Am I signing up for permanent shock loss in my recipient area with this transplant?

[singh]

Quoted 800 grafts to add density to my traction alopecia affected hairline. Hair loss stabilised and improved since 2020 since I stopped tying my hair a in the traditional sikh bun. I'm concerned about losing my current density chasing more. The length of my affected hairline is 13cm and vertically affected area is 1cm and reduces in height at the temples to about 0.5mm. Assuming a uniform 1cm height, I'm looking at about 800/(13*1) = 61 CM/square of density with transplanted hair alone. 

I'm just concerned about permanent shock loss of my native hair, is it avoidable? I'm also wondering if my native hair will grow back in a month post op so I can at least go out without a hat while the transplant catches up in 6 months?

Edit: Red line in image = 13cm

Edited August 1, 2023 by singh

[HappyMan2021]

to clarify, you do not suffer from male pattern baldness at all?

I dont think permanent native shock loss should be an issue for you. As long as you go to a quality surgeon this should be easy peasy. 

Many HT patients who do not have male pattern baldness seem to be fairly straightforward and layup cases. 

[Gatsby]

For 800 grafts I don’t think you should proceed. Trying to match mother nature’s hairline surgically and to blend it in with your own is a challenge unless you get it right. Why risk it? Can you provide better pics of your hair from the front, sides, etc without the markings? All the best. 👍

[HappyMan2021]

2 minutes ago, Gatsby said:

For 800 grafts I don’t think you should proceed. Trying to match mother nature’s hairline surgically and to blend it in with your own is a challenge unless you get it right. Why risk it? Can you provide better pics of your hair from the front, sides, etc without the markings? All the best. 👍

I agree, surgery is always a bit of a dicey choice with these NW 1.5, NW2 cases

On the one hand surgery is less-challenging, on the other hand surgery inherently carries risk and the prospective patient must assume the risk that their end-result will be worse than their baseline starting point. 

[A_4_Archan]

@singh I don't think 800 grafts will be enough if you wanna bring your hairline down to the red line ....sometimes there is a chance of damage to your native hairs so if you go for a surgery choose your surgeon wisely....you don't have any MPB but this is due to the turban you been wearing since years and this is a common thing among sikhs....so that is a positive thing for you as you don't have to fear of loosing more ground once you don't wear such a hairstyle where you pull back your hairs very tight 

[gillenator]

IMHO, you would need considerably more than 800 grafts to fill in the proposed area, and especially considering the high amount of single hair grafts that would be needed.

[singh]

11 hours ago, A_4_Archan said:

@singh I don't think 800 grafts will be enough if you wanna bring your hairline down to the red line ....sometimes there is a chance of damage to your native hairs so if you go for a surgery choose your surgeon wisely....you don't have any MPB but this is due to the turban you been wearing since years and this is a common thing among sikhs....so that is a positive thing for you as you don't have to fear of loosing more ground once you don't wear such a hairstyle where you pull back your hairs very tight 

My bad, the red line was meant to be a "scale", i want to keep my current hairline in the 1cm marked area. The second picture I just added shows the area I want improvement in

Edited August 1, 2023 by singh

[singh]

4 hours ago, gillenator said:

IMHO, you would need considerably more than 800 grafts to fill in the proposed area, and especially considering the high amount of single hair grafts that would be needed.

Sorry for the confusion, the red line is just. a "scale", I want to keep my current hairline but add density to the 1cm area. The second picture shows the area I want improvement in marked by the clinic

Edited August 1, 2023 by singh

[singh]

12 hours ago, HappyMan2021 said:

to clarify, you do not suffer from male pattern baldness at all?

I dont think permanent native shock loss should be an issue for you. As long as you go to a quality surgeon this should be easy peasy. 

Many HT patients who do not have male pattern baldness seem to be fairly straightforward and layup cases. 

That is correct. I don't have MPB 

[singh]

11 hours ago, Gatsby said:

For 800 grafts I don’t think you should proceed. Trying to match mother nature’s hairline surgically and to blend it in with your own is a challenge unless you get it right. Why risk it? Can you provide better pics of your hair from the front, sides, etc without the markings? All the best. 👍

I just added new pictures, the second image is a accurate description of my needs, I think my markings were confusion for a lot of people that replied.

[A_4_Archan]

21 minutes ago, singh said:

My bad, the red line was meant to be a "scale", i want to keep my current hairline in the 1cm marked area. The second picture I just added shows the area I want improvement in

Oh okay for that are around 1k would be fine but there is a chance you may loose some of those native hairs ...still you can consult a good doctor and take his/her opinion about this...did you consult anyone ? And if yes than who are they and what was his/her advice ?

[singh]

2 hours ago, A_4_Archan said:

Oh okay for that are around 1k would be fine but there is a chance you may loose some of those native hairs ...still you can consult a good doctor and take his/her opinion about this...did you consult anyone ? And if yes than who are they and what was his/her advice ?

I'm going tomorrow for consultation. Just wanted to post here so I can ask the right questions. 

[Rahal Hair Transplant]

@singh,

Permanent shock loss typically only occurs when hair is transplanted in between and around natural hair that is already in the process of miniaturizing due to androgenetic alopecia a.k.a. male pattern baldness.  Now, I believe that you said that you don’t experience genetic hair loss but the thinning you are experiencing is more related to traction alopecia.  Have you been diagnosed by a hair restoration specialist or a dermatologist or is this a guess based on how you’ve sold your hair over the years?

Now keep in mind, trash and alopecia usually only comes from extended overly tight hair braiding or ponytails over many years and is often reversible if you stop selling your hair in such a way that continues pulling of the hair.  Reversibility also depends on whether or not any scarring has developed in the area and whether or not any damage occurred to the follicles that were pulled..  

In looking at your photos, I see nothing definitive suggesting that you suffer from traction alopecia versus androgenetic alopecia.  Now, if you’ve already been diagnosed, then by all means let us know and please also let us know what the doctor recommended in terms of treatment. If it really is traction alopecia, I would think that time without styling your hair in any way that damages your hair along with potentially using non-surgical solutions would be the first step.

That said, if it is androgenetic alopecia, your hair loss will be progressive and you will need to plan for the long term rather than just a short term. In other words, 800 grafts May be enough for now, but you will very likely need more in the near future depending on how far your genetics will dictate your hair loss to spread.  Unfortunately, there’s no way to find that out for sure but by obtaining some additional information such as family history of hair loss, age, etc.  a surgeon can make an educated guess on predictability of hair loss and come up with a plan that will re-create a patient’s full, dense looking and natural head of hair.

At the end of the day, I would suggest that you get diagnosed by a hair restoration specialist or German colleges and then based on the type of hair loss, make decisions from there.

I hope this helps 

Rahal Hair Transplant

Edited August 1, 2023 by Rahal Hair Transplant

[singh]

2 hours ago, Rahal Hair Transplant said:

@singh,

Permanent shock loss typically only occurs when hair is transplanted in between and around natural hair that is already in the process of miniaturizing due to androgenetic alopecia a.k.a. male pattern baldness.  Now, I believe that you said that you don’t experience genetic hair loss but the thinning you are experiencing is more related to traction alopecia.  Have you been diagnosed by a hair restoration specialist or a dermatologist or is this a guess based on how you’ve sold your hair over the years?

Now keep in mind, trash and alopecia usually only comes from extended overly tight hair braiding or ponytails over many years and is often reversible if you stop selling your hair in such a way that continues pulling of the hair.  Reversibility also depends on whether or not any scarring has developed in the area and whether or not any damage occurred to the follicles that were pulled..  

In looking at your photos, I see nothing definitive suggesting that you suffer from traction alopecia versus androgenetic alopecia.  Now, if you’ve already been diagnosed, then by all means let us know and please also let us know what the doctor recommended in terms of treatment. If it really is traction alopecia, I would think that time without styling your hair in any way that damages your hair along with potentially using non-surgical solutions would be the first step.

That said, if it is androgenetic alopecia, your hair loss will be progressive and you will need to plan for the long term rather than just a short term. In other words, 800 grafts May be enough for now, but you will very likely need more in the near future depending on how far your genetics will dictate your hair loss to spread.  Unfortunately, there’s no way to find that out for sure but by obtaining some additional information such as family history of hair loss, age, etc.  a surgeon can make an educated guess on predictability of hair loss and come up with a plan that will re-create a patient’s full, dense looking and natural head of hair.

At the end of the day, I would suggest that you get diagnosed by a hair restoration specialist or German colleges and then based on the type of hair loss, make decisions from there.

I hope this helps 

Rahal Hair Transplant

Hi, thank you for the detailed reply. I have been diagnosed with traction alopecia over a year back by a dermatologist. He told me there's nothing I can do to see improvement, the hair that has gone, is permanent and I'll need a transplant. He did say that my loss was minimal so it was my choice to get one or not. I also clearly remember having early signs of TA such as white bumps and pain in my hairline follicles which I attributed to late puberty. 

I was a practicing sikh man, and from the papers I've read all of them mentioned Sikh men and Carribean women suffer the most from it. If I ever see signs of androgenetic alopecia, I'm 100% fine with taking finesteride. For my family hair history, there's no one in my family with signs of androgenetic alopecia before 40, and only the ones who tied their hair tight had similar hair loss to mine even before puberty. 

My hair has been the same for the last 2-3 years since I stopped tying a bun like Sikh men do under their turban. I also lose less than 20 hair per day since I stopped tying it back. 

Edited August 1, 2023 by singh

[singh]

On 8/1/2023 at 9:08 AM, gillenator said:

IMHO, you would need considerably more than 800 grafts to fill in the proposed area, and especially considering the high amount of single hair grafts that would be needed.

Hey I read this comment again, I wanted to ask what is your estimate? I measured the area and it is 12cm/square so wouldnt 800 grafts give a  = 65 single grafts per cm square of density? (Second photo)

Edited August 16, 2023 by singh