15 years post op

[BaldyBee]

I've had two Bosley procedures. I do not recall how many grafts I got each time, but they took place in 2001 and 2004, when I was in my late 20s and early 30s. The cost each time was around $6000. By now, I am fairly confident 0% of my grafs are left. 

When I did my procedure, I was told the following:

- The hair from the donor area does not fall out. We do not know why that is, but the hair we will graft is "forever hair"
- Start taking propecia, and you will increase your chances of reducing existing hair loss, and even re-grow some hair

For several years, I was happy with the result. I took propecia daily (or rather, roughly 1.25mg of finasteride since I could get a prescription to 5mg finasteride from my doctor). But fast forward several years, and I stopped taking it because my wife and I were trying to have a baby, and my lack of sex drive was a problem. I expected this to cause my non-grafted hair to fall out, but I noticed a significant decrease across the board, and by now my hairline begins at the top of my scalp. From the right angles, I look completely bald.

I've come to terms with this by now, but because of my scar, I do not want to shave my head. I'm too conscientious (so far)

My wife is very supportive and says I should spend the money on getting more transplants done, but I am telling her it would probably take $100k to make it look "normal" again. Whenever I see pictures of myself from 10+ years ago, I contemplate looking at wigs, but the stigma around that is so comical that I refrain from doing so. 

Is the "forever hair" promise given to me by Bosley completely BS, or am I an edge case ?

Has anyone started off with hair transplants and gone the wig / toupee route ?

[Melvin- Admin]

It’s possible some of the hair has thinned. But it’s most likely you’ve lost your native hair. You can do a partial hair system. Transplant just the front with a toupee in the back. 

[mafpe]

from further research... transplanted hair does get miniaturised over time, just that the meds holds them like how they slow down balding. so you're normal case.
if you never stopped using meds, most likely you'll retain more.

you can transplant the front then use hair system on the crown though if you want a full coverage

 

[SeanT1]

Just now, mafpe said:

from further research... transplanted hair does get miniaturised over time, just that the meds holds them like how they slow down balding. so you're normal case.
if you never stopped using meds, most likely you'll retain more.

you can transplant the front then use hair system on the crown though if you want a full coverage

 

I've heard some people keep results by taking finasteride twice a week rather than every day while keeping libido up, I wonder if there is any truth to it.

 

[mafpe]

12 minutes ago, SeanToman said:

I've heard some people keep results by taking finasteride twice a week rather than every day while keeping libido up, I wonder if there is any truth to it.

 

from people who tried to do it, some did claim that it helped. they either microdose or space it like you said. i guess everyone have a different point of tolerance, and you just have to find the individual line and stay below it. i tried changing ortal to topical but i haven't felt the effect yet, but its not like they're instant or very visible since i didnt lose that much of my drive 

[Navthedon]

Ive just had my third transplant now with Asmed to shore up my hairline which was thinning. I stopped taking med right after my transplant and over time the hair just starts to thin. This time ill keep using Finistride but at a low dosage. Unfortunately the myth behind "transplanted hair is hair that lasts forever" is just that, a myth. Even with transplanted hair it comes with a ticking clock. Its just life I guess. Good luck

[Euphoria]

On 4/27/2022 at 10:41 PM, Navthedon said:

Ive just had my third transplant now with Asmed to shore up my hairline which was thinning. I stopped taking med right after my transplant and over time the hair just starts to thin. This time ill keep using Finistride but at a low dosage. Unfortunately the myth behind "transplanted hair is hair that lasts forever" is just that, a myth. Even with transplanted hair it comes with a ticking clock. Its just life I guess. Good luck

I think I read somewhere few years ago that the transplanted hair actually inherit/adapt the features of the recipient area ie become sensitive to DHT. How much of that happens and how much the recepient area changes to the DHT resistant hairs from back, that’s something for further research. 

Perhaps this is where individual differences we see here. I know people who don’t take any meds and still retain their transplanted hair for life but then there’s cases like yours.

It could also simply be you’re a Norwood 7 with very thin safe zone and the hairs they took were not the safe zone. When those unsafe hairs were transplanted into DHT sensitive recepient, they become more sensitive.

 

 

[Rahal Hair Transplant]

I want to address a couple things here so that hopefully things become more clear. The concept that transplanted hair is permanent is actually fully and well understood but it is only as “permanent“ as the “donor” area which is typically the hair on the sides and back of your scalp.  This is because hair transplant surgery operates on a principal known as “donor dominance“.   This essentially means that transplanted hair will maintain its properties from where it was taken.  since hair on the sides and back of the scalp is resistant DHT (the hormone responsible for male pattern baldness), it maintains it’s DHT resistance and even when moved to the top of the scalp.

Now, keep in mind that there are nongenetic reasons for people to lose their hair as well which have nothing to do with Dehydrotestosterone or DHT.  Therefore, if you are losing hair for other reasons then genetic causes, it’s possible that the transplant hair and the hair on the sides and back of the scalp would be affected.  This could be what’s happening to you.

More likely however, since hair transplant surgery does nothing to stop the progression of genetic pattern baldness, you could very well just be losing more natural hair around the transplanted hair making it appear much thinner than it was previously even though the transplanted hair might be holding up.

Like you, I am approximately 15 years out from my last hair transplant procedure and because I’ve already lost all the natural hair on the top of my scalp, my hair is just as thick as it was one year after my last hair transplant.  So this is certainly evidence that transplanted hair will last essentially a lifetime or at least as long as any hair that’s not affected by DHT.

in your case, I recommend consulting a leading and reputable hair transplant surgeon to evaluate your scalp and help you determine what is going on. I suspect you’ve lost more natural hair since your procedures 15 years ago rather than the alternative of losing hair for nongenetic reasons especially since you’ve stopped taking finasteride.

The only other possibilities I can think of for losing transplanted hair are 1) The hair transplant clinic took her outside of the universal safe zone meaning that the so-called “donor hair“ they took was actually susceptible to the HT which is why you are losing it now or 2) there was some mild damage to the transplanted hair either during excision or implantation that lead the transplanted hair to grow for a while but eventually stop because of the damage during surgery or 3) some unknown variable has caused the transplanted hair to fall out over the many years.

like I said, consulting a reputable hair transplant clinic to evaluate your scalp would be the best move at this point especially since you haven’t undergone surgery for about 15 years.

I hope this helps.

Rahal Hair Transplant

Edited April 29, 2022 by Rahal Hair Transplant