Do Hair Transplants Thin? THE TRUTH with Dr. Shapiro, Dr. Wong, and Dr. Bisanga

[Proportions]

I watched this video, but I still didn't get a clear picture as to why the transplanted hair thins.

 

To me it seems: Some of the donor would have thinned out anyway even if it wasn't transplanted - and with some hair transplants we therefore see the transplanted hair thinning.

[jjalay]

I am also the same opinion. It comes down to genetics and how the hair in the donor area will evolve in your 20s, 40s and 60s.

[Melvin- Admin]

All of the above, donor hair is DHT resistant. Not DHT proof, as we age our hair thins. Hair transplants will thin around 15-20% in 20-30 years. Probably sooner without medication. 

[Proportions]

50 minutes ago, Melvin- Admin said:

All of the above, donor hair is DHT resistant. Not DHT proof, as we age our hair thins. Hair transplants will thin around 15-20% in 20-30 years. Probably sooner without medication. 

The recipient area being more hostile to transplanted hair. Would that also be true?

[Melvin- Admin]

9 minutes ago, Proportions said:

The recipient area being more hostile to transplanted hair. Would that also be true?

There’s no scientific data, donor dominance would mean it doesn’t matter where the hair is located. But I think DHT effects hair all over the scalp. But donor hair is more resistant. 

[alexmillne]

4 hours ago, Melvin- Admin said:

All of the above, donor hair is DHT resistant. Not DHT proof, as we age our hair thins. Hair transplants will thin around 15-20% in 20-30 years. Probably sooner without medication. 

Melvin, I like your posts because they're clear and on point. Are you in the medical field, or did you gain your knowledge over time? Thanks for sharing what you know – I've learned a lot from you!

[manutd4545]

Not sure what happened to mine, from age 24 to 34 my original hair transplanted hair seemed to thin massively.  I had a third HT with Farjo and either the oral minoxidil helped thicken it or  the surgery triggered some regrowth of the original transplant.

Edited October 28, 2023 by manutd4545

[alexmillne]

22 hours ago, Proportions said:

I watched this video, but I still didn't get a clear picture as to why the transplanted hair thins.

 

To me it seems: Some of the donor would have thinned out anyway even if it wasn't transplanted - and with some hair transplants we therefore see the transplanted hair thinning.

there is also such things as retrograde alopecia. Apparently it is very common and many people dont realise they have it. basically hairloss in the donor area

[Proportions]

1 minute ago, alexmillne said:

there is also such things as retrograde alopecia. Apparently it is very common and many people dont realise they have it. basically hairloss in the donor area

That appears to be something affecting the more advanced Norwoods. NW6-7.

[manutd4545]

I went from this to this, 4,500 grafts.  Normally you would expect it to be the other way around.

Edited October 28, 2023 by manutd4545

[Proportions]

10 minutes ago, manutd4545 said:

I went from this to this, 4,500 grafts.  Normally you would expect it to be the other way around.

So all your transplanted hair fell out?

[manutd4545]

11 minutes ago, Proportions said:

So all your transplanted hair fell out?

In Dr Feriduni's opinion the follicle groups reduced, he stated that all hairs on our heads have a certain life and what was once 3/4 follices reduced to maybe 2/3 and 1/2. Either way was most of my transplanted hair thinned and probably fell out. I sent him that photo to ask for his opinion. The one with the hair is 1 year post op from my 2nd with the worst picture being 10 years after.

Edited October 28, 2023 by manutd4545

[Proportions]

25 minutes ago, manutd4545 said:

In Dr Feriduni's opinion the follicle groups reduced, he stated that all hairs on our heads have a certain life and what was once 3/4 follices reduced to maybe 2/3 and 1/2. Either way was most of my transplanted hair thinned and probably fell out. I sent him that photo to ask for his opinion. The one with the hair is 1 year post op from my 2nd with the worst picture being 10 years after.

Were you on medication?

Did you donor thin as well?

[manutd4545]

Yes was on finasteride, no donor did not thin. I had a third HT in July 21 by Dr Farjo and donor hair was deemed fine.

[Proportions]

1 minute ago, manutd4545 said:

Yes was on finasteride, no donor did not thin. I had a third HT in July 21 by Dr Farjo and donor hair was deemed fine.

So strange that this happened to you. Did Dr. Feriduni do the initial transplant?

[manutd4545]

Yes he did the first two. I put this question to to him and did got a long email back stating at a conference he and other surgeons had come across similar cases in nw 5/6 cases. He believes finasteride helps prolong the lifecycle but as members here have stated donor is not immune to DHT. It appears that my donor has been transplanted to the front and possibly take in local characteristics and possibly lost some of the DHT protection.

 

 

Edited October 28, 2023 by manutd4545

[Proportions]

2 hours ago, manutd4545 said:

It appears that my donor has been transplanted to the front and possibly take in local characteristics and possibly lost some of the DHT protection.

 

 

Sounds crazy. But who knows. I guess there is still a lot of discovery to be made in this field.

[alexmillne]

8 hours ago, Proportions said:

Sounds crazy. But who knows. I guess there is still a lot of discovery to be made in this field.

I could imagine this... I tell you why. there are rapports out there that body hair transplanted to the head starts taking characteristics of the head hair follicles, so why not also DHT? 

[manutd4545]

1 hour ago, alexmillne said:

I could imagine this... I tell you why. there are rapports out there that body hair transplanted to the head starts taking characteristics of the head hair follicles, so why not also DHT? 

I remember watching a video with Nilofer Farjo and another expert about 12 months ago with them saying they have come across cases where transplanted hair takes on characteristics of their new environment, wish I could find a link to it.

Edited October 29, 2023 by manutd4545

[BurnieBurns]

The real question comes back to the notion of the recipient scalp increasing the DHT sensitivity of the transplanted follicles.

General age thinning is less of an enigma

It would be interesting to hear from Surgeons who have patients not on finasteride have noticed over the years

[Melvin- Admin]

On 10/28/2023 at 1:35 PM, alexmillne said:

Melvin, I like your posts because they're clear and on point. Are you in the medical field, or did you gain your knowledge over time? Thanks for sharing what you know – I've learned a lot from you!

I’m in the healthcare field, but I gained all of this knowledge from this forum. This forum is like a hair university 😊

[GoliGoliGoli]

10 hours ago, BurnieBurns said:

The real question comes back to the notion of the recipient scalp increasing the DHT sensitivity of the transplanted follicles.

General age thinning is less of an enigma

It would be interesting to hear from Surgeons who have patients not on finasteride have noticed over the years

ManutD above was on fin and it looks like a lot of his transplanted hair fell out. So fin might give you some protection but apparently it doesn't work for everyone. 

[ScottishGuy21]

Important thread for anyone having a transplant.
 

No result is guaranteed to last forever and you should  as others have pointed out factor in that some loss later in life will occur. The younger you are the more likely it is you’ll need a top up at some point.

Through medical therapy and sensible donor hair selection we  / Dr’s can try as best as they can to stave off recession but with a small few Mother Nature unfortunately will have others plans. 

 

Edited October 30, 2023 by ScottishGuy21

[misc1729]

Manutd, how long did your HT last before it started notably thinning? Was it good for awhile then suddenly start to diminish, or was it a pretty immediate process?

Edited November 4, 2023 by misc1729

[asterix0]

On 10/29/2023 at 5:06 AM, alexmillne said:

I could imagine this... I tell you why. there are rapports out there that body hair transplanted to the head starts taking characteristics of the head hair follicles, so why not also DHT? 

I made posts about this, nobody here really credited it seriously, but it is a concern.