Donor Dominance Theory Revisited

[asterix0]

2 minutes ago, lovinitl9 said:

no, I'm talking about hair that has grown

Ok then, let's assume a judicious surgeon who only extracted from Norwood 7 bounds via FUT, did extensive miniaturization examinations before the transplant, and found the rate to be minimal in that region.

How would you explain the hair falling out then?

You are claiming you have seen examples of cases 1 year + out due to the surgeon's decisions for graft placement/ slit size? Can you provide an example, as I have not seen this.

Edited December 26, 2020 by asterix0

[lovinitl9]

sure, this tends to especially be the case if a surgeon uses a needle as opposed to blades to make the slits. there is unnecessary trauma, consequently leaving a competition for the bloodline that results in these aforementioned cases. 

[asterix0]

1 minute ago, lovinitl9 said:

sure, this tends to especially be the case if a surgeon uses a needle as opposed to blades to make the slits. there is unnecessary trauma, consequently leaving a competition for the bloodline that results in these aforementioned cases. 

Again, do you have a specific example or this just your personal theory?

To repeat, a finalized hair transplant result, meaning 12 to 18 months post operation, that failed years later due to the reason you claim.

[lovinitl9]

several friends of mine and retrospective cases that I looked back on this forum to see which physician they used and what technique was employed. 

[asterix0]

Also, saying just a blanket statement of insufficient blood flow is insufficient for proof.

Why?

Because Insufficient blood flow is a symbiotic cause of hair loss with androgenetic alopecia! Your scalp is in a hypoxic, inflammatory state that DHT is sent to to amelerioate. It is among one of the many causes that lead to the final result of hair miniaturization.

Usage of anti androgens such as finasteride is exactly what is used to prevent this. What do you think minoxidil is? A Vasodilator! 

Edited December 26, 2020 by asterix0

[lovinitl9]

sure, i'm not going to write a dissertation on this topic, just trying to chime in 

[asterix0]

7 minutes ago, lovinitl9 said:

sure, i'm not going to write a dissertation on this topic, just trying to chime in 

No need for a dissertation, just copying and pasting one or two links that support your claim, as to help other forum posters understand this better.

 

Edited December 26, 2020 by asterix0

[TrialAcc]

15 minutes ago, asterix0 said:

Also, saying just a blanket statement of insufficient blood flow is insufficient for proof.

Why?

Because Insufficient blood flow is a symbiotic cause of hair loss with androgenetic alopecia! Your scalp is in a hypoxic, inflammatory state that DHT is sent to to amelerioate. It is among one of the many causes that lead to the final result of hair miniaturization.

Usage of anti androgens such as finasteride is exactly what is used to prevent this. What do you think minoxidil is? A Vasodilator! 

You came in here with an awfully conducted study and subsequently have dismissed or asked for proof from every person who has tried to supply a theory for why these hairs have fallen out, when you yourself have supplied none. There is no way that these transplanted hairs would have gone through androgenic cell death within 5 years after being moved from the NW7 zone to the top of the head. DHT is present at the back of the head as well, and would not have killed the entirety of those follicles within that span. 

If you want to have a civil discussion as to why this is happening, then be open to different avenues of discussion. Elon Musk is a perfect example of why there is more to this then simply disproving donor dominance. He got his first hair transplant over 20 years ago and still has frontal hair from that and the subsequent surgeries, and he was almost fully bald in the frontal area by 30, proving aggressive MPB. What's the different between him and these guys? Probably the quality of surgeon, for one. I'd say that's a good place to start further diving into this if you want. Check the history between the top surgeons and the back ally clinics beyond the 12-18 month mark. I would be shocked if you didn't see a significant trend of poorer long term results from the cheaper clinics. 

Edited December 26, 2020 by TrialAcc

[asterix0]

4 minutes ago, TrialAcc said:

You came in here with an awfully conducted study and subsequently have dismissed or asked for proof from every person who has tried to supply a theory for why these hairs have fallen out, when you yourself have supplied none. There is no way that these transplanted hairs would have gone through androgenic cell death within 5 years after being moved from the NW7 zone to the top of the head. DHT is present at the back of the head as well, and would not have killed the entirety of those follicles within that span. 

If you want to have a civil discussion as to why this is happening, then be open to different avenues of discussion. Elon Musk is a perfect example of why there is more to this then simply disproving donor dominance. He got his first hair transplant over 20 years ago and still has frontal hair from that and the subsequent surgeries, and he was almost fully bald in the frontal area by 30, proving aggressive MPB. What's the different between him and these guys? Probably the quality of surgeon, for one. I'd say that's a good place to start further diving into this if you want. Check the history between the top surgeons and the back ally clinics beyond the 12-18 month mark. 

Do you know if Elon Musk is on finasteride?

Show me an example of one link or study you provided as proof that I "dismissed".

Quote it, everything is in the thread here for everyone to see.

[TrialAcc]

7 minutes ago, asterix0 said:

Do you know if Elon Musk is on finasteride?

Show me an example of one link or study you provided as proof that I "dismissed".

Quote it, everything is in the thread here for everyone to see.

Huh? Just go read your last posts. "a blanket statement and insufficient proof" "Do you have a specific example or is this just your personal theory?" "You are claiming you have seen examples of cases 1 year + out due to the surgeon's decisions for graft placement/ slit size? Can you provide an example, as I have not seen this."

We don't have this type of evidence available to us, for obvious reasons. Most people who have successful hair transplants are not doing what people on these forums are doing and discussing every detail about them, they are just out being normal people. We are just trying to contribute to the discussion and explore different avenues for why these results are seen in some people and not others. 

As for Elon, he's probably on finasteride or some similar variant. Personally (and I don't mean to call anyone out here), I don't see why you would ever bother with a HT if you were not on finasteride unless you were legitimately a NW4/5/6 already and been that way for years. If you're going to make this type of investment in your personal appearance with so many routes for it to go wrong even if you do everything right, why would you take the added risk of the rest of your hair going to shit in the meantime. 

Edited December 26, 2020 by TrialAcc

[asterix0]

8 minutes ago, TrialAcc said:

Huh? Just go read your last posts. "a blanket statement and insufficient proof" "Do you have a specific example or is this just your personal theory?" "You are claiming you have seen examples of cases 1 year + out due to the surgeon's decisions for graft placement/ slit size? Can you provide an example, as I have not seen this."

We don't have this type of evidence available to us, for obvious reasons. Most people who have successful hair transplants are not doing what people on these forums are doing and discussing every detail about them, they are just out being normal people. We are just trying to contribute to the discussion and explore different avenues for why these results are seen in some people and not others. 

As for Elon, he's probably on finasteride or some similar variant. Personally (and I don't mean to call anyone out here), I don't see why you would ever bother with a HT if you were not on finasteride unless you were legitimately a NW4/5/6 already and been that way for years. 

I have supplied a theory for why they have fallen out. You have claimed there is no way for these hairs to experience androgenic cell death 5 years after transplantation from the Norwood 7 region.

However, there is evidence abound from other posters that it indeed does happen. I have provided some links, I will provide you more as to why:

Recipient-Site Influence in Hair Transplantation
A Confirmative Study

https://journals.lww.com/dermatologicsurgery/Citation/2009/06000/Recipient_Site_Influence_in_Hair_Transplantation_.22.aspx

Here is more:

"We propose that both recipient and donor sites have influences on the donor hair growth and character- istics."

https://www.researchgate.net/profile/Rodney_Sinclair/publication/5338309_Donor_Site_Dominance_in_Action_Transplanted_Hairs_Retain_Their_Original_Pigmentation_Long_Term/links/5e12cf704585159aa4b47c35/Donor-Site-Dominance-in-Action-Transplanted-Hairs-Retain-Their-Original-Pigmentation-Long-Term.pdf

So, I have not dismissed any of your evidence. Because you have yet to provide any that donor dominance is proven. 

Edited December 26, 2020 by asterix0

[Ron5566]

32 minutes ago, asterix0 said:

Also, saying just a blanket statement of insufficient blood flow is insufficient for proof.

Why?

Because Insufficient blood flow is a symbiotic cause of hair loss with androgenetic alopecia! Your scalp is in a hypoxic, inflammatory state that DHT is sent to to amelerioate. It is among one of the many causes that lead to the final result of hair miniaturization.

Usage of anti androgens such as finasteride is exactly what is used to prevent this. What do you think minoxidil is? A Vasodilator! 

You said something extremely interesting that I had no clue but explains something I thought helped me in the past but just to ensure I got this right, you are saying weak blood circulation in the scalp has something to do with people that are sensetive to DHT?? 

[asterix0]

2 minutes ago, Ron5566 said:

You said something extremely interesting that I had no clue but explains something I thought helped me in the past but just to ensure I got this right, you are saying weak blood circulation in the scalp has something to do with people that are sensetive to DHT?? 

Yes, there is much scientific study on this:

"...long-term effects of muscles surrounding the affected scalp (including the frontal, occipital, periauricular, and temporal muscles) tighten the affected scalp, resulting in reduced blood flow to the terminal vessels at the top of the head and forehead, which eventually leads to a hypoxic state in these affected areas [23]. Moreover, DHT is prone to activation under hypoxic conditions, and it is the most crucial factor that terminates hair follicles and causes hair loss. Previous studies suggested that there were hemodynamic abnormalities including microvascular dysfunction and reduced blood flow in the alopecia region of AGA patients."

https://www.hindawi.com/journals/bmri/2020/1501893/

[asterix0]

18 minutes ago, TrialAcc said:

Huh? Just go read your last posts. "a blanket statement and insufficient proof" "Do you have a specific example or is this just your personal theory?" "You are claiming you have seen examples of cases 1 year + out due to the surgeon's decisions for graft placement/ slit size? Can you provide an example, as I have not seen this."

We don't have this type of evidence available to us, for obvious reasons. Most people who have successful hair transplants are not doing what people on these forums are doing and discussing every detail about them, they are just out being normal people. We are just trying to contribute to the discussion and explore different avenues for why these results are seen in some people and not others. 

As for Elon, he's probably on finasteride or some similar variant. Personally (and I don't mean to call anyone out here), I don't see why you would ever bother with a HT if you were not on finasteride unless you were legitimately a NW4/5/6 already and been that way for years. If you're going to make this type of investment in your personal appearance with so many routes for it to go wrong even if you do everything right, why would you take the added risk of the rest of your hair going to shit in the meantime. 

I am taking finasteride and minoxidil myself, so I don't disagree with you!

But that is the question that in the end I want to raise.

Should clinics and doctors have a disclaimer saying, this procedure may not be permanent by any means, without the use of finasteride or another anti androgen you run the risk of failure even with perfect surgical execution.

Hell, even with finasteride it may fail, but I am stating that clinics have an ethical obligation to communicate this to prospective patients as a risk factor. 

 

Edited December 26, 2020 by asterix0

[Ron5566]

Just now, asterix0 said:

Yes, there is much scientific study on this:

"...long-term effects of muscles surrounding the affected scalp (including the frontal, occipital, periauricular, and temporal muscles) tighten the affected scalp, resulting in reduced blood flow to the terminal vessels at the top of the head and forehead, which eventually leads to a hypoxic state in these affected areas [23]. Moreover, DHT is prone to activation under hypoxic conditions, and it is the most crucial factor that terminates hair follicles and causes hair loss. Previous studies suggested that there were hemodynamic abnormalities including microvascular dysfunction and reduced blood flow in the alopecia region of AGA patients."

https://www.hindawi.com/journals/bmri/2020/1501893/

Holy... Okay this MAY explain something I have been struggling to understand, would like to hear your opinion:

 

When I was 18-19 I went to do temporary SMP in my country, I went to crappy artist that used such a weak ink that faded off every month, I went twice a month for 3 months straight.

My hairloss was so aggressive back then, I was thining everywhere, after like two months I noticed my hairloss stopped, I thought I was imagined but it did stop, I know because Whenever I tried to pull hair, at least two came easily, whenever I shampoo I saw tons of hair, none came out during that time. 

 

8 years later I went under FUT, I am suffering from retrograde alopecia or even DUPA since it effects all my scalp, after the FUT producer I did lose transplanted hair (Because obviously, I was also shedding at the back).

 

Without going too much into this story which is complicated and you probs ask why I went to another surgery if I am losing my sides and back, I went again under FUE this time (To pick the best grafts on my head for small producer just to fill my temples to wear my hair piece successfully)

 

However, something shocking happened afterwards, I used to lose 100 hairs in my donor on daily basis (By donor I mean nape, sides, sideburn etc) I am two months post OP, hair is in the regular length about 2.5cm-3cm which is long enough, no matter how hard I pull, no hair is going out, zero hairs in shower, zero hairs on my pillow.

 

I was thinking what did I change again? And I actually wrote down everything :

 

1) Stopped working out

2) Slept outside my room for a month (I was thinking maybe because I sleep with router so idk)

3) Haven't sex for 2 months (Maybe lol)

4) And the last thing, I did FUE which caused tons of blood flow to my donor.

 

I don't know how to explain it but after your message, maybe, just maybe it's all about blood in my situation, would like to hear your opinion.

 

P.S - Propecia never helped me or slow downed my hairloss (took for 6 years straight and basically became Norwood 6 from 15.5-22).

The article you sent me is extremely interesting, thank you!

[asterix0]

@Ron5566 This is a complicated story so it is hard to say, if you weren't on an anti androgen I would say that is the most likely cause.

I am by no means a finasteride advocate either. I take it begrudgingly.

What I think though is that it helps just keep push back against the recipient forces of one's scalp, and keeps the transplanted hair safe. 

For some patients, not all. To find the percentage is the real question.

[Ron5566]

2 minutes ago, asterix0 said:

@Ron5566 This is a complicated story so it is hard to say, if you weren't on an anti androgen I would say that is the most likely cause.

I am by no means a finasteride advocate either. I take it begrudgingly.

What I think though is that it helps just keep push back against the recipient forces of one's scalp, and keeps the transplanted hair safe. 

For some patients, not all. To find the percentage is the real question.

I see.. what's your opinion about PrP?

Maybe if we can actually get more blood to our scalp, just maybe it may help drastically for some people.

 

I am really curious how my hairloss stopped and tbh only FUE explains it. (speaking on donor).

[asterix0]

1 hour ago, Ron5566 said:

I see.. what's your opinion about PrP?

Maybe if we can actually get more blood to our scalp, just maybe it may help drastically for some people.

 

I am really curious how my hairloss stopped and tbh only FUE explains it. (speaking on donor).

PRP in theory should help, but I can't speak for its efficacy as I havent read the literature too much about it.

Certainly a multi-pronged approach is needed to fight hair loss effectively. 

[asterix0]

Just wanted to bump this because I have seen some more frequent accounts lately of people losing transplanted hair several years down the road. If you are worried about your dht sensitivity you should at least try topical finasteride, if you want to give yourself the best chance of protecting your transplanted hairs.

[Euphoria]

This is a useless crappy study and doesn’t help anything. You can style the hair of the same person different ways and appear to have different levels of hairloss. 

The proper way would’ve been to analyse it with microscopes and those things the doctors have, they’re the only objective assessment tools without any bias and can see minitiarization too which is the aim of this study to see if the hair became susceptible to DHT.

No other attention need to be paid to it. 

[Al - Moderator]

There are too many problems with that study which makes it completely useless.

All of the patients were done at the same clinic and they admit that 18.75% of their one year patient results are poor. You don't really need to see or read anything more than that on this study. The only thing clear is that this is not a clinic anyone should go to!

On top of that, even the one case that they show that's supposedly a good result looks like a very poor result to me. It makes the entire study useless as you have to go on their word that they had a lot of good results at the one year mark while only being able to see one of them which as I just said looks like a poor one to me.

Someone posted here that since it's FUT then surely they took hair from the safest area, but that is not necessarily the case. Talk to some elite Drs who have done a lot of FUT repairs and they will tell you that a lot of FUT scars they see were done improperly. A lot of times they make the scar too low and it goes into the nape area which may have some retrograde thinning. In fact I have FUT scars very low in my nape which has completely lost all hair around it over the years. With the clinic who did this study, If by their own admission 18.75% of their transplants are poor results then it becomes very easy to think that they may not be so good at placing FUT scars in the proper location.

 

 

[Al - Moderator]

 

Look at the pictures below. This is from the study. The first picture is before. You can see he has a lot of frontal loss. The middle picture is at one year. They transplanted the frontal zone and if you look closely you can see the hair in the mid scalp is being combed more forward now as compared to the first picture, so it provides more coverage to the frontal transplanted area. Now look at picture 3 taken several years later. It's clear that the hair he lost is all of the mid scalp that was never transplanted in the first place, so of course it looks worse at that point in time. Not only does he not have hair in the mid scalp, but that leaves him without that mid scalp hair to comb forward to help cover a thinly transplanted front which then makes the front look worse as well.

 

 

[osmosis]

I just saw this thread and so joined the forum to reply.

Here is a video explain why donor dominance is no longer a viable theory: