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Is Shock Loss Inevitable?


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No. Obviously every patient is different and the skills of a surgeon are important. Meds like finasteride/minoxidil can also help to mitigate against shock loss. 

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7 hours ago, dtap said:

Hello everyone. Will ht patients experience shock loss to one degree or another in any procedure no matter how big or small it is?

Going to a decent/elite Dr/Clinic should minimise the risk. It can never be ruled out but it definitely doesn’t always occur. 
Seen some horrible shock loss occur from some of the hair mills. 

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If you have a lot of native hair, to an extent yes.

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Your pain threshold, the more injections the more incidents, the mix of epinephrine/saline etc, miniaturisation levels, skill level of the doctor. I have seen in the best hands some shock in the donor and usually around the ears is more prone or just behind, so there are really a fair few factors that play a part. 

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As we know, trauma induced to the scalp is undoubtedly the main inducement of shock loss and most of this trauma is caused by the countless number of incisions made to the scalp...the more incisions, the higher level of corresponding trauma....and we all respond differently.

IMHO, it's the individuals that have an advanced diffused pattern of loss whereby the native hair that is diffused and weak is at the highest risk of shock loss.

This is why many females with diffused hair loss patterns run a high risk of shock loss and surgeons are not as likely to do larger sessions for that reason.

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I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice, but are my own views which you read at your own risk.

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22 hours ago, Dr. Suhail Khokhar said:

No. Obviously every patient is different and the skills of a surgeon are important. Meds like finasteride/minoxidil can also help to mitigate against shock loss. 

Unfortunately I cant take those meds.

 

5 hours ago, Melvin- Moderator said:

If you have a lot of native hair, to an extent yes.

Kinda confused by that. What does the number of native hair have to do with shock loss?

 

1 hour ago, gillenator said:

As we know, trauma induced to the scalp is undoubtedly the main inducement of shock loss and most of this trauma is caused by the countless number of incisions made to the scalp...the more incisions, the higher level of corresponding trauma...

IMHO, it's the individuals that have an advanced diffused pattern of loss whereby the native hair that is diffused and weak is at the highest risk of shock loss.

I did not know that. So if thats the case the more follicles transplanted the higher the shock loss to surrounding native hair, right?

As to your 2nd point, if a patient has a diffused pattern of hair loss, it wouldnt matter that those diffused hairs are killed off by shock loss since theyre diffuse, weak and few in number relative to the higher amounts of other surrounding native hairs nearby, is this right?

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I think there is always a small chance of it happening. It depends on several factors but seems epinephrine plays a major role. I find it happening in 2-5% of patients in the donor area and the majority happening in the area behind the ears. 

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On 7/23/2021 at 7:36 PM, dtap said:

Unfortunately I cant take those meds.

 

Kinda confused by that. What does the number of native hair have to do with shock loss?

 

I did not know that. So if thats the case the more follicles transplanted the higher the shock loss to surrounding native hair, right?

As to your 2nd point, if a patient has a diffused pattern of hair loss, it wouldnt matter that those diffused hairs are killed off by shock loss since theyre diffuse, weak and few in number relative to the higher amounts of other surrounding native hairs nearby, is this right?

It’s not necessarily the number of follicles being transplanted that presents a higher risk, it’s the larger number of incisions throughout the recipient area that raises the level of trauma…and it’s also the type of instruments used to create those incisions…some of the top doctors elect to use custom sized blades which in skillful hands can potentially be less invasive.

Some individuals that have a diffused pattern of loss have a large percent of their thinning native hair in an advanced diffused state…and they can be at a higher risk for acute shock loss in a mega-session case.

Gillenator

Independent Patient Advocate

I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice, but are my own views which you read at your own risk.

Supporting Physicians: Dr. Robert Dorin: The Hairloss Doctors in New York, NY

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8 hours ago, DrTBarghouthi said:

I think there is always a small chance of it happening. It depends on several factors but seems epinephrine plays a major role. I find it happening in 2-5% of patients in the donor area and the majority happening in the area behind the ears. 

Hi Doctor TBarghouthi. Its a pleasure receiving your professional input.

In your vast professional experience, do you know if theres a way to reduce epinephrine (adrenaline hormone) and/or other contributing factors/hormones to reduce trauma and in turn reduce shock loss?

IMHO, I strongly feel shock loss is the BIGGEST enemy in the hair transplant world. Once thats mitigated completely out of the picture for good, hair transplantation as a surgery becomes a godsend for the leery patient.

Awaiting your feedback doctor!

 

42 minutes ago, gillenator said:

Some individuals that have a diffused pattern of loss have a large percent of their thinning native hair in an advanced diffused state…and they can be at a higher risk for acute shock loss in a mega-session case.

Ok that makes sense. Appreciate that gillenator.

I'll be sending you my pics soon. Just give me some time. Always appreciate your honest feedback!

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5 minutes ago, dtap said:

Hi Doctor TBarghouthi. Its a pleasure receiving your professional input.

In your vast professional experience, do you know if theres a way to reduce epinephrine (adrenaline hormone) and/or other contributing factors/hormones to reduce trauma and in turn reduce shock loss?

IMHO, I strongly feel shock loss is the BIGGEST enemy in the hair transplant world. Once thats mitigated completely out of the picture for good, hair transplantation as a surgery becomes a godsend for the leery patient.

Awaiting your feedback doctor!

 

Ok that makes sense. Appreciate that gillenator.

I'll be sending you my pics soon. Just give me some time. Always appreciate your honest feedback!

Thank you for your message. Ofcourse you need to be cautious with the amount of anesthesia and epinephrine used. We have to use enough to numb the area but not to over do it. Also the use of tumescent fluids helps with being able to use anesthesia and epinephrine in diluted amounts. I personally use triamcinolone (steroids) in my tumescent solution which has a potential effect in reducing swelling and shock loss in some studies presented by colleagues.

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7 minutes ago, DrTBarghouthi said:

Thank you for your message. Ofcourse you need to be cautious with the amount of anesthesia and epinephrine used. We have to use enough to numb the area but not to over do it. Also the use of tumescent fluids helps with being able to use anesthesia and epinephrine in diluted amounts. I personally use triamcinolone (steroids) in my tumescent solution which has a potential effect in reducing swelling and shock loss in some studies presented by colleagues.

Hi Doctor. Very sorry, but I need some clarity. When you mention epinephrine do you mean you use it as a medicine? Or do you mean its a pesky hormone that contributes to shock loss which needs to be reduced from affecting the scalp?

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20 minutes ago, dtap said:

Hi Doctor. Very sorry, but I need some clarity. When you mention epinephrine do you mean you use it as a medicine? Or do you mean its a pesky hormone that contributes to shock loss which needs to be reduced from affecting the scalp?

Epinephrine is present in all anesthesia that we inject. It is possibly one of the contributors of shock loss among other mentioned factors. 

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14 hours ago, DrTBarghouthi said:

Epinephrine is present in all anesthesia that we inject. It is possibly one of the contributors of shock loss among other mentioned factors. 

I see. Unfortunate.

Perhaps there are alternatives to epinephrine that can be used instead?

As far as you know, is there any ongoing research into ways of blocking or reducing shock loss?

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But almost always the shockloss is temporary and the hair grow back from what i understand?  I am currently 1 month out pretty sure i lost alot of native hairs in the middle area. Hoping they grow back. They were pretty thick 

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23 hours ago, GorillaSquad said:

But almost always the shockloss is temporary and the hair grow back from what i understand?  I am currently 1 month out pretty sure i lost alot of native hairs in the middle area. Hoping they grow back. They were pretty thick 

Shock loss in the donor region almost always comes back.  Shock loss in the recipient area is less certain since these hairs were more vulnerable in the first place.  

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And it's the diffused hair in an advanced stage that typically does not grow back.

Gillenator

Independent Patient Advocate

I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice, but are my own views which you read at your own risk.

Supporting Physicians: Dr. Robert Dorin: The Hairloss Doctors in New York, NY

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