Do transplanted hair stay in temples without finasteride?

czecha

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If the hairloss is stopped.

Are there papers on this, or does someone have experiences with it?

I'm kinda sceptical bc the tissue is still going to befibrotic.

I know clinics require finasteride but I'm not sure if it's to counter further loss behind the transplant or also for the transplanted hair.
 

justinbieberscombover

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Do they look off iff you buzz them down very short? Ever tried that?
After the last transplanted I buzzed all down and it looked like I had very even density all over. Almost passed as someone who never had any hairloss lol.

With that being said I decided to keep it grown out because of other aesthetic benefits.
 

zerafian

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if transplant hairs are healthy they should act like they did when they were in the back of your head, when they are moved to the front or crown.

If the surgeon knows what they and their team is doing, it should look like natural hair, not weird in any way.
 

whatintheworld

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Yeah it stays for as long as there is no miniaturisation in the donor area.

Wrong. Even if you do not have donor miniaturization, depending on how aggressive your male pattern baldness is, you can still lose transplanted hairs in the recipient area.

It is all on an individual basis. Does it happen for most patients? Probably not. But it is more frequent than just a one off case as well.

This is assuming you do not take finasteride or other anti androgens.
 

giegnosiganoe

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Wrong. Even if you do not have donor miniaturization, depending on how aggressive your male pattern baldness is, you can still lose transplanted hairs in the recipient area.

It is all on an individual basis. Does it happen for most patients? Probably not. But it is more frequent than just a one off case as well.

This is assuming you do not take finasteride or other anti androgens.
Do you have any good examples of this? If you're just going by eye, then thinning in the recipient area would obviously more noticeable than in the donor.
 

whatintheworld

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Do you have any good examples of this? If you're just going by eye, then thinning in the recipient area would obviously more noticeable than in the donor.
There are examples across the forums from patients, and publications on google scholar that support this. I don't have the time to dig them up now but they aren't hard to find.

A disclaimer: I'm not a shill for either side, hell I plan to get a transplant myself so why would I speak ill of something I myself intend to do? I'm only interested in letting people know the truth so they can make an informed decision for themselves.

The risk is small, but not non-zero.
 

giegnosiganoe

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There are examples across the forums from patients, and publications on google scholar that support this. I don't have the time to dig them up now but they aren't hard to find.

A disclaimer: I'm not a shill for either side, hell I plan to get a transplant myself so why would I speak ill of something I myself intend to do? I'm only interested in letting people know the truth so they can make an informed decision for themselves.

The risk is small, but not non-zero.
I'm open to it being possible, but I can't say I've seen anything that clearly demonstrated that, where the donor wasn't affected to a similar degree (which is easier to hide). Microscopic evidence would be even better.
 

whatintheworld

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I'm open to it being possible, but I can't say I've seen anything that clearly demonstrated that, where the donor wasn't affected to a similar degree (which is easier to hide). Microscopic evidence would be even better.

https://pubmed.ncbi.nlm.nih.gov/16931898/

Abstract​

Pathogenetic mechanisms in androgenetic alopecia are not yet fully understood; however, it is commonly accepted that androgens like testosterone (T) and 5alpha-dihydrotestosterone (5alpha-DHT) inhibit hair follicle activity with early induction of the catagen. Thus, we investigated the influence of T and 5alpha-DHT on proliferation, cell death and bcl-2/bax expression in cultured dermal papilla cells (DPC) from nonbalding scalp regions of healthy volunteers. T and 5alpha-DHT induced apoptosis in DPC in a dose-dependent and time-related manner; in addition a necrotic effect due to T at 10(-5) M was found. Interestingly, bcl-2 protein expression was decreased in T- and 5alpha-DHT-treated cells, leading to an increase in the bax/bcl-2 ratio. In addition, T and 5alpha-DHT induced proteolytic cleavage of caspase 8 and inhibited proliferation of DPC at 10(-5) M. High concentrations of T and 5alpha-DHT were needed to induce apoptotic effects in DPC. These data suggest that DPC from nonbalding scalp regions do have the capacity to undergo apoptosis, but need a high androgen stimulus. The present study provides an interesting new pathogenetic approach in androgenetic alopecia.

https://www.jcasonline.com/article....;issue=4;spage=292;epage=297;aulast=Kumaresan

Abstract
Background: The longevity of the grafted hair follicles is still debated and there are limited literature available on this topic. Aim: To assess the longevity of transplanted hairs after follicular unit transfer (FUT). Materials and Methods: A total of 112 patients who had undergone FUT were included in the study and their results at the end of 4 years were compared with the 1 year post surgery results by standardized images. The reduction in the density of the grafted hair follicles was graded by a blinded observer in a grading scale. Results: Among 112 subjects 50.89% had grade 4, 46.42% had grade 5, 2.67% had grade 6 alopecia respectfully. The 4 year follow up grading of hair loss showed moderate reduction in transplanted hair density in 55.35%, slightly reduced density in 27.67% greatly reduced in 8.03% and no change in the density in 8.92% subjects. Conclusion: The hair grafts transplanted may not last permanently for all the subjects. Recipient site influence might affect the growth and long-term survival of the transplanted hairs.
 

giegnosiganoe

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@whatintheworld the studies you linked above say nothing about the donor area though. The Eugenix video says they believe the recipient area thinning occurs precisely because of thinning in donor area.

Earlier you said that thinning can occur in the recipient area even if the donor area shows no signs of thinning. That is what I'm unsure about.
 

whatintheworld

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@whatintheworld the studies you linked above say nothing about the donor area though. The Eugenix video says they believe the recipient area thinning occurs precisely because of thinning in donor area.

Earlier you said that thinning can occur in the recipient area even if the donor area shows no signs of thinning. That is what I'm unsure about.

The point of the video is that there is always "some" level of androgen susceptibility in the donor area.

The recipient area affecting and changing hair follicles is already proven. Look at beard and body hair grafts changing ever so slightly as they adapt in the recipient area. They take on "some" characteristics of the recipient, but still retain most of their inherent genetic programming.

The donor may not show visible signs of thinning immediately. Or it may be very, very slight. Even under a microscope I am unsure if a surgeon could say precisely, this follicle is 100% healthy vs 98% healthy. How would we even know how to quantify such slight differences? I don't think any surgeon would tell you grafts are completely binary, either healthy or non-healthy. It is a spectrum, like everything else.

For most people this difference is not relevant though. Their androgen susceptibility in the recipient area may not exceed the threshold that the graft would need to surpass to be compromised once transplanted. However, this all depends, again, on a case-by-case basis for each individual patient, and what their particular susceptibility is.

This risk, however, in my opinion, is almost 0 with finasteride. You take an already quite resistant graft from the donor, and protect it even more with finasteride, and it should be good for life (just my opinion).
 

whatintheworld

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You can think of it like this.

The life of a hair follicle that is prone to miniaturization on the top of your head is much shorter than one in your donor area. Of course through drugs we can mitigate this and prolong the lifespan.

Let's say, for the sake of argument, your particular hair falls out at 40% of your normal DHT production. Meaning, let's say you have a natural DHT level of 100. That means that any DHT level 40 or up is the threshold that will make your hair fall out.

If your finasteride usage brings your DHT down by 70%, your DHT level is now 30, and your hair will no longer fall out, despite having a higher sensitivity to where it would fall out at 40.

Your DHT resistant graft still has some susceptibility in the donor area, and a different one in the recipient area. It is higher than your native hair, but it is not invincible.

The amount of androgen susceptibility in your donor is not enough to make the hair completely fall out on the top because of numerous factors. These include:

a) inherent boosted genetic resistance of the hair follicle
b) the donor area not having the calcification, fibrosis, restricted blood flow like your recipient area.

It is not only the follicle at work. The donor area itself is inherently more "fertile", so to speak, than your recipient area.
 

giegnosiganoe

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Thanks for the context. I am open to b) being true and it makes sense theoretically, but I can't say I've seen any great evidence for it. Hopefully that'll change in the near future.
 

whatintheworld

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Thanks for the context. I am open to b) being true and it makes sense theoretically, but I can't say I've seen any great evidence for it. Hopefully that'll change in the near future.
It makes sense that you wouldn't see a lot of great evidence for it. Why would any clinic want to push this information? It would only hurt their business.

Digging around on forums you can find such cases: https://www.baldtruthtaIk.com/threads/5760-Transplanted-hair-receding-years-after-hair transplant.

Then again, how frequently does this type of stuff happen? Probably not very frequently. But the subset of people posting on hair loss forums is very small anyway, considering the total number of people who get transplants. So you would be looking for a small subset of a very small subset, which is tough.
 

BetaBoy

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It makes sense that you wouldn't see a lot of great evidence for it. Why would any clinic want to push this information? It would only hurt their business.

Digging around on forums you can find such cases: https://www.baldtruthtaIk.com/threads/5760-Transplanted-hair-receding-years-after-hair transplant.

Then again, how frequently does this type of stuff happen? Probably not very frequently. But the subset of people posting on hair loss forums is very small anyway, considering the total number of people who get transplants. So you would be looking for a small subset of a very small subset, which is tough.
it's a little frustrating that no pictures are provided but from that thread the patient seems to suggest the donor was thinning.
 
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