Does a hair transplant completely destroy all the existing follicles?

[washingtondc]

Take a square inch of scalp that's affected to a degree by MPB. It has some existing non-miniaturized hair and some miniaturized hair. It also has some hair that's in the 2-5 month-long exogen phase, where the visible hair has shed out but a new hair is starting growth under the skin in the follicle.

If you get a hair transplant, are all of the follicles in the recipient zone that are still viable but don't have a hair currently visible destroyed by the incisions/grafts, or do some survive? Depends on the density maybe?

[LaserCaps]

You are over analyzing.  

Based on your scenario, this particular person is experiencing shedding, which is normal.  

There are two types of loss, the type you see and the type you don't see.  The type you see typically involves shedding of the native hair.  The follicle gets tired of producing hair and takes a vacation.  About 3 months later that hair will return.  This will happen randomly to every hair on your head.  So when you see hair on the sink, pillow etc, just smile.  That hair will return.  Most believe 100 hairs a day is the norm.  Hair loss is different.

Hair loss involves miniaturization of the native hair.  Look at the hair in the temporal area.  You'll notice some very thick strands while others look thinner.  Eventually that thinner strand will become even thinner and eventually whither away.  That's hair loss.  This is the time to consider medical therapy to help not only with retention but also with the reversal of this thinning.  

Lastly, during an intervention, the doctor is working with magnification and he can clearly see where to make the recipient sites.  Most times he is giving you a haircut as he is working with very sharp instruments.  From time to time shedding of the native hair can occur.  This happens to women particularly.  That's why it is often recommended they get on Rogaine a few months prior to the procedure to help keep this to a minimum.

 

[washingtondc]

16 minutes ago, LaserCaps said:

You are over analyzing.  

Based on your scenario, this particular person is experiencing shedding, which is normal.  

There are two types of loss, the type you see and the type you don't see.  The type you see typically involves shedding of the native hair.  The follicle gets tired of producing hair and takes a vacation.  About 3 months later that hair will return.  This will happen randomly to every hair on your head.  So when you see hair on the sink, pillow etc, just smile.  That hair will return.  Most believe 100 hairs a day is the norm.  Hair loss is different.

Hair loss involves miniaturization of the native hair.  Look at the hair in the temporal area.  You'll notice some very thick strands while others look thinner.  Eventually that thinner strand will become even thinner and eventually whither away.  That's hair loss.  This is the time to consider medical therapy to help not only with retention but also with the reversal of this thinning.  

Lastly, during an intervention, the doctor is working with magnification and he can clearly see where to make the recipient sites.  Most times he is giving you a haircut as he is working with very sharp instruments.  From time to time shedding of the native hair can occur.  This happens to women particularly.  That's why it is often recommended they get on Rogaine a few months prior to the procedure to help keep this to a minimum.

 

Right, thanks. The point to the question was to try to find out whether, during a hair transplant, follicles that are resting in the recipient area are destroyed by the incisions/grafts that are implanted, or if they're not affected, or if maybe surgeons can still tell where they are and avoid them.

People with telogen effluvium, for example, have a massive number of hairs (far above the normal percentage) pushed into the exogen phase. These hairs will restart their anagen cycle and grow back, but my question is whether most of the follicles that are in the exogen phase are destroyed in the recipient zone during a transplant. Surgeons put hair where there isn't hair; do the exogen follicles with no hair present to mark them get destroyed in the process of implantation of a graft, and to what degree?

Edited July 29, 2021 by washingtondc

[follically challenged]

Yeah i feel as though you ask a valid question yet LaserCaps hasn't really answered it.

I think transplanting on to an area with follicles there can do some damage though i'm not exactly sure how much.. i'd love to get a solid answer on this...

[Westview]

OP has asked a really good question. 

I often wondered myself something similar, what if I get a transplant and a few years later a cure for hairloss is invented.

Will that destroy the existing follicles. The answer is much pretty much no according to Dr. Bernstein. Even if you were to transplant a graft right into a dormant follicle, that graft will just come out as a double with the native hair according to Bernstein (although he does concede it might come out a bit unnatural, but I dont necesssarily agree with that).  Read what he wrote here:

https://www.bernsteinmedical.com/answers/timing-of-a-second-hair-transplant/

Quote

 

Q: If a second hair transplant is performed before the first had a chance to grow could the second procedure destroy the follicles from the first? — B.M., Upper East Side, NYC

A: Hair from the second hair transplant session would not damage the follicles transplanted in the first session, even if follicular unit grafts were transplanted in exactly the same spot as in the first session.

The reason to wait until the hair grows in, however, is so that you can better plan the subsequent hair restoration procedure. If two follicular units are placed on top of each other or very close together, you will essentially be creating a mini-graft and the results will not look natural.

We advise waiting at least 8 months between sessions with 10-12 months being ideal so that the grafts of the second session can be evenly distributed among the grafts of the first

 

 

[washingtondc]

1 hour ago, Westview said:

OP has asked a really good question. 

I often wondered myself something similar, what if I get a transplant and a few years later a cure for hairloss is invented.

Will that destroy the existing follicles. The answer is much pretty much no according to Dr. Bernstein. Even if you were to transplant a graft right into a dormant follicle, that graft will just come out as a double with the native hair according to Bernstein (although he does concede it might come out a bit unnatural, but I dont necesssarily agree with that).  Read what he wrote here:

https://www.bernsteinmedical.com/answers/timing-of-a-second-hair-transplant/

 

Thanks for finding this; it definitely seems to be his opinion that it wouldn't damage at least a transplanted existing follicle (which you would hope would also extend to native follicles). That's a pleasantly surprising answer honestly if that's really the case. Maybe the depth of the incisions doesn't go far enough to actually damage follicles that are already there? And then even if there's a new follicle above or overlapping, the existing one just kind of works the hair around or something?

I would love to see him or some other surgeon actually test and prove this.

[Westview]

13 minutes ago, washingtondc said:

Thanks for finding this; it definitely seems to be his opinion that it wouldn't damage at least a transplanted existing follicle (which you would hope would also extend to native follicles). That's a pleasantly surprising answer honestly if that's really the case. Maybe the depth of the incisions doesn't go far enough to actually damage follicles that are already there? And then even if there's a new follicle above or overlapping, the existing one just kind of works the hair around or something?

I would love to see him or some other surgeon actually test and prove this.

No, I think its more a case of even if the scalpel incision did damage a dormant follicle, , that follicle will just heal itself and the new graft will grow right next to it

[LaserCaps]

It takes a lot to destroy a follicle.  Consider removal.  It takes several visits regardless if electrolysis, laser, etc.  These "things" are sturdy.  Very seldom do I hear of follicle damage during any intervention.  Perhaps if there is a self immune system involved - maybe then.  

[Westview]

4 minutes ago, LaserCaps said:

It takes a lot to destroy a follicle.  Consider removal.  It takes several visits regardless if electrolysis, laser, etc.  These "things" are sturdy.  Very seldom do I hear of follicle damage during any intervention.  Perhaps if there is a self immune system involved - maybe then.  

A buddy of mine fell of the back of a pickup truck during accident, he scraped his scalp along the pavement and for about 2 years he had a large bald spot on the side of this head.  But the doctor said the scalp will eventually repair itself, and sure enough in the 3rd year all the hair had grown back