Thoughts on Shock Loss

[deitel130]

What is everyone's thoughts on Shock loss for a diffuse thinner. If transplanting between existing hair is it too risky to permanently damage existing hair or is this rare?

[Melvin- Admin]

It can be risky, depends how weak the hair is, can you post pictures?

[deitel130]

Thanks Melvin. Here are some pics. Wanted to add density to hairline where seen from front and I'm thinking to leave everything else alone except add to the crown. I've had 3500 grafts in front and on Finasteride for many years. Hair loss has stabilized but I felt like last year my front thinned a bit the same time I was weight lifting. I know everything says there is no real relationship between the two however, I feel like everyone is different and lifting weights increases testosterone meaning more conversion to DHT happened even though Finasteride blocks most of it still not all of it. This may have resulted in increased thinning the same time.

 

I've attached pics with hair moved to get a better idea.  You will notice there are definitely see through spots. I've been told another FUT can get me approximately 3000 grafts. I'm thinking to use 1000 in the hairline and 2000 in crown. The mid seems ok for now. What are your thoughts on how I should use the grafts? Want to get advice so that I use the grafts strategically. After this I may no longer have laxity for any more grafts.

 

 

 

 

 

 

 

 

 

 

Edited October 16, 2020 by deitel130
Added pics

[deitel130]

Been on Finasteride for a decade.

 

 

 

 

 

 

Edited October 16, 2020 by deitel130

[Raphael84]

As Melvin explained, much will depend on quality and strength of your native hair. 

3000 grafts will be a nice addition to increase density throughout and it is good to hear that you are using finasteride and have been for several years.

I see from your first procedure that your recipient was not shaven. Making sites and placing grafts amongst native hair is a more challenging procedure and with potentially less visibility when having to manipulate native hair to make each site, shock loss can be more common. If shockloss is a concern discuss this with your doctor and he may recommend a shaven recipient.

I wish you the best. Please keep us updated.

[deitel130]

16 minutes ago, Raphael84 said:

As Melvin explained, much will depend on quality and strength of your native hair. 

3000 grafts will be a nice addition to increase density throughout and it is good to hear that you are using finasteride and have been for several years.

I see from your first procedure that your recipient was not shaven. Making sites and placing grafts amongst native hair is a more challenging procedure and with potentially less visibility when having to manipulate native hair to make each site, shock loss can be more common. If shockloss is a concern discuss this with your doctor and he may recommend a shaven recipient.

I wish you the best. Please keep us updated.

Thank you for the feedback. I have no issue with shaving recipient site. I am trying to get opinions on where I should use the grafts. I was initially thinking 3000 through front and mid. This means nothing in crown but I am hoping for a future procedure to address the crown later and may have to go FUE route. Should I spread the 3000 front to back? Probably will not make a big difference this way. Perhaps 4000 grafts would have made a bigger difference.

[Al - Moderator]

The front half is almost all transplanted hair now. You probably have been losing any remaining native hair over time and that's why it is thinner, so I wouldn't worry much about permanent shock loss in the front half since that should almost all be good, strong transplanted hair. I'd probably opt for putting 2000 grafts throughout the front half into the mid scalp and scatter 1000 throughout the crown. With only 1000 spread out in the crown your chances for a lot of shock loss there are much lower than if you put 2000 there. Even though 1000 in a crown isn't much it will make sure you aren't completely bald there if you continue losing native crown hair over the years and can't (or just don't) get any more work done. This is just my opinion and probably what I would opt for (although I don't know any other details) if it was me.

You could also go for a smaller 2000 graft session with 1000 in the front half and 1000 in the back which will give you some extra grafts for future use.

 

[Bill-Dr-Rahal]

Deitel,

I will admit upfront that I have not read everybody’s reply but I just wanted to respond to Your initial question. Ultimately, shock loss or telogen effluvium can occur anytime hair is transplanted in between existing hairs. So if you are a diffuse thinner and you are getting a hair transplant all of the scalp to a density, it’s very possible that you will lose some if not all of the natural hair on top… Especially those that are miniaturizing.  your initial question. Ultimately, shock loss or telogen effluvium can occur anytime hair is transplanted in between existing hairs. So if you are a diffuse thinner and you are getting a hair transplant all of the scalp to a density, it’s very possible that you will lose some if not all of the natural hair on top… Especially those that are miniaturizing. While terminal hairs are less likely to be “shocked“, it’s still possible but the good news is, those hairs will grow back starting between 3 to 6 months. Velous or miniaturizing hairs however, may not grow back because they were on their way out anyway. The only chance of saving them would be if you somehow reversed the hair growth cycle so that they would become terminal again… Which is possible by using Propecia or even Rogaine.  
 

Whether or not a hair transplant is the right choice for you may depend on how much sitting you have on top versus how much donor hair you have available. Moreover, if you have a lot of natural hair left, I think it’s a good idea to try Propecia or Rogaine for a while first to see if you can stop or even reverse the hair loss process through medication.

I hope this helps.

Bill