Shock loss

**SpencerKobren** · 02-09-2009, 12:32 PM

Hair Transplant Shock Loss

Originally posted by Denver Mint

Hello all,

I am new to the forum and have a question.

I had a trasplant about a month ago. I went to Bosley in Atlanta. I just discovered this site so I guess I am an ignorant balding 29 year old.

I started Propecia about 5 weeks ago and had the procedure the following week. I am experiencing quite a bit of hair loss in addition to the transplanted hairs.

I have read that many men will experience non-transplanted hair loss. How long should I expect the hair to keep falling out? I used to find about 3 hairs in my hand when I showered. Now I find upwards of ten to fifteen. Is this something to be concerned about or is this normal? How long should I expect this to last? I have read that I should grow this back but I am really starting to notice thinning at a rapid rate at the middle and top of my head.

I am 29 and really started to thin over the last year but it wasn't very obvious. I just wanted to jump ahead of the loss before it is obvious in hopes of others not finding out. I had about 1500 grafts to fill in my front which is where most of the loss occured and scattered throughout my middle and top.

Overall I am pleased with the recovery. My scar is not noticable so I am happy about that. I did experience swelling but it went down after about 5 days.

I really appreciate this forum.

I look forward to the responses.

Hey Denver Mint,

Welcome to the forum! Shock loss after a hair transplant procedure while distressing, is very common. I’m assuming that your surgeon over at Bosley explained this to you during your initial consultation. The good new is that most if not all of your lost native hair should return within a year.

It sounds to me like you really didn't have too much hair loss to begin with, so I’m curios to know if your surgeon might have recommended that you wait to see how Propecia worked for you before considering surgery?

As far as how long the shedding will last, it’s hard to say for sure, but it shouldn’t last more than a few weeks or so.

I’m glad that you're happy with your scar and I wish you a speedy recovery.

If you’d like to post some images showing your area of shedding and where your grafts were placed, our members and myself will be glad to comment more specifically on your situation.

Hang in there, sometimes it gets worse before it gets better.

Here’s some interesting reading about hair transplant shock loss from the IAHRS Info Center:

What Are The Possible Complications of Hair Transplant Surgery?

Female Hair Transplant Shock Loss - Will My Hair Grow Back?

Concerned About My Hair Falling Out From a Hair Transplant Procedure

**TeeJay73** · 02-09-2009, 01:26 PM

Hey Denver Mint,

Can you share with us a little bit about your transplant experience with Bosley? I had an initial transplant with Bosley in the year 2000 (the "dark ages"), and I was just curious to know if they have changed or anything? How was the consultation?

Best of luck for being on your way to an awesome head of hair! :-)

TeeJay

**Denver Mint** · 02-09-2009, 09:23 PM

Yeah, I guess I probably wasn't a typical hair transplant candidate in the fact that I have quite a bit of hair to lose but I started to notice my scalp was showing at the middle and top of my head. It is hard to swallow when you look at pictures just 2 and 3 years ago and then look in the mirror. Like I posted previously, the front has been thinning for a while. I will post pics later on.

I was actually very impressed with Bosley. I did not experience any pressure whatsoever. I met with the consultant and the doctor on the same visit. The doctor explained to me my balding category, which is 5 or 5A, I can't remember. I left on my own terms and negotiated a reasonable price. I realize the fees are inflated but the total price was about 20 percent less than what the fee schedule indicates.

I was a little disappointed in that the doctor does not implant the hair. He performed the incisions and the nurses and techs put the hair in. I think they did a good job but I thought the doctor would do that as well. I couldn't see but it seemed like he used a scalpel to cut little incisions all over my head. It was not like the John and Kate plus 8 procedure where they punch holes in your head. He did not explain that I could possibly experience shock loss. I just wanted to get ahead of my hair loss and put a few hundred grafts in the area that was starting to thin, however I am anticipating the re-growth of my hair lost and new hair in the middle and top of my head. I think I will need to have a second surgery to fill in the rest of top of my head and I am hoping that will be all that I need. Like many others, I am nervous in how the end result will look like but there is nothing I can do but wait and see.

In looking at other pictures, I don't think I have alot of surface area to cover because the balding area is relatively small compared to many of the pictures I have seen.

Everyone was very courteous and they did everything I asked. For some reason the anesthetic did not numb me very well so I had about 100 shots. It was crazy but the middle of my scalp did not respond very well at all.

My biggest fear about hair loss is that I have wierd shaped head and I think it will look funny bald. That is my main motivation in trying to curb the shedding.

Like I said before, this forum has really encouraged me because I am able to read about others experiencing the same anxieties and worry as I am experiencing.

**gillenator** · 02-10-2009, 12:17 PM

Denver Mint,

The good thing is that it does not sound like your shockloss was substantial because for some, it can be, especially those with a diffused thinning pattern, commonly seen in women with MPB.

First let me inform you that I am not a doctor, but I do have nearly three decades of clinical observations and did work on the inside before.

I see and hear of many younger patients having surgery at roughly the same time they are starting Propecia. IMHO this is not the ideal approach because as you found out, some guys can experience a massive shedding just from the active ingredient. This usually occurs in the first 90 days of starting the drug IF the patient responds to the meds with shedding.

The problem is that the recipient incisions cause trauma to the scalp and the scalp often will respond with some level of shockloss to the exisitng native hair and you end up with a double whammy of loss, both from the meds and the trauma! Thankfully most of it does grow back. Your native hair and transplants should start breaking scalp at 3-4 months post-op.

The primary reason that a patient wants to wait on surgery is to see if in fact Propecia stabilizes one's hairloss. But let's say for example it does not work and the patient continues with a rapid progression of hairloss. Having surgery at that point IMO can do far more damage than help as far as any visual benefit is concerned. Surgery at that point can in fact ADVANCE the rate of loss. It's so unpredictable. But whenever a new patient arrives with advanced hairloss at a young age, and then also states he/she is losing at a rapid rate ARE CLEAR INDICATIONS that this particular patient is at higher risk of shockloss, and even permanent shockloss. And let us remember, women cannot take Propecia, only minoxidil. But for these younger men losing fast, moving them right into surgery IMHO, is inappropriate. The medicinal route should be tried first for the reasons I have mentioned, again my opinion, and you do not have to be licensed in medicine to see the prudent sense in that and act responsibly in the patient's best interest.

For the most part, those individuals who have family history of the advanced levels of MPB, and do not respond favorably to hairloss meds, should think twice about surgery because there is a good chance they will regret it should they move forward. Something to think about.

All in all, I wish you the best in the months to come!

**Spex** · 02-18-2009, 09:01 AM

Shockloss is something that can be experienced when transplanting into existing hair although highly unpredictable. Shockloss occurs when the native hair is weak and isn't strong enough to resist the trauma thats going on around it. More often than not the hair that has gone into shock will grow back but after 3/4 months - after the resting phase
Hair that goes into shock and doesn't return is hair that was inevitably on its way out anyway and wasn't strong enough to return.
Increased trauma to a localised area will increase the chances of shockloss
Shockloss is unpredictable and there is no hard and fast rule to avoiding it - especially if you are transplanting into existing hair.

There are risk factors that either heighten or lessen someone's risk. Diffuse thinners seem more prone to shockloss than receders because the hair in a diffuse area is often less stable than that of a receder. Very often, a lot of the hair in a diffuse area is "on its last legs" and in the latter stages of the miniaturization process.

**Codeman** · 02-07-2011, 07:59 PM

I can relate

Hi Denver Mint, my situation is EXTREMELY similar to yours. I am 26 yrs old and went to Bosley in Atlanta and had a transplant done (prior to doing enough research). I feel after doing my research on the back end that I would have not had a hair transplant had I seen all the threads that I have now seen. The hair transplant procedure that I experienced in Atlanta went well and the staff was very nice. I do however feel that I WAS somewhat pressured into the procedure and the possibility that I was not a candidate because I was so young was not even brought up. Nor was the possibility of shock loss, which I am experiencing. However I fear this loss may be more serious than shock loss. I had the procedure done in October 2010 and it is now February 2011 and I am noticing some disturbing loss of hairs that don't appear to be transplanted hairs. This is very frightening for me and I am concerned that I made an awful decision because I am a student living off of loans now and I do not have any cash to fix anything that ends up looking awful. I did not start taking finasteride until approximately 1 week prior to the surgery and was not notified that I could have waited 6 months to see if the hair loss would subside. I also feel that the doctor may have given me false hope in how low he could bring my hairline and provide adequate thickness at the same time. I am currently using minoxidil and finasteride as well as taking an SSRI to help with the anxiety I feel over the possibility that I have made the worst decision of my life. Maybe not... I surely hope not but all I can do is wait and see what my 1 yr results look like. Denver mint, how do your results look now? I think we had very similar situations and I'm trying to decide what to plan for in the future. Thanks

**Denver Mint** · 02-07-2011, 08:58 PM

Codeman:

I can feel your pain and sorry you are going through this. My anxiety was like a roller-coaster for a long time. With that being said, there is hope. I actually quit taking propecia and haven't done so for about a year and half. My shedding slowed down significantly and I don't really notice much shedding anymore...even less than before I had the procedure. I think the shedding prior to the surgury was my hair pattern finishing out my "island patch" in the front.

That being said, I can share with you what I have went through. The back 2/3 of the top of my head still looks worse than before the surgery and I have come to grips with it. It was a long emotional journey and I still feel the emotional remnants of it and I just passed my 2 year anniversary of the procedure. My hair was too thin to wear any longer than a 5 guard without feeling self-conscious.

In May of 2009 I really started researching strip-scar revisions because I came to the conclusion I could not afford another surgery so my decision was to go shorter...ironically the reason I had the surgery in the first place because I didn't want to shave my head. The problem is, you can't shave your head with a huge scar covering the back of your head. The scar was concealed but I couldn't go lower than a 5 guard without it being noticeable. So I was stuck with overly thinning hair on top or risk everyone seeing the scar and knowing I had the surgery.

I am not sure if I can recommend surgeons on this site but I will mention who I went to. I researched and found Dr. Cole in Atlanta. I believe it is IHTI. From what I read I had to put faith because I had nowhere else to turn to resolve it. I went and had an FUE procedure which pulls individual grafts out without scarring. There is supposedly a little scar that is left but unless you shave your head completely you will not notice it. I had 200 grafts placed in the scar area...doesn't sound like much but it has made a huge difference.

I am now able to shave my head all over with a three guard and the scar is undetectable. With it down to a three, the thinning on top is not nearly as noticeable. If you can get strip scar surgery I really think it can buy you some time. It costed me $2,000 for the surgery but it was worth every penny, imo. It is not perfect, but I can go anywhere I want without people seeing the scar.

Another thing I discovered while I had the surgery was Toppek. You may want to look into this. The Toppek fibers work pretty well. I used it when my hair was longer when I was still nervous about shaving my head and it really gives pretty good coverage. It is a fiber that sticks to your hair. The one thing to keep in mind is that it usually doesn't match your hair perfectly. I have dark brown hair and if I over-applied it, it looked closer to black. Because of fighting with putting Toppek on everyday, I decided to shave it. I still use Toppek to fill in some thin spots with my 3 guard shave but I use a little spray nozzle which makes it very easy. I have been able to shave the top of my head as low as a 1 guard and my side and back I can go as low as a 2 guard but I have to use Dermatch to put on the scar area. Don't get too bogged down in the dermatch stuff, I was just experimenting with ways to see how low I could go.

All that said, I decided to put grafts into my scar and go shorter. If nothing else it has bought me time to if and when I would like another procedure. If I do decide it will be with FUE procedure, not Bosley. If I wouldn't have had the scar in the first place, at least I would be able to shave it and move on. I regret the decision to go and if I had it back I would've rather flushed the money down the toilet...that stinks to live with that kind of regret but I have to move forward. My regret is because I have the scar, not for the hair thinning. As I said before, the hair did stop falling out. I would have had an FUE...if only I had done a little more research prior to them putting the knife to the back of my head.

Hope this helped. Hang in there and stay strong. Alot of men have been through what you are going through and we have survived.

I wanted to add that the front portion that really needed the implant looks pretty good. It is not as thick as I would've liked but I can't complain about it. I actually have turf over my entire head and nobody knows or at least has looked at my funny or made a single comment about my hair looking different.

**Denver Mint** · 02-08-2011, 10:39 AM

I just looked over my post and wanted to clarify if I had to it over again I would not have transplanted in the thicker hair. I indicated it wasn't for the thinning but obviously that is what concerned me.

**dgman21** · 02-08-2011, 11:45 AM

So you would recommend guys thinking of surgery just to accept thinning and balding?I'm 32 next month and I really can't stand my thinning hair,especially windy days or rain/swimming,seeing hairs on my shirt,etc.....I feel like its holding me back from doing things in life at my job and women,and other things. I keep looking in the mirror and comparing myself to other guys.

**Denver Mint** · 02-08-2011, 02:25 PM

In regards to Codeman, whom said he felt we were in similar situations, I recommended the strip scar repair surgery. And only because that is what I did and I have found contentment in being able to have my hair at a certain length and not let it be hindrance to my self-confidence in appearance. I may have been a little confusing in my original post. It was getting late and I was typing fast.

Because my one and only hair transplant surgery so far, transplanted hairs were transplanted in a region that did not need hair and caused thinning that was not thinning prior to the surgery. He indicated he could not afford a major repair job. I found it to be much cheaper to buy some years by being able to go shorter with the scar repair/scar transplant surgery as opposed to going back in and transplanting more hair on the top of my head and possibly causing more shock loss.

dgman221, did you have shockloss also from strip surgery?

**dgman21** · 02-08-2011, 02:52 PM

Denver,
I am really contempalting getting strip surgery but after posts I get scared. I'm just so sick of seeing my thinning hair. It's like I'm afraing to take a shower or brush it due to more hairs falling out and more of my scalp being exposed. I just want to thicken it up. I've gotten 3-4 doctors opinions on the IAHRS website and they vary saying I don't need it yet to 600 grafts to 2,000 grafts. I wish I can get over this. I have to fix my hair a certain way so I don't expose my balding areas.

**Denver Mint** · 02-08-2011, 03:28 PM

dg,

I am only one person with an opinion, but I wouldn't tell my worst enemy to get a strip surgery. FUE is more expensive but you don't risk the scar. I am young but one day I may have to have chemotherapy. I don't even want to think about dealing with having a scar from one ear to the other on the back of my head knowing my hair would probably fall out...to me, people knowing I had the surgery is even worse than going bald.

Also, in the event you are not happy with the surgery and decide instead of chasing your baldness for years to come and spending thousands of dollars, now you may be stuck with dealing with your thinning hair, bad surgery and a scar to deal with to determine how you are going to proceed.

Keep doing research and think about it and you will make the right decision. I am not against hair transplant surgery so I don't want to sway you but it is good to know the risks.

**Codeman** · 02-09-2011, 09:58 AM

Denver mint, How short is your hair right now? And how much did the scar transplant/repair cost you? You say it was worth it so apparently you would recommend it? I am ok with shaving my head as close as I can but need to know if Dr. Cole is affordable and if he gave you good results. I was hoping he could take my donor hairs from either my front hairline where the Bosley "doctor" placed them too low and too far apart. How is your scarring in the donor area? I actually scar little compared to others and have great healing skin. I just don't want noticeable scarring on my forehead, however I also don't want a patch of sprouts on my forehead that is isolated when it starts growing back out because I was too busy to shave EVERY DAY.

I agree with what you said about not wishing the strip surgery on your worst enemy. It has really turned my life upside down. I have a lot going for me but it makes you CONSTANTLY embarrassed that you went through with it. I DID NOT do my research and sort of rushed into it. How stupid can one be?! I put my faith in other human beings and learned a hard lesson. One that will stay with me until the day I die.

Scars do get better over time and my hope is to be able to shave my head with a razor and just have the scar which in a # of yrs will be skin color instead of pink. Lots of people have scars in visible places. Mine just happens to be on the back of my head now. I will own it and hope and pray that it is not as noticeable as it could be. I have a wife that loves me no matter what scars I have so I am extremely blessed. Everybody else that sees the scar can assume what they want about me and if they judge me then that is their sin. I don't really care. The people that matter are my family and those that love me and to those people, the scar is exactly that, just a scar! It still doesn't mean I don't want it to be as minimally noticeable as possible ha!

Thanks for your replies, information, and support DM. I am really glad you feel better about the whole situation and with the way things are only 2 yrs after THE PROCEDURE. If you have any pics you could share I'd love to see them. Really thinking about visiting Dr. Cole because I may could actually afford it. I am in graduate school and have no income for the next 2 yrs but I have some emergency cash put away that might take care of his fee. I sure hope so!

Codeman

**Denver Mint** · 02-09-2011, 12:01 PM

Right now my hair is at a 3 guard with a Wahl razor. I shave it about once a week. As I said before, I have actually had it down to a one on top and 2 on the back and sides. It sounds wierd to have the top shorter but a 1 and 2 guard are so close that it doesn't look bad...however, I cannot go any lower than a 2 guard on the razor without the scar being noticeable.

Info on the scar correction: The transplanted hairs do not cover the scar completely. Dr. Cole indicated it takes two or even three surgeries to get the scar where you want it to be, but he and is and his office staff told me not to expect to ever fully conceal it. That is not to scare you away from getting the scar repair done. I had one surgery and it has done wonders.

Dr. Cole did tell me if I wanted to have the implanted hairs taken out he can do that in the front. There is however risk of minimal scarring but nothing like the strip scar. Give them a call and get a consultation.

My repair surgery was $2,000.

Shock loss

Shock loss

Comment

Comment

Comment

Comment

Comment

Comment

Comment

Comment

Comment

Comment

Comment

Comment

Comment

Comment