Anyone know what is Shock Loss? - Page 2 -
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  1. #11
    IAHRS Recommended Hair Transplant Surgeon John P. Cole, MD's Avatar
    Join Date
    Dec 2008
    Atlanta, GA


    Narnia, I am very sorry to hear about your situation. Isolated crown loss in females is not common. Typically, hair loss in females begins in the front behind the hairline and progresses backward while retaining the frontal hairline. Only later does the loss involve the crown area. I wonder if something else is going on in your case.

    Neograft usually goes together with an assistant doing the entire surgery. Seldom does the physician get involved in the case. Most physicians, who use Neograft have no idea how to perform a transplant. Many are plastic surgeons, who consider this very complex surgery simplistic. In fact, a hair transplant surgery takes many more hours than any surgery these plastic surgeons perform.

    The first thing to ask your surgeon is who did the surgery? If it was an assistant, I'd start by asking for a full refund.

    Before I go further, it is important to answer your primary concern. Your hair should grow back over time in full. Shock loss is temporary. Progressive hair loss is not. Progressive hair loss tends to occur in waves like falling of one plateau and landing on another one that lasts for a period of time. Then you fall off that plateau and land with less hair again. This sort of hair loss does not return. Shock loss does return. Your history does suggest shock loss.

    I learned something many years ago in females. Don't maximally pack grafts because this predisposes individuals to shock loss. Shock loss in females is devastating. It is bad in men. It is devastating in women.

    What can you do? There is no data to suggest that you can do anything. We could try many things such as high-quality PRP or lysed platelets, amniotic membrane, fat stem cells, and exosomes. There is no data to support any of these in treating shock loss. You could try topical minoxidil or oral minoxidil. Again, no data to support this. I do think you will feel better doing something. I do know that high-quality products other than minoxidil do promote faster regrowth of grafts. You might do the same with shock loss and I'd expect this.

    The real issue is hat your hair will regrow at a slow rate of 1/4 inch per month once it starts. It will not be until the hair is of a stylable length that you will see increased fullness. So, no matter what you need to wait it out.

    The maximum graft count I shoot for in women is 1000 grafts. Above this, shock loss seems more common in women. I will say that I see much less shock loss pre-conditioning the scalp with high concentrations of growth factors from lysed platelets.

    I would be very interested in trying some regenerative protocols on you to see if we can return you to a more normal state faster. Having said this, you should be ok in about one year from now without these protocols.

    I'm sorry to hear what you have been through. I know this is traumatic for anyone, but especially for women.

    Dr. Cole
    John Cole, MD
    Member, International Alliance of Hair Restoration Surgeons
    View my IAHRS Profile

  2. #12
    Junior Member
    Join Date
    Sep 2019


    Thank you Dr. Cole - your understanding words helped already. I regretted choosing the surgeon. He is a plastic surgeon but he made the neograft procedure sound like a simple, quick, no-side-effect procedure perfect for my hair loss case, and I wanted a full head of hair for years so I didn't do enough research.

    For my procedure (I'm in Northern California), two Neograft assistants did the extraction of hairs, and the insertion. The surgeon did the punching in the recipient area (vertex and nearby crown area). In CA it seems only surgeons are allowed to punch skin, which is why I think he did the punching. It was very quick though. The punching time was around 10mins, 15min maximum.

    I started using Rogaine for women (5%) yesterday - the foam version. BTW yesterday was Day 35 post op. I never used Rogaine in my life so I don't know what to expect. I'm happy to update. I also did some research and am wondering if using an Illumiflow (LLLT) Laser Cap is helpful. I don't think it will do any more damage but I wonder if from your years of experience, you have seen any benefit of this, particularly in treating recent, sudden hair loss like the shock loss in my case. It's a significant amount of money ($800) so any advice is appreciated.

    It's a relief to hear in my case the hair can grow back. If you tell me the hair loss is permanent I'm really going to depress, but I can take it and will hopefully one day find out a solution.

    I'm 43 btw. I started the crown area hair loss when I was 17. It did plateau and in recent years have gradually gone worse but I hadn't lost all of them although it was very visible from the back. Interestingly, I don't have any hair loss in my frontal hairline and if you look at me in the front you wouldn't tell I have a hair loss issue. I'm East Asian, not sure if this info is relevant.

    I forgot to mention that the surgeon did a PRP on me about 3 weeks post-op. I read mixed reviews on PRP but he offered it to all his Neograft patients at a discount and said it has been successful. He suggested 3 times first with 1 month interval. I'll do another one in about 3 weeks. Since I don't think PRP will make situations worse (will it?), I'm willing to try it for 3 times but I do wonder if the surgeon's experience affects PRP effectiveness (it seems a much simpler procedure so even though I do not trust him any more I hope at least he can do a PRP OK).

    I'm interested in the regenerative protocol you mentioned if I'm a candidate. I just did a quick search and it seems you are in Georgia? It's a bit far from where I am so I'm wondering if there's a way for me to try this from remote. Could you let me know if it's doable? I'll check back on this post and if it is, I can follow up with you offline.

    Thank you so much Dr. Cole.

  3. #13
    Junior Member
    Join Date
    Sep 2019


    Sorry I forgot to add a question Dr. Cole - I read it that if the shock hair loss is due to transection they will not grow back. Is this true? Could my case be that and how do I know if so? I plan to ask my surgeon in my next followup but I do not trust he'll be completely honest with me on this (I'm pretty sure he will say shock loss is common and my case is not transection). Hopefully I can be better prepared for this question when I see him. Thank you!

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