Permanent shockloss, any suggestions?

[freakin]

 

This a post-op and 15 months after 2150 graft Dr Rahal transplant. The photo clearly shows permanent shockloss to the forelock that became very noticeable just 5 months post. I have been advised it will take an additional 1000 grafts to fill this region. I only have at most 2000 grafts left to harvest via strip from the donor and seek the safest way to fill/repair this area. Does anyone have an opinion on an approach to fill this region? This was to be a final 3rd HT to cover some micro/minis from other doctors. Not a happy camper.

[freakin]

 

This a post-op and 15 months after 2150 graft Dr Rahal transplant. The photo clearly shows permanent shockloss to the forelock that became very noticeable just 5 months post. I have been advised it will take an additional 1000 grafts to fill this region. I only have at most 2000 grafts left to harvest via strip from the donor and seek the safest way to fill/repair this area. Does anyone have an opinion on an approach to fill this region? This was to be a final 3rd HT to cover some micro/minis from other doctors. Not a happy camper.

[Forrest Gump]

Sorry to hear about your shock loss. Do you have any clearer before/after pictures?

 

Hopefully, you'll be able to remedy the situation soon. Good luck!

[Severn]

I'm not trying to defend the results but the first picture shows just a very small amount of frontal hair left immediately post-op. I assume a lot of it was miniturized and was on it's way out with or without the transplant. I'm guessing the trauma from the transplant just rushed things along.

[freakin]

 

Forrest, my post op photos are all a little blurry, I had a problem with the camera lens. These after photos should be clearer for viewing.

[Bill - Seemiller]

Freakin,

 

Thanks for posting. First off, have you shared your concerns with Dr. Rahal? What did he say?

 

Dr. Rahal is a class act surgeon who stands behind his work. Thus, if after evaluating you, he determines your growth was less than optimal, I trust he'll do whatever he can to help you meet your goals.

 

I've taken the liberty of contacting Dr. Rahal regarding your concerns. In the event he wants to reply to this thread, he may need you to identify yourself to him privately and give him the necessary permission to share information about your case. To see how we maintain a fair and safe environment on our forum for patients and physicians, click here.

 

Best wishes in coming to a speedy and optimal resolution,

 

Bill

[Fingers Crossed]

I know Propecia doesn't prevent shock loss from occurring but just out of curiosity are you on Propecia? Like Severn said, I assume as well some of the hairs have miniturized. I would contact Dr. Rahal about this unfortunate situation and I'm sure he'll get you all squared away. Good luck

[Forrest Gump]

freakin, thanks for the additional pictures. As others have pointed out, if you contact Rahal's office, I am confident that they'll take care of the problem.

 

Good luck!

[balody]

freakin,i would say this isn't just shock loss as your immediate post op pic shows he transplanted about an inch in front of the forlock.

your present photo seems to show little growth in this area also?

just my opinion.

[ScottishGuy]

One thing that strikes me from the immediate post op picture is that the recipient area is pretty large for just 2150 grafts. How do you find the density in the non-shocked areas? Do you think most of the grafts survived?

 

Regardless, I really hope you can get this resolved and will keep us updated.

[Rahal Hair Transplant]

Because this was a repair case, as the patient received some pluggy work in the past (as you can see from the pre-operative images below). The first concern was fixing the hairline area to look more natural.

 

After discussion with this patient it was mutually decided not to work on the forelock area. This was a conscious decision by the patient and he elected not to do the forelock area for certain reasons.

 

The main point is that the patient lost hair in areas not transplanted due to the natural progression of hair loss. This is not necessarily the fault of surgery. The risks were explained and do occur.

 

The forelock area is easily correctable by adding more grafts to this area. We have discussed with him a plan of action on the phone and have yet to hear from him. We now see that he has taken his case public, so we wanted to issue a response to this recent posting.

 

[HairHope]

Yup, shockloss is my biggest fear for #3.

 

Best of luck Freakin - I'm sure the good doc will take care of you; stay positive, it will work out.

[Bill - Seemiller]

Freakin,

 

Based on Adrian's response and the photos he presented, I'd argue that the reason for the thinning patch is due to the progression of male pattern baldness, which may or may not have been expedited by surgery. Know that miniaturizing hair can be permanently shocked, but would have fallen out on its own shortly anyway.

 

Since it sounds like this was a mutual decision and all the risks were explained, I find no fault in the actual surgery itself.

 

Losing additional natural hair is an inconvenient reality that most patients face and must then address in time. This is why hair restoration is a process and requires a long term time and financial commitment.

 

In my opinion, contact Adrian and/or Dr. Rahal and schedule an appointment to discuss your options moving forward.

 

All the best,

 

Bill

[freakin]

I would like to say I mentioned to the doctor I would like this to be my last surgery and money was no object. The doctor made the suggestion to leave the area alone, I followed his advice which obviously proved to be a poor approach; Is not this what you pay an expert for? Everyone has a crystal ball on when my native hair would start to fallout. Remarkable! How about Thanksgiving 5 mons after the HT the spot was very obvious. Did 2150 pricks of a needle and a very red scalp have anything to do with it? I did not want to get in a snowball fight, I was just looking for advice on an approach. Dr Rahal suggested 1000 more grafts to fill in the area, that is almost 50% of my original surgery. Go figure your self folks..

[Bill - Seemiller]

Freakin,

 

You really need to speak with Dr. Rahal and/or Adrian because now I'm getting conflicting reports.

 

I understand that you may have wanted this to be the last procedure. But you must have been aware that nobody can guarantee this. Risks of additional hair loss always exist and can't be predicted with 100% certainty.

 

There appears to be no fault in the procedure though I suspect that there were communication issues due to the conflicting reports.

 

Dr. Rahal said that he's already offered you a discounted price for a second procedure even though growth was optimal. In my opinion, this is very generous and you should consider taking him up on this.

 

Before you proceed with another procedure however, I encourage you to go over with Dr. Rahal risks of future hair loss and long term commitment that hair restoration often brings.

 

And if you're not already using it, consider getting on Propecia and/or Rogaine to help prevent future hair loss.

 

Best wishes,

 

Bill

[aaron1234]

freakin,

 

Are you on Propecia? From what I hear it does prevent permanent shockloss. I know the shockloss sucks, but you really have no choice but to go through another procedure. I will say the growth around the area looks pretty good. Get on propecia, get a touch up, and then you should be done.

[Fingers Crossed]

aaron1234,

 

I don't think Propecia prevents shockloss after a hair transplant, however it HELPS prevent from future hairloss. Somebody can correct me if I am wrong but I don't believe this was an accurate statement....but i do agree with your advice toward freakin.

[Forrest Gump]

That's an interesting point raised by aaron. I had no idea that propecia can prevent permanent shock loss. That's an interesting thought. Perhaps doctors or technicians or more experienced patients can chime in on this.

[alijame]

Well some doctors point out that if you use propecia for at least 6 month before surgery your minitiarised hair will be stronger so less vulnerable to shock loss.

[aaron1234]

I've read Dr. Rassman's blog for years. And one thing he always reiterates is the need to get on Propecia before surgery to prevent shockloss in the recipient region. He even puts pre-op patients on it (sometimes just for a few weeks) who do not intend on staying on Propecia for the long haul (even though he highly recommends it). So, I could be wrong. I'm just going by what I read over on baldingblog.com.

[freakin]

Adrian,

 

Those photos that you entered on my blog are not me and may lead to an inaccurate portrayal of my situation. Kindly remove them as soon as possible.

 

Thank you,

 

Freakin

[Severn]

.

[Ventuoguy]

Regarding Propecia and hair transplants-it seems like everyone is giving advice for propecia with claims that it prevents shockloss-either temporary or permanent? Is there any real medical literature regarding this? Seems like all the reports are antecdotal. With regards to Freakin's unfortunate situation, it appears to me that the central forelock region which has been lost seems that it was an 'island' of hair having grafts placed all around it. Could it have been a bloodflow issue perhaps? Also, if you look at freakin's last posted photo, the hairline itself below the forelock region has been affected-the density is not what one would expect. One last factor is the style-almost parted in the middle which is the most severe way to style a HT. Perhaps combing forward or parting on the side temporarily would help the appearance until a definitive solution is accomplished.

[Bill - Seemiller]

Freakin,

 

I sent Dr. Rahal and Adrian an email about this. Apparently they must have overwritten your photos with the above photos on whatever third party site use to display photos. As a result, the photos on this thread were changed to the new photos they replaced them with by mistake. I've made them aware of the problem so they can rectify it.

 

Thanks for your patience.

 

Bill

[ShavedDethMonk]

Hey Freakin,

 

I sense your disappointment however if you really listen to what Adrian and Billeroc are saying is that they wish to help rectify the problem, so you can probably let down your guard and let them help you to get rid of your frustrations. Dr. Rahal and his clinic seem like a 'stand up' organization with the patient as their primary concern so take their advice and revisit them with an open mind and calmed nerves ... everything will work out buddy if you dont try to escalate the situation with further negative talk and accusations. If you just realize that it doesnt matter who did what and who said this you can concentrate on a solution rather than non-constructive finger pointing.

 

Good luck on your hair plan.

 

SDM