Transplanted Hair falling 3 Years post op

[Charls 37]

Hello

I had a hair transplant in Canada with good doc of 1500 grafts fut taken from a safe donor area on the hairline corners to fix a receding hairline around 4 years ago.(37years old)

My hair is very thick overall, been taking propecia for years and I am very healthy and fit although I eat plenty of pastries, all blood tests though are good and no vitamin deficiency.

I was very happy with the transplant , the problem is that around the 3 year mark(over a year ago), the transplanted hair started falling by areas.

It's been over  ONE YEAR where the TRANSPLANTED area is unstable, as in hairs from one section fall, then regrow but a month after on another area they hairs fall, and then regrow, and on and on..

The hairs that fall are 100% transplanted because there used to be no hair there, hair is very thick everywhere else.

The hair regrows but it falls again months later? as it looks like the same sections have suffered loss over the last year twice.

My doctor says is the hair cycle, but if the hairs go through the telogen phase after the anagen is over, why would the same hairs fall again months later???

Any input would be appreciated as this is very unnerving

 

[aaron1234]

Got pics? Nothing stays the same. 

[asterix0]

Can you post some pictures? It's hard to assess just with your verbal description.

[Charls 37]

Sorry no pics

It's a clear description, 3 after a successful HT, the transplanted hair falls and regrows intermittently by sections and there are no health underlying issues

Is it the hair cycle, anagen synchronization?

[asterix0]

The reason I'm asking is because lighting and angles can play tricks on you. You may be sure you are seeing what you think you're seeing, but unless you have some evidence in the same lighting conditions and general environment, it seems very unusual what is happening.

Losing transplanted hairs is possible, but as you are on finasteride I doubt that is happening.

If they didn't grow in initially, that is a yield issue that would have been evident after the first year of your transplant.

What I'm saying is, maybe the initial pleasant impression of the transplant made you think the area is denser than it actually is, and only now you are noticing after some time the yield isn't as high as you thought it was.

Edited November 5, 2021 by asterix0

[Charls 37]

Nah

The reason i don'r share pics is due to my job being in media and for privacy

I am extremely well aware of what I see and can compare from personal pics and the loss is as clear as day, as it's the difference between a closed hairline and a receding one at the corners 

The transplant grew perfectly, only after the 3 year mark started falling by sections, then regrowing and falling again, Dr says is "anagen synchronization", but close to a year and a half into it it starts to sound suspect

I am aware that this is unusual that's why I ask here where there's experts on the matter.

I am on finasteride as well for years, i'm sorry but your doubts do not correlate with the facts, this is happening despite being on finasteride

Looks like by the way you wrote and tried to mistakenly make this a perception issue, that you are defending the ht industry.

I got nothing against the industry, don't have a dog in this fight as I was very satisfied with the results until this up and down started to happen after 3 years, hopefully this is temporary and someone can give some clarity

 

[Etownone]

Check your test levels.   

[JDEE0]

2 hours ago, Charls 37 said:

Nah

The reason i don'r share pics is due to my job being in media and for privacy

I am extremely well aware of what I see and can compare from personal pics and the loss is as clear as day, as it's the difference between a closed hairline and a receding one at the corners 

The transplant grew perfectly, only after the 3 year mark started falling by sections, then regrowing and falling again, Dr says is "anagen synchronization", but close to a year and a half into it it starts to sound suspect

I am aware that this is unusual that's why I ask here where there's experts on the matter.

I am on finasteride as well for years, i'm sorry but your doubts do not correlate with the facts, this is happening despite being on finasteride

Looks like by the way you wrote and tried to mistakenly make this a perception issue, that you are defending the ht industry.

I got nothing against the industry, don't have a dog in this fight as I was very satisfied with the results until this up and down started to happen after 3 years, hopefully this is temporary and someone can give some clarity

 

Chill a little bit - he's only trying to help. Doesn't really bode very well to come on here and get all passive aggressive by saying he's trying to spin this in a particular light to suit whatever agenda it is you're accusing him of. The reason people are asking for pics is because this sort of post happens fairly frequently, when they finally do post some, half the time it's clear they have just lost more native hair and don't want to accept it, and the other half there seems to be no discernible difference to us as impartial observers.

Now I'm not saying either of those are happening to you, maybe you are indeed losing your transplanted hair, but how do we know that you're any different to the above type of posters I described? We don't, and so we can't give any advice without actually seeing what's going on. It just comes across as a little entitled to get all arsey when people are willingly giving free advice with purely altruistic motives and insinuate people have vested interests in something that they don't. Also, no offence intended, but I can assure you that you're not that important or high profile that people are going to recognise pictures of your scalp, blur your face out like everyone else does.

Anyway, if it truly is your transplanted hair noticeably thinning after just 3 years and on meds, then this is very unusual and hard to explain. Apart from the cycling explanation, I can only theorise that maybe they were extracted from an extremely unstable source, or perhaps you have some sort of scalp/autoimmune condition. Do you have any issues with itching, redness etc?

 

Edited November 5, 2021 by JDEE0

[Charls 37]

2 hours ago, JDEE0 said:

Chill a little bit - he's only trying to help. Doesn't really bode very well to come on here and get all passive aggressive by saying he's trying to spin this in a particular light to suit whatever agenda it is you're accusing him of. The reason people are asking for pics is because this sort of post happens fairly frequently, when they finally do post some, half the time it's clear they have just lost more native hair and don't want to accept it, and the other half there seems to be no discernible difference to us as impartial observers.

Now I'm not saying either of those are happening to you, maybe you are indeed losing your transplanted hair, but how do we know that you're any different to the above type of posters I described? We don't, and so we can't give any advice without actually seeing what's going on. It just comes across as a little entitled to get all arsey when people are willingly giving free advice with purely altruistic motives and insinuate people have vested interests in something that they don't. Also, no offence intended, but I can assure you that you're not that important or high profile that people are going to recognise pictures of your scalp, blur your face out like everyone else does.

Anyway, if it truly is your transplanted hair noticeably thinning after just 3 years and on meds, then this is very unusual and hard to explain. Apart from the cycling explanation, I can only theorise that maybe they were extracted from an extremely unstable source, or perhaps you have some sort of scalp/autoimmune condition. Do you have any issues with itching, redness etc?

 

Thanks I appreciate the post and all the advice I can get

The strip was taken from a safe area and all my hair is thick except where I had recession, which was covered by the transplant

The transplanted hair is not thinning, the transplanted hair, still thick, just falls by sections and then regrows successfully, but it has fallen in the same areas twice over the last 1.5 years

It is not that it's a slow process the hair is losing diameter or there is miniaturization, there isn't. The hair is normal and just very noticeably falls in a section in matter of a handful of days

I've got no underlying health issues or conditions, my diet and all that is all the same as when the transplanted hair was perfect the first 3 years

I understand it is very unusual that's why I ask here as I don't find the answer anywhere and the doc says it's anagen synchronization and he doesn't help beyond that

What are your thoughts on the anagen sycnhronization or the hair cycle possibility?

 

 

 

[asterix0]

5 hours ago, Charls 37 said:

Nah

The reason i don'r share pics is due to my job being in media and for privacy

I am extremely well aware of what I see and can compare from personal pics and the loss is as clear as day, as it's the difference between a closed hairline and a receding one at the corners 

The transplant grew perfectly, only after the 3 year mark started falling by sections, then regrowing and falling again, Dr says is "anagen synchronization", but close to a year and a half into it it starts to sound suspect

I am aware that this is unusual that's why I ask here where there's experts on the matter.

I am on finasteride as well for years, i'm sorry but your doubts do not correlate with the facts, this is happening despite being on finasteride

Looks like by the way you wrote and tried to mistakenly make this a perception issue, that you are defending the ht industry.

I got nothing against the industry, don't have a dog in this fight as I was very satisfied with the results until this up and down started to happen after 3 years, hopefully this is temporary and someone can give some clarity

 

How am I defending the industry?...quote the exact line where I am defending it so I can understand your point. 

[asterix0]

Last post I'll make as it seems you only want to hear what you want to hear...if your transplant was very densely packed, it is possible your grafts have insufficient blood flow to grow properly, which can cause (some) of them to fail.

[Charls 37]

Well I'd certainly rather hear "anagen synchronization" is the reason for this rather than the alternative

The only reason I'm asking if you know that term and if you have any second hand experience is because that's what the Dr said is the reason, I never heard the term before

I'm asking you guys is because I start to doubt the Dr because it's been over a year of this up and down 

I see your point though, there was no dense packing done and the hair grew perfectly for 3 years, how would it be that was has worked well for that long stops working?

[asterix0]

I'm not a doctor but too me I have never heard of such a case. But if you had 1,500 grafts only into the corners of your hairline, that is absolutely dense packing. 

[aaron1234]

3 hours ago, Charls 37 said:

I see your point though, there was no dense packing done and the hair grew perfectly for 3 years, how would it be that was has worked well for that long stops working?

A handful of top tier docs have stated in recent interviews with Melvin that HT's can thin over time.  It may or may not be your situation, but it is impossible to say without pics.  The best advice I can give you is to get another transplant to improve the situation.  

[Charls 37]

Ok unfortunately that seems to be the issue, it is very rare

To clarify it was mostly on the receding corners but also some on the temples and the hairline, basically we turned a v shape hairline into a close to straight looking hairline 

The doctor is a top Dr always recommended here

[JDEE0]

8 hours ago, Charls 37 said:

Thanks I appreciate the post and all the advice I can get

The strip was taken from a safe area and all my hair is thick except where I had recession, which was covered by the transplant

The transplanted hair is not thinning, the transplanted hair, still thick, just falls by sections and then regrows successfully, but it has fallen in the same areas twice over the last 1.5 years

It is not that it's a slow process the hair is losing diameter or there is miniaturization, there isn't. The hair is normal and just very noticeably falls in a section in matter of a handful of days

I've got no underlying health issues or conditions, my diet and all that is all the same as when the transplanted hair was perfect the first 3 years

I understand it is very unusual that's why I ask here as I don't find the answer anywhere and the doc says it's anagen synchronization and he doesn't help beyond that

What are your thoughts on the anagen sycnhronization or the hair cycle possibility?

 

 

 

I have heard the term before and am familiar with the theory. From my understanding, it is hypothesised that this synchronisation happens due to the majority of the implanted follicles being 'reset' to a new cycle in unison after their initial shed. Obviously, when you have a HT, most of the hairs shed within a month or so and the follicles are forced into a telogen resting phase as a result.

They have essentially been given a new cyclical calendar mostly all at the same time, so when the natural growth cycle next ends and the hairs shed, there can be a noticeable difference in density. Usually, follicles enter their resting phase (after a number of years of growing) in a completely random fashion, so even if 100 do this every day, it is distributed across the scalp and thus unnoticeable. If this all instead happens in a concentrated area as all these transplanted hairs are now on the same timeline so to speak, then it would become lots more noticeable.

However, the anagen or growth phase usually (and should) lasts a handful of years, so in my opinion it doesn't really explain your situation if its happened multiple times within one year or so. Unless maybe the trauma to the follicles hasn't been completely recovered from yet or something and they are still a bit out of whack. It would be unusual, but who knows. It's a bit of a weird one, but I have seen similar complaints once or twice in the past. Maybe some people experience some sort of rare phenomenon related to this sometimes, but honestly I don't think anyones going to be able to give you a concrete answer.

If I was you, I would consider just getting my scalp checked by a good derm to check for any potential underlying conditions that could be causing issues. It doesn't sound like this is the case, but might be worth doing anyways.

 

 

[blackislback]

15 hours ago, Charls 37 said:

The doctor is a top Dr always recommended here

Even it's "top" Dr, just saying it's "anagen synchronization"  , it's easiest way say some expert term or strange, and explain poor in few words and don't take further action to investigate case of patient, in any way, scalp checking by top dermatologist, or any other type checkings realted to specifi case, if i'm on your place, will consult other "top" ht surgeon about that phenomenon, as it's strange like you say that repeat in cycles, ok understand once happens, but more times, not so clear...

Maybe better check with 1-2 more experienced HT surgeons for opinion, if your dr. not accept further checking else tell what he thinks it's , and not investigate fruther to help you...

One is fact,here was few cases that even those called "safe" area, like many doctors say "it's for a lifetime hair, no loss" , it's not true, as every organism is univers for itself, and no 2 same cases, but reaction of every organism after HT is unique, same by shading transplantated hair is not something impossible, but it happens to people due do x different reasons, blood supply, reaction of skin, orgnism, quality of grafts, etc. , that's why i say it's better check with at least 1 more experienced top HT surgeon and if necessary further check scalp by dermatologist , blood checking different, etc. , as only get term as answer to your case isn't solution, at least not feel ok, just to have as term answer to all your doubts and problems, that's not professional.

Who was doctor at your HT?

[Charls 37]

On 11/5/2021 at 11:04 PM, JDEE0 said:

I have heard the term before and am familiar with the theory. From my understanding, it is hypothesised that this synchronisation happens due to the majority of the implanted follicles being 'reset' to a new cycle in unison after their initial shed. Obviously, when you have a HT, most of the hairs shed within a month or so and the follicles are forced into a telogen resting phase as a result.

They have essentially been given a new cyclical calendar mostly all at the same time, so when the natural growth cycle next ends and the hairs shed, there can be a noticeable difference in density. Usually, follicles enter their resting phase (after a number of years of growing) in a completely random fashion, so even if 100 do this every day, it is distributed across the scalp and thus unnoticeable. If this all instead happens in a concentrated area as all these transplanted hairs are now on the same timeline so to speak, then it would become lots more noticeable.

However, the anagen or growth phase usually (and should) lasts a handful of years, so in my opinion it doesn't really explain your situation if its happened multiple times within one year or so. Unless maybe the trauma to the follicles hasn't been completely recovered from yet or something and they are still a bit out of whack. It would be unusual, but who knows. It's a bit of a weird one, but I have seen similar complaints once or twice in the past. Maybe some people experience some sort of rare phenomenon related to this sometimes, but honestly I don't think anyones going to be able to give you a concrete answer.

If I was you, I would consider just getting my scalp checked by a good derm to check for any potential underlying conditions that could be causing issues. It doesn't sound like this is the case, but might be worth doing anyways.

 

 

What you wrote describes perfectly what I've been through, except the over the last few months where the loss happened in the same areas as before

The comment about the follicles not having recovered and being out of whack and that could be why they have fallen twice is very astute

I guess I'll know soon enough,  I might do just that and if this happens again check my scalp in case to make sure it's not something else

 

Edited November 8, 2021 by Charls 37

[mcr7777]

I'm thinking a good thing to do is to investigate/rule out autoimmune conditions e.g. alopecia areata or lichen planopilaris (LPP). Do you have any itching/burning/crawling sensations?

[Charls 37]

On 11/8/2021 at 12:56 PM, mcr7777 said:

I'm thinking a good thing to do is to investigate/rule out autoimmune conditions e.g. alopecia areata or lichen planopilaris (LPP). Do you have any itching/burning/crawling sensations?

Now that you ask I might feel some slight crawling sensation now and then recently but not during the last year where I still went through this fall and regrowth of transplanted hairs

Zero itching, pain or nothing of the sort

Always had a dry scalp and flaky skin depending on the weather since I was a teenager, besides that no autoimmune conditions that I know of

Could this be underlying stress related? although I never been the stressful kind (only affecting the transplanted hairs)

 

 

 

Edited November 11, 2021 by Charls 37

[mcr7777]

Do you notice actual thinning of the hair? or are small numbers falling and regrowing that it doesn't appear thinner than before.  I suppose it could be a number of things e.g. telogen eflluvium?_ - but would normally affect entire scalp rather than just transplanted hairs 

[Charls 37]

There is absolutely zero thinning or miniaturization. The hairs fall by sections with normal thickness and regrow all the same.

It is strange, because as you say TE affects usually the whole scalp and this only has affected the transplanted hairs

[mcr7777]

That's good you have no thinning at least.  TE usually affects the whole scalp but there can be localised TE sometimes but there is usually some underlying cause.  Dr Donovan (specialist hair doctor) talks about it.

 

  If it continues for some time you might want to see a specialist hair dermatologist - but if no thinning that is a plus.

 

Edited November 14, 2021 by Melvin- Moderator
Removed link do not repost

[Alfie123]

Hi I am in the exact position im 5 years now post FUE and my transplanted hairs are thin! First 3 years looked awesome and then all of a sudden looks bad. TRANSPLANTS ARE NOT FOR LIFE JUST A FEW YEARS BEFORE YOU NEED ANOTHER ONE?!!!!

[JDEE0]

23 minutes ago, Alfie123 said:

Hi I am in the exact position im 5 years now post FUE and my transplanted hairs are thin! First 3 years looked awesome and then all of a sudden looks bad. TRANSPLANTS ARE NOT FOR LIFE JUST A FEW YEARS BEFORE YOU NEED ANOTHER ONE?!!!!

The general rule is the complete opposite in that a transplant should last you a very long time before declining, certainly would be a rarity for them to thin out after a few years, so no.

Post a thread of your situation pre op, post op and now so we can see what's going on. I looked at your profile and you did post some poor quality pics, but from them it looks like you have just continued to lose hair. You're a NW6 chasing hair-loss and it overwhelmingly looks like you have just progressed in the past five years.