Transplanted hair receding years after HT.

slo,

Listen my friend. We need to talk. Contact me at my email link below and we can discuss by phone. It's better that I call you because it would take me forever to type the reply you are seeking. I can talk much faster than type. My following opinions are based on the past three decades of observation in HT patients.

You may very well be experiencing a phenomenon that some patients do unfortunately experience. I am and have been actually doing a research project on this phenomenon. Thank goodness it is the exception and not the rule!

I do not know how your doc confirmed the fact that you are "losing" your past transplants other than simply looking at what was once there and how much is left. In other words, comparing past photos post-op when everything from your past procedure grew in.

IMHO, the best way to determine if you hair is diffusing or being lost is by closely examining the individual transplanted hair shafts under a scope with at least 30X empowerment. I use a densiometer because it has a light meter built in. It's a hand held instrument that can be purchased at Radio Shack for approximately $20 US. Believe it or not, you can even use a magnifying glass to monitor and compare the differences in "hair shaft diameter". So to make my pount clear, you are comparing differences in hair shaft diameter to confirm the diffusion.

You simply take small individual hair samples in any zone that you notice diffusing going on. You then take "terminal" hair samples from the donor zones (sides and back zones, parietal/occipital). Compare hair shaft diameter between the diffused hair samples to the terminal hair.

You can even mail the samples to me and I will examine them for you providing that you acknolowledge by reply email that I am not a licensed physician nor making any clinical representations and/or any formal certifications. You are getting my lay opinion, nothing else.

But I have been doing this on myself and some other younger men who are just beginning to notice the effects of MPB. I use the same approach to informally confirm if finasteride is working to stabilize the loss of hair shaft diameter. I am also as I said conducting my own research on past HT patients who feel they may be losing their transplants. I can say that most of the participants are at least 5 or more years post-op.

It is extremely rare to see the loss occur at such a soon interval as you are experiencing. I would say the average has been between 10 and 15 years post-op. Let me also say it is rare for this phenomenon to occur. Clearly, this is not the norm and I have tried to get more feedback from several HT docs. But what I have found is that many of them are uncomfortable discussing or confirming that is in fact a potential part of the risk in HT surgery.

My premonition is that this is occuring more than we realize and why I am doing the ongoing research project.

I will need your written release and cooperation if you would like to participate and why we need to talk further. You can also forward to me ongoing digital quality pics of the thinning zones, again for comparison purposes only. Your case and file is strictly confidential with me.

It's the "why is this occuring" question that we are trying to answer with a scientific conclusion.

Now, if you want my opinion to date as to why this phenomenon is occuring, here it is: I believe the main reason why any patient may lose their transplants at a future date is because some of the donor hair is in fact DHT receptive. In other words, I am realizing more and more, or better stated, I am becoming more convinced with time that terminal hair is not a black and white issue.

Just because it was harvested from the occipital zone does not necessarily imply that it will last forever. Some of it will last for decades and some will not. There is no way of telling strand by strand because an extremely high percent of HT patients are doing the procedure when most of their donor zones appear as terminal hair without exception. I am finding that there are in fact exceptions. Those zones do not show very much miniturization if any at younger ages. It begins to show as we age. That's why it is easy to be mistaken.

Here's the key folks! This is the most critical statement I can state on this issue. If You have donor zone thinning in your family history on either side of your family (maternal or paternal), then there's a real possibilty that you will experience it as well. So if donor zone thinning is in your cards, then it is very possible that some of your transplanted hair is in fact DHT receptive!

One last statement. One of the similarities between the participating patients have in common is guess what? Donor zone thinning in their family history! That's is the only real evidence that supports the answer to this phenomenon. I do not include individuals who are on meds with hairloss as a potential side-effect nor people with diseases that can also cause hairloss like Lupus for example.

To date, I cannot find any other source or reason as to why the permanency of transplanted hair fails other than some of it is DHT receptive to begin with.

I began to come to this conclusion about 3 years ago and why some of you have noticed that I began to warn and inform new patients to reconsider HTs "if" and I repeat "if" they have histories of donor zone thinning in their families. At the same time, I began to warn new patients to not consider "nape hair" for donor use "if" they have donor zone thinning in their families.

I have been criticized for this opinion in the past, yet as time rolls on, there are more patients like you experiencing this dilemma.

Again, it is something for every patient to explore and consider before they ever step into the OR room!

I truly hope this has been helpful to you and any others who may be experiencing the same thing.

Let me know if I can be of any futher help. See what I mean by the amount time it takes to type all of this?

slo,

FYI, I won't be available until August 11th, just in case you try and get in touch with me and do not get a reply.

Slo, this is the nightmare I've been going through for the past 6 months. I too have been losing a lot of my transplanted hair. The thing is, I've had FOUR HTs, all in the frontal area over the past decade but continued to notice more thinning. The last HT was just over 1 1/2 years ago. Six months ago my hair started falling out like rain, which left the frontal area thinner than ever before. Went to see my doctor only to be shocked when he told me that I was one of the rare cases where the transplanted hair is lost with time. I was completely devastated and ever since my depression has shot through the roof. I am mad because we're always told that transplanted hair is permanent. No body cares to tell the truth that in some cases it ISNT permanent. Yes, those might be rare cases but doctors SHOULD tell us about that possibility. Had I known that, I wouldn't have gotten my last HT.

You have no idea how depressed and sad I am about this. Over $20,000+ interest spent on HTs and now I find out it maybe be for nothing. I am furious because I didn't sit around and pray for a miracle. No, I got out and spent my own god damn hard earned money that I took years to make to fix this ****ing curse but then god decides no, you're not gonna have your hair back. This is like a double curse. First my ****ing father gives me the baldness gene, then I find out that even my transplanted hair will fall out. How nice is that ?

I think this needs to get out. People need to know about it, even if it is a rare condition, although I DON'T think it's as rare as they'd like us to believe.

**** LIFE.

Gillenator, fantastic write up. Someone else asked the question of whether transplanted hair is permanent in one of the other sub-forums and I told them yes and no and it kind of depends. What you say about occipital thinning is I think true in many of these cases.

We also know that a young man will have higher denisty in his donor region, perhaps 100FU/cm2, compared to a man 20 years older who may have 80FU/cm2. Therefore it was my train of thought that in fact you could expect to lose some transplanted hair over time. When you're transplanting at 45FU/cm2 and you lose 9FU/cm2 or 20% over time then it's going to have a dramatic effect. 36 will look significantly thinner whereas 45 with favourable lighting could look full.

This brings up another interesting point; the virgin scalp at 40, 45 may be in a more favourable position than a 25 year old as donor density may have already thinned a little meaning that it could be more likely that the hair transplanted at this age is for want of a better term 'more permanent' or likely to be permanent. Just a thought.

I don't think the transplanted hairs fall out because of DHT effects. At least not in my case and other similar cases. My transplanted hairs seem to fall out all of a sudden. They're there for a year, two, three or four and maybe more then many of them start disappearing within a couple of months. I doubt that has anything to do with them being susceptible to DHT effects.

Yes I agree with you, the hair don't seem to be shedding and getting smaller and smaller, they just seem to fall out as big thick shafts and not return. The remaining hairs are all thick and strong just sparsely distributed due to the lack of density.

This is strange because even if the donor was affected by dht, wouldn't the transplanted hairs thin at the pace of the donor? Even if the donor thins, why are they dying or falling earlier? Plus, I've seen pics of guys with real thin hair in donor that get HT with good results. I doubt it's the DHT on donor.

I was undecided whether I should go for hair transplant operation. I recently asked my family doctor for some advice and he is against it. From what he said, for many people the transplanted hair will eventually fall out; the transplanted hair seems to take on the characteristics of other hair in the recipient area and eventually suffer the same fate. He said if I start hair transplant, there maybe an unending cycle of catch-up to follow, until I am exhausted.

I am quite scared by what he said and am now holding back. I feel sorry for guys who have to go through this.

The thing is, on the other hand, the hair transplant doctor told me there are more than 95% transplanted hair survival and it is for life. I just don't know if he is intentionally hiding the fact from me or if this is really so rare that it doesn't worth mentioning.

dont even think to have a ht ..if they care about bald ppl its time for a better treatment ...and for the rest its time to shave that bluddy hair lol at least till they will come out with a real nice treatment....

The lack of knowledge in here is overwhelming. First, it's admirable that you're all on here in hopes of gaining knowledge -- But let's get a few things straight.


The gene causing MPB is from your mother (the X chromosome) 100% of the time; so don't blame your lock-lost father.

Secondly, HT (from a good doc) is meant for men with their alopecia under control. Regardless of the "DHT resistant" strands of hair, if your body is still producing the DHT, it will choke out the relocated hair.

It is said to not even bother undergoing these treatments unless you are on a *working* DHT inhibitor, or until after ~40 (when ~90% of men are finished with their MPB).

Until then, you will most often find that within a few months the hair is falling out, regardless of what your money-eyed physician told you.

You're wrong. The transplanted hair does NOT fall out within a few months and NO, being under 40 does NOT mean your transplanted hair will fall out. I had an HT in 2003 and was satisfied with the results with no thinning until 2009 when within two months there was noticeable thinning especially in the right temple. So, for six years I had thick hair in the front and no, I wasn't 40. Most people who get HTs don't lose their transplanted hair.

Secondly, whether under 40 or over 40, what does that have to do with the production of DHT? DHT is in the body 40 or under or over. If the DHT is the reason why transplanted hairs fall out, they WILL fall out regardless of what age the person is and ALL people who get HTs WILL lose their transplants, however, that's not the case.

"alopecia under control...". What does that mean ? How can alopecia be under control ? I do take Fin and have been taking it for over a decade, yet I have the problem of losing my transplanted hairs after a random number of years.

You'll be surprised how many GPs don't actually know shit about HTs.

Like I said, I do believe I'm losing my transplanted hairs for some unknown reason that has nothing to do with DHT. DHT doesn't cause the hair to fall out all of a sudden and within a couple of months.

And no, the mother isn't 100% responsible for passing down the baldness gene. Both the father and the mother can pass it down, but if the mother has no bald men in her family while the father is bald, it doesn't take a genius to figure out who's responsible for the baldness in their children.

Wow. You took just about everything out of context.

First things first. I am a biology major. The gene for MPB is on the sex chromosome X. Which, if you are a male, comes from your MOTHER. NEVER your father.

There is a little thing called expressivity, which is the amount a gene expresses itself in an individual. Most often, it is very hard to see a woman with the trait because it does not effect women as bad (on average).

Also, women are XX while men are XY. If women possess the trait, they can have a DOMINANT ALLELE on the other X chromosome that MASKS the expressivity of the MPB gene, while still being able to pass that trait down to her offspring.

Secondly, "alopecia under control" refers to the MPB gene taking full effect (due to age) or the successful use of a DHT inhibitor.

So, you're telling me that my father, age 62, who hasn't lost any hair since his 30's, isn't finished with his MPB process?

My word, after all of the time and thought it took to write my initial reply in this thread, I would have thought to at least received a modest thank you.

Guys, the condition for MPB can be passed by either side maternal or paternal. I am rather convinced of this after making observations in people for three decades.

Far more women suffer from MPB than you might think. They just know how to mask the thinning with hair length and styling. Far more women wear hair systems than you might think.

FDR, thanks for your comments. I prefere to call it donor zone thinning because it can happen in other donor areas other than the occipital zone. You make some valid points. Let me also invite you to consider hair caliber in this phenomenon of donor zone thinning. Younger patients can get by with lower density goals as measured by FU cm2 mainly due to the fact that their grade of hair caliber (degree of coarseness) is usually much higher on people under 40 years of age.

IMHO, the type of hairloss that slo and Victim are describing are more related to those transplanted hair follicles going dormant more permanently. It is not exactly the same as alopecia areata but similiar in cyclical behavior. With alopecia areata, there are blotches of total loss, not necessarily receding or thinning by hair count. Visual thinning can be seen or comfirmed by loss of density (hair count) or loss of caliber (diffusion). It does not sound like slo or Victim are "losing caliber" to their transplants; it sounds like they lost hair density. Please correct me if I am misunderstanding either patient. In most donor zone thinning cases, patients are in fact losing both hair count and caliber, however it is loss of hair count that most notice in the beginning stages of donor zone thinning.

If I am correct, than how can it hurt to have several biobsies done to at least confirm that the transplanted follicles exist, but just are not in hair production, the anagen phase? In other words, in both cases, these men initially experienced cyclical growth in their transplants right? That means that their transplanted follicles did take, they did produce, but later shut down. If either of you do have biopsies done, be sure that a comparison is made to hair follicles extracted from a terminal hair zone. Why? Because you also want to know if your transplanted follicles have miniturized "after" they were relocated to the recipient area.

If the transplanted follicles have not miniturized, then possibly efforts to stimulate those follicles into their respective growth phases is the answer. Who knows? That's where doctors need to investigate to see if there are viable efforts once they know the follicles are still intact, but just are not producing. That is what I want to convey to patients like slo and Victim. IMHO, they should not look to additional HTs. Thankfully they both appear to know that.

It is true that many GPs/internal medicine physicians have very limited knowledge of hair loss much less surgical hair restoration. There are unending phisiological processes and genetic implications behind hair growth as well as varying forms of alopecia (hairloss). Far too complex for us lay people.

Some choose to take a purely scientific path in their evaluations however I have observed many of them absolutely stumped by their own conclusions, by all of the stupifying examples that tell something all entirely different. I have chosen to base my opinions on true life examples of what indiviuals experience "across the board". There are almost always "pools" of individuals who have similiar experiences regardless of race. Age however is an entirely different factor and can have a huge implication in areas like donor zone thinning.

I also agree that all HT doctors should disclose this phenomenon as a low occuring risk and it should be taken into consideration "IN ITS PROPER CONTEXT". I also afore-mentioned a consideration that all potential HT patients should look at histories of obvious donor zone thinning within their respective families, both maternal and paternal sides!

Man I am sorry that your are going through this tough time

but doctors don't make money with the truth, sometimes they lie to mislead you.

I DO NOT blame you, but the industry for what it has become. My doctor did not educate me on any of the negative of this procedure, and I had plenty.

Thats why strip is so much more risky too. I this happens you can't go clean and shave down. Strip was the worst thing I have ever done, no I take that back, going to PHx,Arizona to get a HT is the worst thing I have ever done.

Hang in there my friend