work, they'll continue working for as long as you do them.  Rogaine does lose some of its effectiveness at about 7 years - but the patient should continue using it otherwise they'll see more fall-out.

When you say, "stop working" are you referring to the visual change? So, when you see hair fall out, in the shower, sink, pillow...do you think this is hair loss? So, no fall-out - the meds are working?

 

I do not take propecia for personal reasons, however based on my research the drug simply slows down the process of hair loss and could eventually not work as well (Continued miniaturization after a while, not pillow shedding.) The debate on weather or not this drug is useful long term could go on and on. 
 

As for achieving full coverage via surgery alone. Let’s do the math. Let’s take a Nw 5 with limited native hairs left. If he has 6000 total grafts to harvest (most do) and a 200 sq cm surface zone of loss (which is front to back on a nw5). You can either  1. cover 30 grafts per sq cm throughout the whole head. 2. Distribute them where it’s denser in the front, 40 grafts per cm in the hairline zone, 30 mid scalp, 25 in the crown. If you’re referring to people not having the donor for a full set of dense hair like when we were 20, then of course we can all agree. But do you agree that you can Atleast get full coverage with very acceptable density in the front half while compromising density in the crown? 

[gillenator]

From my own observation, hair loss meds, especially low dose finasteride works efficiently for a larger percentage of the men who take them.

Still, it's always a good idea to plan your restoration from a more conservative approach because you never know what can occur in the future...the meds begin to lose their efficiency or the individual cannot tolerate taking them any more, etc. 

[Hair4Days]

3 hours ago, gillenator said:

From my own observation, hair loss meds, especially low dose finasteride works efficiently for a larger percentage of the men who take them.

Still, it's always a good idea to plan your restoration from a more conservative approach because you never know what can occur in the future...the meds begin to lose their efficiency or the individual cannot tolerate taking them any more, etc. 

This is what i was telling @LaserCap 

you shouldn’t rely so heavily on taking meds for the rest of your life. The main focus should be keeping the donor in best shape possible so you could  utilize every graft to obtain maximum coverage if need be. 

[Al - Moderator]

Side effects from finisteride can definitely come after several years of taking it. If you are young you may not notice a small decrease in how easily you get an erection, but as you get older and naturally don't get those erections as easily then any small decrease can start to make a big noticeable difference. This is what happened to me on top of my hair falling out again anyway along with some other things made there be no reason to continue taking it. I was so glad I stopped. I hated taking a daily medication. I stopped taking it over 10 years ago.

 

[Al - Moderator]

On 2/19/2020 at 10:39 PM, James C said:

You run no risk of Losing transplanted hairs if they were taken from the center of the donor via FUT strip.

This is not true, although the risk is less with FUT than with FUE because FUT generally concentrates the donor from the safest areas.

 

On 2/19/2020 at 10:39 PM, James C said:

A 22 year old can do a procedure if his pattern calls for it.

But it's nearly impossible to know what pattern a 22 year old will have.

 

On 2/20/2020 at 11:03 AM, James C said:

As for achieving full coverage via surgery alone. Let’s do the math. Let’s take a Nw 5 with limited native hairs left. If he has 6000 total grafts to harvest (most do) and a 200 sq cm surface zone of loss (which is front to back on a nw5). You can either  1. cover 30 grafts per sq cm throughout the whole head. 2. Distribute them where it’s denser in the front, 40 grafts per cm in the hairline zone, 30 mid scalp, 25 in the crown. If you’re referring to people not having the donor for a full set of dense hair like when we were 20, then of course we can all agree. But do you agree that you can Atleast get full coverage with very acceptable density in the front half while compromising density in the crown?

1. It doesn't usually happen that way. Many people get the hairline dense packed because they don't yet have much thinning anywhere else. Then they start getting mid scalp and crown loss, but they already covered the frontal hairline band with 65 grafts per sq cm. If this person progresses to a NW 5 or worse they will run out of grafts well before covering it all.

2, 40 grafts per sq cm is usually  not enough to get decent coverage and if you average only 30 overall as you wrote then it's not going to look very good. A lot of guys would rather shave then have extremely thin hair.

3. A quick estimate of my bald area is 460 sq cm. That's more than double what you wrote. 460 sq cm at a 40 graft per sq cm average density would be 18,400 grafts.

 

Edited February 22, 2020 by BeHappy

[Hair4Days]

30 minutes ago, BeHappy said:

This is not true, although the risk is less with FUT than with FUE because FUT generally concentrates the donor from the safest areas.

 

But it's nearly impossible to know what pattern a 22 year old will have.

 

1. It doesn't usually happen that way. Many people get the hairline dense packed because they don't yet have much thinning anywhere else. Then they start getting mid scalp and crown loss, but they already covered the frontal hairline band with 65 grafts per sq cm. If this person progresses to a NW 5 or worse they will run out of grafts well before covering it all.

2, 40 grafts per sq cm is usually  not enough to get decent coverage and if you average only 30 overall as you wrote then it's not going to look very good. A lot of guys would rather shave then have extremely thin hair.

3. A quick estimate of my bald area is 460 sq cm. That's more than double what you wrote. 460 sq cm at a 40 graft per sq cm average density would be 18,400 grafts.

 

I  have never seen anyone in my life permanently lose the hair in the center of their donor zone where an fut strip is taken. 
 

it seems like your an advanced nw 7 and expectations should be a little different. So in your opinion what’s the best result a nw 5 can achieve (grafts, coverage, density)

[Al - Moderator]

24 minutes ago, James C said:

I  have never seen anyone in my life permanently lose the hair in the center of their donor zone where an fut strip is taken.

Unfortunately I have to see it every day   😕

 

25 minutes ago, James C said:

it seems like your an advanced nw 7 and expectations should be a little different.

But I wasn't a NW 7 when I started and that's the point.

 

26 minutes ago, James C said:

So in your opinion what’s the best result a nw 5 can achieve (grafts, coverage, density)

So I'm guessing you are a NW 5. If so, you weren't always a NW 5. At one time you had a full head of hair NW 0. Then you progressed through NW 2, 3, 4, and now at 5. Don't assume it will suddenly stop if you have a hair transplant. If I were able to go back and do it again with the technology and techniques available today I would mix several thousand beard grafts in the mid scalp and crown. This way you have something like a frontal third of around 3000 scalp grafts and midscalp and crown with a mix of maybe 2000 beard grafts and 1000 scalp grafts. That's 6000 grafts while only using 4000 from your head donor. I currently have over 4600 beard and chest grafts and wish I could have done those way back in the beginning.

 

 

 

[Hair4Days]

9 hours ago, BeHappy said:

Unfortunately I have to see it every day   😕

 

But I wasn't a NW 7 when I started and that's the point.

 

So I'm guessing you are a NW 5. If so, you weren't always a NW 5. At one time you had a full head of hair NW 0. Then you progressed through NW 2, 3, 4, and now at 5. Don't assume it will suddenly stop if you have a hair transplant. If I were able to go back and do it again with the technology and techniques available today I would mix several thousand beard grafts in the mid scalp and crown. This way you have something like a frontal third of around 3000 scalp grafts and midscalp and crown with a mix of maybe 2000 beard grafts and 1000 scalp grafts. That's 6000 grafts while only using 4000 from your head donor. I currently have over 4600 beard and chest grafts and wish I could have done those way back in the beginning.

 

 

 

So how many total grafts did you have done? How is your coverage / density considering you’re nw 7? 
 

im not a nw 5 yet but I’ll get there because i refuse to take anything that will negatively affect my performance in the sack. What’s the point of having hair if you can’t deliver. However, i do feel optimistic about surgery alone once i reach that point. I’ve spoke to many clinics that say it’s possible to have  dense frontal third coverage with reasonable coverage in the crown which I’m fine with. And I’ve seen photos of this being done With around 6000 grafts in a nw 5

[gillenator]

On 2/21/2020 at 8:28 PM, James C said:

This is what i was telling @LaserCap 

you shouldn’t rely so heavily on taking meds for the rest of your life. The main focus should be keeping the donor in best shape possible so you could  utilize every graft to obtain maximum coverage if need be. 

 

Could not agree more!