Retrograde Thinning?

[gxm100]

Hi Everyone,

I've been consulting with Dr. Blake Bloxham about a possible hair restoration procedure. I sent him some photos and he suggested that I would be a good candidate (29 y/0 male norwood 3). When I sent him my photos, my head was buzzed (I did that to intentionally make the pattern clear). 

Recently, I learned of retrograde hair loss.  For almost as long as I can remember (early high school maybe even junior high) the hair on the sides of my head has been different from on top - it's thinner and more wiry. But now that my hair has grown back in, I'm wondering if this is retrograde hair loss (see pic attached).  It is only like this on the sides, the back of my head is full and thick as could be. I've never really thought much of it because I usually keep the sides very short, and when it's cut like that, you can't tell a difference at all.  I'm wondering if this is a signal that I should not proceed with a HT and am curious to get your thoughts. 

I think it's important to note, for added context that to the touch, the hair in this region feels notably different from the rest of the hair on my head - not thinner but far more coarse and wiry. I am going for an in person consult with Dr Bloxham and I will raise this concern, but I just wanted to get some opinions.

 

Thanks!

Edited July 7, 2021 by gxm100

[SD1984]

Yes, retrograde. Though fortunately not too drastic (unlike mine, check out my thread).

You're still a candidate for a HT. They just can't take many from that area.

[gxm100]

@SD1984 - thanks for the input! I just checked your thread...yours doesn't really seem that exceptionally bad to me either, though. Only difference I can really see is around the very very bottom on the back of your head...but grafts (from what I've seen) are not usually taken from that low anyway.  Your more 'traditional' donor area seems to be very strong to me - I was surprised that people were calling it fairly aggressive. 

[Melvin- Admin]

What does the back look like? It does loom fairly aggressive to me. 

[EvoXOhio]

My hair from my temple points  to my ears has always been different. It’s thinner, it doesn’t grow very long, and it’s wiry/curly. When I was 16 I grew my hair down to my shoulders, but that area around my temples and ears never grew longer then 2 inches. When my hair is shorter, my hair looks similar to yours in that area. I’ve had this since as far back as so can remember (age 16 if not younger). It has thinned out more over the years, as is common for balding men to lose their temple points. But the point is that even before I had hair loss I had this same issue. So it’s hard to tell if you’re the same or if it’s something else. I’ve attached a pic when I was 26 (I can’t find any older pics that show my hair from this angle), which was before my hair loss started. You can see that the same area is much thinner. My hair was cut the same length all around the sides, but you can only see scalp on this area due to the thinness. 

[gxm100]

3 hours ago, Melvin- Moderator said:

What does the back look like? It does loom fairly aggressive to me. 

Well, unfortunately for the purposes of this thread I just got my hair cut about an hour ago.  Here is a photo from the back, though I feel the length at which I get it cut makes it pretty difficult to tell much from it. When it was longer earlier today, I didn't really seem to think it was thinning much.  This photo is with a skin fade, so I will have to post another in a week or two.  

 

How does this impact the prospect of a transplant? Particularly on the back (if there is any thinning at all), I don't see this as being really a part of the 'traditional' donor area, so would it really limit the # of potential grafts?  

 

 

[Melvin- Admin]

36 minutes ago, gxm100 said:

Well, unfortunately for the purposes of this thread I just got my hair cut about an hour ago.  Here is a photo from the back, though I feel the length at which I get it cut makes it pretty difficult to tell much from it. When it was longer earlier today, I didn't really seem to think it was thinning much.  This photo is with a skin fade, so I will have to post another in a week or two.  

 

How does this impact the prospect of a transplant? Particularly on the back (if there is any thinning at all), I don't see this as being really a part of the 'traditional' donor area, so would it really limit the # of potential grafts?  

 

 

You don’t have aggressive thinning in the back, it’s hard to be sure at this length. The good news is your crown looks healthy. If you can preserve what you have, you won’t need many grafts. Preservation>transplantation.

[Nounours]

I've got similar retrograde thinning too (I'm also NW3) so I would be interested to hear what Dr Bloxham says to you!

[BLE123]

I have the same. When shaved short you can't really notice it and when longer it's ok too but there's a weird middle length where it becomes quite apparent. It doesn't really bother me and at worst it just looks like a shoddy attempt at a fade but I wonder what it means for me down the line? I have otherwise thick hair and only a little temple recession so right now not much to be concerned about but does having retrograde mean that advanced loss is for sure on the horizon? I've still yet to really find an answer to this but anyway, I don't think it should deter you from looking at getting a transplant.

[gxm100]

5 hours ago, BLE123 said:

I have the same. When shaved short you can't really notice it and when longer it's ok too but there's a weird middle length where it becomes quite apparent. It doesn't really bother me and at worst it just looks like a shoddy attempt at a fade but I wonder what it means for me down the line? I have otherwise thick hair and only a little temple recession so right now not much to be concerned about but does having retrograde mean that advanced loss is for sure on the horizon? I've still yet to really find an answer to this but anyway, I don't think it should deter you from looking at getting a transplant.

@BLE123I'd be curious about the same.  Could anyone answer that question? Generally, is retrograde loss an indication of very high norwood patterns in the future? Or is it possible that it is coupled with moderate hair loss levels from the top?

[giegnosiganoe]

Not sure if I'm allowed to link to other forums.. Here is an example of someone with a similar retrograde pattern, but with much more advanced diffusion (he's 42): minutes 

Based on how you look now, and your age, I kind of doubt it'll expand much more. It may become more thin, but hopefully the DHT blocker will prevent that.

I'm dealing with a similar situation, and simply avoided taking extractions from that area. If anything, it'll help to balance out the difference in density.

Regarding the course/wiry hairs, I've noticed that but only on select hairs in that area.

[BD99]

I have similar thinning on the sides, and also had a procedure with Dr. Bloxham. The back of my head also looks similar to yours at that length. I think you're still a fine candidate for surgery, but just beware that your donor in the back might be a little deceiving if it's anything like mine. For instance, it may appear as if you'd have a 7-8k graft donor capacity, but the reality is that the hair itself isn't all that dense and the capacity is more like 6k. 

Joe Tillman talks about this same thing in a video on YouTube. Look for the title "Too Thin for A Hair Transplant? Hair Transplant Consultations #4"

[SD1984]

2 hours ago, BD99 said:

I have similar thinning on the sides, and also had a procedure with Dr. Bloxham. The back of my head also looks similar to yours at that length. I think you're still a fine candidate for surgery, but just beware that your donor in the back might be a little deceiving if it's anything like mine. For instance, it may appear as if you'd have a 7-8k graft donor capacity, but the reality is that the hair itself isn't all that dense and the capacity is more like 6k. 

Joe Tillman talks about this same thing in a video on YouTube. Look for the title "Too Thin for A Hair Transplant? Hair Transplant Consultations #4"

Any before and afters of your donor?

[Melvin- Admin]