Transplanted Hair Permanent Or Not ?

[jumpingjackgazz]

Hi all,

I'd like to share my experience and see if some of you guys went through the same process and eventually found some solution or could give advice…

Ok, So I got a hair transplant @ASMED back in Feb 2013, 3000 grafts on the first third of the scalp.
Got very happy with this transplant, got a huge growth rate on the transplanted grafts, and very happy with the cosmetic improvement, until a few month ago...
So it's been 7 years I had this transplant, and back in October 2018 I start to notice thinning of my hairs. And today I can see that almost the entire transplanted hair are thinning and falling…. The bad trip is back….

On a French Hair Lost forum, some guys report the same thinning after 5 to 10 years post op.
One guy who had 3 FUE claims the transplanted hairs last 4 to 10 years...

On this forum, I saw @max310 in the same case and a couple of other guys...
I know ppl can be reluctant to report such experience, but I think it's interesting if the "old" transplanted guys could report their evolution on this forum ! So please, tell us.

ciao

 

[TomRiddle]

It's either like trying to grow something on a radioactive soil and that means that everything you plant there, will eventually fall, sooner or later depending on who knows how many factors, or it's just that the transplanted hairs were predisposed to male pattern baldness also, but later in life, maybe the aging process has something separate to say besides the male pattern baldness who's onset was earlier.

Nothing in between, nobody knows the answer and the research is poor because we need maybe 10-20 more years of experience from people who had transplants 10-20 years ago. I also saw a lot of report of people who lost their transplanted hair after 5-10-15 years but i also heard of people who didn't. As i said, we need more research and especially, more time and experiences.

 

[jumpingjackgazz]

It's either like trying to grow something on a radioactive soil and that means that everything you plant there, will eventually fall, sooner or later depending on who knows how many factors, or it's just that the transplanted hairs were predisposed to male pattern baldness also, but later in life, maybe the aging process has something separate to say besides the male pattern baldness who's onset was earlier.

Nothing in between, nobody knows the answer and the research is poor because we need maybe 10-20 more years of experience from people who had transplants 10-20 years ago. I also saw a lot of report of people who lost their transplanted hair after 5-10-15 years but i also heard of people who didn't. As i said, we need more research and especially, more time and experiences.

But the underlying message for the future transplanted guys is : Be aware that this can be NOT permanent !
So take this into account in your decisions...

 

[whatintheworld]

This topic is interesting, but can I ask some questions:

Are you sure the transplanted hair is falling out and not your native hair?

Are you sure the surgeon extracted only from the Norwood 7 region and not higher? Some surgeries I see go way to high up around the crowd where further thinning can definitely take place.

Are you on finasteride?

 

[jumpingjackgazz]

@whatintheworld and @pegasus2 :
I'm sure it's not my natives cause thinning also happens on areas were I had no hair anymore before surgery.
The extracted area was carefully delimited. My crown is not touched by hair loss.
There is no N7 in my familly and the hair loss pattern is mostly the 1st third of the scalp up to N6 or 6A max.
I'm under fina for decades now, Duta for a couple of years and oral minoxidil a couple of month.
Koray did the operation, I think his results speaks for him. I'm sure operation was done according to best standard quality.

I'm convinced today that most of the time it's NOT permanent for multiple reasons : the one you listed above and certainly more unknown today.
I can tell you that more and more ppl can attest about that now that we have 10 to 20 years of experience behind us.
I'm not saying it's always the case, but it's a strong risk.

I'd be interesting if 'old' transplanted ppl with at least 7 years from their operation could report their experience here !

 

[whatintheworld]

I understand, I'm sorry to hear this is happening.

Would you be able to provide some pictures so we can see the extent of the loss? In densly packed transplants, from my understanding, sometimes lack of blood flow may cause graft failures.

 

[jumpingjackgazz]

yep sure, 1st is pre op 7 years ago, a couple of pictures from the operation, then the result a year after, and finally today...

To enhance my blood flow, oral minoxidil should help, I'm also microneedling.
I'm also exploring the scalp tension theory and have ordered a growband which seems to improve blood flow. There is a interesting study from 1990 showing good results (you can easly google it)

I also found in the FUE litterature :
"“While the follicular units in the optimal donor area of the occipital and parietal scalp are ″relatively″ protected from androgenetic hair loss, even those follicular units may be somewhat affected with time.”"
ref : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2956960/

Another interesting paper here :
https://perfecthairhealth.com/hair-transplants-debunk-scalp-tension-hair-loss/
extract : "In my conversations with other Androgenetic Alopecia researchers, a few have stated – contrary to popular belief – that transplanted hairs do thin. There’s even an emerging theory that transplanted hairs simply restart their “balding clock” post-transplantation – meaning that in 5, 15, or 25 years, we can expect more FUE transplants to start thinning."

 

[whatintheworld]

Hmm I see, it is thinned out a bit, I'm surprised that even finasteride is not strong enough to stop the supposedly resistant follicles against dht.

You rarely see patients with 5-10 year follow up stories how they are doing, so perhaps this is happening more frequently than we think.

The operation looks clean I agree, have you contacted your surgeon with your concerns?

 

[Wolf Pack]

Anyone who says it is always permanent is lying. It can be for some patients but not for all! If a transplant thins later in life it's one of these factors:

1) Taken from a DHT sensitive zone, either outside the safe zone or even within the safe zone. Advanced baldites usually thin in their donor so their transplanted hair won't look the same later. The guys who are displaying a horseshoe pattern in their 20s even with their top hair there, they will struggle later.
2) Another pathology affecting the hair. Could be age related thinning, thyroid or anaemia for example.

Just another reason to take Finasteride, it protects all your hair but again it may not be bulletproof for some people. My transplant is a few years old now and looks the same as does the rest of my hair including my donor.

 

[whatintheworld]

Reading online there are many anecdotal cases of this happening, unfortunately the hair transplant industry does not provide enough clarity into this risk.

I think, ultimately, even donor hair is not completely immune to dht, but its original placement does play a factor in how it is able to stay alive. The analogy would be that for many of us, the front of our heads are not "fertile soil" for hair to grow, even if taken from the more dht-resistant zones. It's like trying to grow flowers in the desert.

OP in your case, and Im not a doctor by any means, I would think that dense packing may have played a role in maybe not optimizing the blood flow to the new grafts. Because blood flow is already restricted in these dht-sensitive areas for us, it may negatively affect graft survival.

Are you noticing that your existing transplanted hairs are miniaturizing, or just falling out?

 

[Wolf Pack]

Reading online there are many anecdotal cases of this happening, unfortunately the hair transplant industry does not provide enough clarity into this risk.

I think, ultimately, even donor hair is not completely immune to dht, but its original placement does play a factor in how it is able to stay alive. The analogy would be that for many of us, the front of our heads are not "fertile soil" for hair to grow, even if taken from the more dht-resistant zones. It's like trying to grow flowers in the desert.

OP in your case, and Im not a doctor by any means, I would think that dense packing may have played a role in maybe not optimizing the blood flow to the new grafts. Because blood flow is already restricted in these dht-sensitive areas for us, it may negatively affect graft survival.

Are you noticing that your existing transplanted hairs are miniaturizing, or just falling out?

Blood flow and fibrosis are acute to subacute factors. Certainly not 7 years later. About the front of the head being more sensitive, that's a tricky one. They say no it doesn't affect plugs, but who knows? Maybe DHT receptors are more sensitive in the frontal area, full stop, even with the plugs. I doubt this because a hair that is destined to die can be moved to any part of the body and it still won't survive even if you stick it on your a$$. I'd stay on finasteride forever just in case.

 

[Jonny Craig]

Is this only for FUE or FUT too?