Do Hair Transplants Thin? The TRUTH with Dr. Ron Shapiro, Dr. Jerry Wong, and Dr. Christian Bisanga

[Melvin- Admin]

 

[Future Hair Doc]

Very interesting and informative video. Thanks for making this.

[Melvin- Admin]

Just now, Dr. Suhail Khokhar said:

Very interesting and informative video. Thanks for making this.

Yea it was good to get all three of these legends to answer this question.

[kirkland]

Dr. Bhatti just released a video which would compliment this video well. He talks about how the hair thins at the end of middle age - around 55 or so - when the body boosts the 5ar enzyme which then converts more testosterone to DHT. This would affect all hair, including transplanted hair. When Dr. Wong talks about a young patient, on a DHT blocker, still having thick transplanted hair after a couple of decades out from a HT, age is as much a factor for maintaining the caliber of the hair.

[aaron1234]

They were unified in their response that transplants do indeed thin over time.  Dr. Bisanga says, "If you can keep your hair transplant good for 10, 15 years then you should be happy."  Every patient should keep this in mind and this is why "max grafts" (i.e. FUT + FUE) is my motto.  

[JP28]

23 minutes ago, kirkland said:

Dr. Bhatti just released a video which would compliment this video well. He talks about how the hair thins at the end of middle age - around 55 or so - when the body boosts the 5ar enzyme which then converts more testosterone to DHT. This would affect all hair, including transplanted hair. When Dr. Wong talks about a young patient, on a DHT blocker, still having thick transplanted hair after a couple of decades out from a HT, age is as much a factor for maintaining the caliber of the hair.

Please don’t tell me the older we get the more dht we have? This is a nightmare… 

[Curious25]

4 hours ago, JP28 said:

Please don’t tell me the older we get the more dht we have? This is a nightmare… 

I have always been led to believe the opposite, from what I have read and heard from doctors over the years - hence the general consensus that the rate of balding more often than not, slows as we get older. 

[asterix0]

Thanks for posting this @Melvin- Moderator, it is very useful for prospective patients to see.

I have posted numerous threads here trying to help educate people on this topic, and I received some pushback but that's ok, it's an uncomfortable topic because we like to idealize hair transplants as the panacea to this very psychologically challenging condition of hair loss, particularly for young and desperate guys.

Recipient scalp characteristics, donor dht resistance (not complete immunity) all play a part, and vary person to person. 

The key point is that prospective patients need to be aware of the risks, particularly if they are young, headed to a high Norwood quickly, and reluctant to take medication (even then finasteride or dutasteride may not be enough, but the statistics show it can and usually does help significantly). 

 

Edited July 1, 2021 by asterix0

[Huncholini]

All 3 hair transplant Drs in this video seem to have impeccable natural hairlines, in fact most of the other Drs I can think of (Lupanzula, Zarev, Muresanu) seem to be at worst NW3s and they're all over 40. What gives?

[Melvin- Admin]

4 hours ago, asterix0 said:

Thanks for posting this @Melvin- Moderator, it is very useful for prospective patients to see.

I have posted numerous threads here trying to help educate people on this topic, and I received some pushback but that's ok, it's an uncomfortable topic because we like to idealize hair transplants as the panacea to this very psychologically challenging condition of hair loss, particularly for young and desperate guys.

Recipient scalp characteristics, donor dht resistance (not complete immunity) all play a part, and vary person to person. 

The key point is that prospective patients need to be aware of the risks, particularly if they are young, headed to a high Norwood quickly, and reluctant to take medication (even then finasteride or dutasteride may not be enough, but the statistics show it can and usually does help significantly). 

 

I believe there’s two factors, one is age. Every living person will have thin hair with age, even if you look at someone without hair loss their hair has thinned.

Clint Eastwood 90

 

At 40

As you can see all of his hair has thinned out, the DHT susceptible area more, but still even his donor has thinned. 

The other factor is DHT susceptibility to the transplanted hair. Some hair may be taken from an area that is prone to thinning, these areas can be near the nape or the border of the crown. I feel with FUE there will be a portion of hair thinning, and FUT as well if the strip is taken lower near the nape. As @Dr. Ron Shapiro said some may thin more than others, it depends on how the surgeon planned and mapped out the procedure. That is why it’s important to go to a clinic like Shapiro, Hasson and Wong, BHR. They don’t just blast your scalp, everything is done with your future in mind.

[dtap]

11 hours ago, Curious25 said:

I have always been led to believe the opposite, from what I have read and heard from doctors over the years - hence the general consensus that the rate of balding more often than not, slows as we get older. 

At least thats a good thing

[dtap]

16 hours ago, aaron1234 said:

They were unified in their response that transplants do indeed thin over time.  Dr. Bisanga says, "If you can keep your hair transplant good for 10, 15 years then you should be happy."  Every patient should keep this in mind and this is why "max grafts" (i.e. FUT + FUE) is my motto.  

Well based on what Shapiro said the transplanted hairs do thin but not by a lot like those natively on top. Thats the gist of what he explained in the interview. He mentioned patients he's worked on from 20 years ago, one of them who received 1500 grafts and his transplanted hair still looks good.

Similarly, in one video doctor Diep worked on an elderly patient who kinda looks like Elvis whose transplant looks very good for someone in their 70s. No evidence of thinning.

All in all we'll do fine in the future.

Edited July 1, 2021 by dtap

[JP28]

11 hours ago, Curious25 said:

I have always been led to believe the opposite, from what I have read and heard from doctors over the years - hence the general consensus that the rate of balding more often than not, slows as we get older. 

What’s the solution then?

Add a topical anti-androgen on top of finasteride? 

[gillenator]

Another factor I believe occurs as we age is some hair follicles have shorter anagen (growth) phase durations...this is especially evidenced in men who do not have MPB however their scalps overall are not as dense, not recession, just overall thinner density.

[Balding Bad]

Great video with great insight! Thanks for sharing! 😎

[Gatsby]

On 7/2/2021 at 12:19 AM, Huncholini said:

All 3 hair transplant Drs in this video seem to have impeccable natural hairlines, in fact most of the other Drs I can think of (Lupanzula, Zarev, Muresanu) seem to be at worst NW3s and they're all over 40. What gives?

Dr Zarev actually wears a hair piece. Though that is a viable option and one I took for 25 years.

[Gatsby]

I have a friend who I have worked with who has now retired. He also like myself had old school punch grafts that were repaired in the early 2000's into single follicular units. Today he would be about 65 and over the past 20 years I have definitely noticed that his hair 'overall' has thinned. In one way it has 'aged/thinned' with him so it still looks natural. Also he could probably have another surgery to add more density. But a great video @Melvin- Moderator and another reason for young people who are impatient to have a transplant to realize that this is a procedure for over the lifespan. Not a quick fix forever.