# Hair Transplants > Hair Transplant: Start Your Own Topic >  Transplanted hair receding years after HT.

## slo100

Hi everybody,
                  My hair started to recede noticeably at the age of 17, GP's and Hair transplant surgeons diagnosed it as Male pattern baldness and I see no reason to disagree with them. I think was about a Norwood 4 to 5 when I received my first Hair transplant at the age of 23 in the front/top of the scalp, my regrowth was slow only starting to really show progress at about 6 - 8 months and continued to improve till about the 12 month mark. I was quite happy with the result, the hair sprouted and thickened quite considerably. 

approximately 2 years later I had a second hair transplant. By that stage i had a suspicion my previous HT result was in a state of decline but I wasn't sure as I hadn't really documented my progress well enough and started to lose perspective and my surgeon didn't make any remarks about it. Anyway we proceeded with the second procedure to fill in the crown and thicken up the front area from my pervious HT. Anyway the second hair transplant yielded poor regrowth at the crown but some regrowth at the front of the head but again about a year later started to show signs of thinning.

It has now been approximately 4 and a half years after my first session and 2 and a half years after my second session and my HT surgeon and myself are convinced that my transplanted hair is gradually falling out. We did a biopsy to test for androgen receptors in the donor region and it came back negative, the hair at the side of my head (donor region) is strong and thick and shows no signs of thinnig, diffused or otherwise. I am fit, healthy, don't smoke etc. and I am hoping for some insight into why my hair transplants are showing positive growth results for a year or so then falling out. 

If any body can give me any guidance I would be so appreciative as I don't know what to do at this point, I am too scared to undertake more H.T (even though my surgeon is offering to do it for free until we reach the desired result) for fear of it just falling out once more. Thanks in advance.

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## gillenator

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? :Wink:

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## gillenator

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.

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## VictimOfDHT

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.

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## Follicle Death Row

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.

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## VictimOfDHT

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.

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## slo100

> 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.

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## CVAZBAR

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.

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## alan7777

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.

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## southeast_eu

> 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....

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## itzbryan

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.

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## VictimOfDHT

> 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.

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## itzbryan

> 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.
> ...


 
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?

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## gillenator

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!

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## Mr. 4000

> 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.


 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

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## UK_

The follicles are not lost through DHT lol - they are rejected by the body at some time or the other - shit happens.

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## VictimOfDHT

Thanks, Mr 4000 and gillenator.

Gillenator, yeah, the loss -of the transplanted hair- has absolutely NOTHING to do with DHT. As mentioned, the new hairs grow well and they stay for sometime -ranging from a year, two, or even a few years- and then out of nowhere some start falling out within a very short period (a couple of months) and they don't seem to grow back. This is really baffling and maddening. I'm surprised no doctor seems to know why this is happening in some HT patients, or maybe they know but they don't want to talk about it so they won't LOSE potential patients. 

So yeah, those hairs that end up falling out look as thick as any healthy hair. No thinning at the tip whatsoever. It's like now you see it, now you don't. 

My doctor told me I could do a biopsy but I don't see what good that is, but now I think I'm going to do one anyway. If those hairs are dormant  how can they be stimulated into production again ? There don't seem to be anything that can do that.

This is really driving me crazy and causing me a very deep depression and extreme sadness it's actually wreaking havoc on my nervous system.


Mr 4000, unfortunately this is the world we live in- no conscience whatsoever. All most HT doctors care about is lining their fat pockets with more and more money -that I hope they take to hell with them. Had 4 HTs by 4 different doctors and NOT one mentioned anything about the possibility of losing the transplanted hairs except the last one and that's on the day of the surgery and then after it turned out I was one of those cursed people. 
I'm just praying now that I don't end up losing all my transplanted hair because that would just kill me. But based on what's been happening to my transplanted hair it would be a miracle if I keep what's left although the doctor did say that usually the farther the transplanted hair is from the hairline, the better chance it will be permanent -in our case.

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## Mr. 4000

> Thanks, Mr 4000 and gillenator.
> 
> Gillenator, yeah, the loss -of the transplanted hair- has absolutely NOTHING to do with DHT. As mentioned, the new hairs grow well and they stay for sometime -ranging from a year, two, or even a few years- and then out of nowhere some start falling out within a very short period (a couple of months) and they don't seem to grow back. This is really baffling and maddening. I'm surprised no doctor seems to know why this is happening in some HT patients, or maybe they know but they don't want to talk about it so they won't LOSE potential patients. 
> 
> So yeah, those hairs that end up falling out look as thick as any healthy hair. No thinning at the tip whatsoever. It's like now you see it, now you don't. 
> 
> My doctor told me I could do a biopsy but I don't see what good that is, but now I think I'm going to do one anyway. If those hairs are dormant  how can they be stimulated into production again ? There don't seem to be anything that can do that.
> 
> This is really driving me crazy and causing me a very deep depression and extreme sadness it's actually wreaking havoc on my nervous system.
> ...


 this is not meant to sound rude, so please don't take it that way

You have to do your best to look past the hair on your head, there is so much more to life than that. Your poor result is going to harm your health if you let it. You have to try and be as positive as possible and control what you can. 

This is something that is beyond your control. This is true for myself as well. My doctor just wasn't any good, certainly not as he claimed to be. 

My doctor (Dr.ALexander phx,arz) informs people after he screws up, his famous line that he mentioned to at least 3 of his recent patients that I have spoke with "some guys don't grow" This is what he says after he screws up a persons head, NOT before. 

Yes you lost money and so did I, and doctors were not on your side, they were on the dollar's side. 

Find a way to live with a look that is cosmetically acceptable for your situation and forget trying to chase. It will destroy you if you let it.

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## VictimOfDHT

Thanks Mr 4000. I wish it were that easy. If it were that simple I wouldn't have gone through 4 1/2 HTs and more than $20,000 in expenses. But it isn't.

My last doctor is a very famous doctor and people come from all over N. America and the world to get HTs by him, it's just that I have shitty luck as I do with everything usually. 

But yeah, for some, it's impossible to look past this curse. My life's already destroyed anyway. Only now it's more so than ever before.

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## Mr. 4000

> Thanks Mr 4000. I wish it were that easy. If it were that simple I wouldn't have gone through 4 1/2 HTs and more than $20,000 in expenses. But it isn't.
> 
> My last doctor is a very famous doctor and people come from all over N. America and the world to get HTs by him, it's just that I have shitty luck as I do with everything usually. 
> 
> But yeah, for some, it's impossible to look past this curse. My life's already destroyed anyway. Only now it's more so than ever before.


 You have a right to hate the industry
you have a right to be pissed at your doc and previous doctors
you have a right to be pissed about the financial loss
you have the right to keep chasing 

I don't have an answer, I just hope that in the end you find a way to live life again and do the things that make you happy. Stop worry about what you think other people are thinking. Stop worrying about looks if you can. 

can you mention who your doc is?

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## gillenator

Victim,

Not sure if you have considered laser therapy but please be careful of using laser combs to stimulate your hair follicles.  Many out there will try and sell you on that approach.  I am still a skeptic for good reason, the results are hit and miss and far more miss than anything.  Possibly you are already researching the area.

IMHO, I belive that your transplanted follicles are still there.  I personally would consider temporary use of steroids or any any topical but as you said, very few understand why hair follicles remain in the dormant phase, and why a cure for alopecia areata has not been achieved.  Use of an oral systemic medication or even a topical cream has been tried more on females and you may find doctors (derms) who treat this condition under the female hairloss section of this community.

My suggestion for scalp biopsy in the recipient area was more to determine that your transplated follicles and even some of you natural hair follicles still exist, and whether or not any minituriaztion is evident.  If by chance the follicles no longer exist or are extensively miniturized, you will at least know whether there is something there to stimulate into the growth phase right?

Has anyone suggested PRP to you?  As a layperson, I encourage you to consider PRP therapy to potentially stimulate your follicles.  Contact Drs. Joe Greco, Dr. Jerry Cooley, and any other physicians doing PRP on a larger scale.  They may have patients in your situation or patients dealing with alopecia areata.  I am hoping you can find someone who would consider doing a series of injections of your own plasma!  It's far less expensive too.  They also may have some advice on the biopsies before PRP.

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## slo100

Okay everyone,
                     Here's my long overdue update. I got my surgeon to perform a biopsy of both the donor and recipient regions of the scalp and what they found was that the donor hair was perfectly viable for transplantation, no signs of androgen receptors, no miniaturization.. however the transplanted hair was miniaturized exhibiting classic signs of androgenetic alopecia. So there you go, I am living proof that non DHT susceptible donor hair can transform into DHT susceptible hair and miniaturize/fall out once relocated to the affected areas of the scalp. While this news is quite sobering at least I know that the reason for the hair falling out is due to DHT and it's not somehow being rejected, so at least I can go down the path of DHT blockers to maintain what I have left (and hopefully resurrect some dormant follicles in the process). Thanks all for your input and advice and I hope that cases like mine garner more awareness in the HT community to warn others that not all transplanted hair is gonna last forever without medication.

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## gillenator

Thanks for the update slo, I will add your comments to my research.

I still wonder if PRP might benefit your recipient area and/or bring any dormant follicles to the growth phase.

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## larsjon

Bump!

Im in almost same situation. 

Slo, didnt u take anti DHT medicine before? Fin or dut? So what do u wanna do different now with ur new knovledge?

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## CVAZBAR

> Thanks Mr 4000. I wish it were that easy. If it were that simple I wouldn't have gone through 4 1/2 HTs and more than $20,000 in expenses. But it isn't.
> 
> My last doctor is a very famous doctor and people come from all over N. America and the world to get HTs by him, it's just that I have shitty luck as I do with everything usually. 
> 
> But yeah, for some, it's impossible to look past this curse. My life's already destroyed anyway. Only now it's more so than ever before.


 Did you get the results of your biopsy? I remember reading that you were going to do it to find more about your problem. Unless I'm confusing you for someone else?

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## VictimOfDHT

Cvazbar, yeah I did get the results a week ago or so -I mentioned that in one of my replies here. The doctor said there was "nothing abnormal", whatever that means. Basically, the biopsy didn't show anything. But he also said biopsies aren't 100% reliable. 
I'd like to know, for those who have had biopsies done, did they take samples from the recipient area alone or did they take some from the donor area? What exactly did your doctors tell you about your results (what did the biopsy show)?

In my case, I don't think miniaturization of the transplanted is the problem. I haven't seen much evidence -if any- of that at all except for maybe two hairs and I can't even be sure they're transplanted. My loss happens all of  sudden at random. I don't know if a biopsy can show those hairs are being rejected or something.

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## gillenator

I have been told that most doctors do not have the expertise to know how to read the test results and exactly what potential deficiencies to look for in hair follicles that are not in a productive state.

Many patients that I have conversed with that had biopsies state that their docs have reviewed their results and do not find anything abnormal.  Same response that Victim got.

At least you know that they are there below the surface.  Could the doc at least distinguish between which hair follicles were transplated and which ones were not?  Obviously the exisitng ones would have appareared much smaller as the transplanted ones are too new to have miniturized that much?

Did a skilled dermatologist who knows what to look for examine your results by chance?

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## Follicle Death Row

Well that bloody sucks if the hairs are in fact susceptible to DHT and donor dominance isn't true. Man this industry sure is sketchy. I wish you both the best.

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## gillenator

These situations are still the exception to the rule as far as I know or I think there would be many more folks posting their stories. What do you think?

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## VictimOfDHT

> I have been told that most doctors do not have the expertise to know how to read the test results and exactly what potential deficiencies to look for in hair follicles that are not in a productive state.
> 
> Many patients that I have conversed with that had biopsies state that their docs have reviewed their results and do not find anything abnormal.  Same response that Victim got.
> 
> At least you know that they are there below the surface.  Could the doc at least distinguish between which hair follicles were transplated and which ones were not?  Obviously the exisitng ones would have appareared much smaller as the transplanted ones are too new to have miniturized that much?
> 
> Did a skilled dermatologist who knows what to look for examine your results by chance?


 Sorry I didn't see your reply until now.

That's what I feel- most doctors don't know what to look for in these biopsy results and don't even care to know. I'm sure there IS an explanation to what's happening to the hair in my case and similar cases but no one cares enough to spend a little bit of time to find out. 
All I got from the doctor is that the test didn't show anything abnormal or something like that. No details or anything.
I've never seen a dermatologist. I need to be referred to one by a GP and I just don't want to go through all that and I'm also embarrassed to talk about my problem to the doctor or the dermatologist and again, I don't even expect I'll be able to find a dermatologist who will bother to find out what the problem is.

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## gillenator

You know I think it's sort of a three-fold dilemma.  First, there's just not enough research done especially in genetic dispostions and even gene therapy.  It's so complex that doctors in general just don't have the clinical information to really understand MPB and how to control or manipulate the genes to either regress hairloss or stop it altogethor.

Second, there has not been enough demand from patients to substantiate the research and even the area of specialization to support a licensed physician's liveliehood and practice.  In other words, there's just no money in it until we can change the insurance industry to include treating hairloss in one's health insurance policy both medicinally and surgically.

That in effect would open up this field however that leads to the third point.  There's far more money in HT surgery than there is in hairloss medications.

Present day however there is far far more reserach being done than there was in the past 50 years and we keep reading its closer and closer...

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## sea of possibilities

hello,
any news with that?

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## gillenator

I have been waiting for 30 years!

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## Killer

Hello there, i had a hair transplantation 3 years ago with good results but after a year started falling slowly. The last 4-5 months i had sudden and rapid loss with itching and a strange sensation of ants crawling at the places that i was thinning.  I also started propecia 1.5 month ago with the hair loss and itching still going on, crawling is gone but i have oily scalp now.

I dont know what to do, are there any updates with your cases guys?

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## VictimOfDHT

Hey Killer, I hardly come here any more but I just saw your post. 

Well, I've definitely lost even more hair in the transplanted area but I keep telling myself maybe it's the original/native hair that's I'm losing- I had a lot of native hair when I first started on this HT journey. Not being sure which hair I'm losing is driving me crazy. By now, I'm sure just about 100% of the hair I have in front is transplanted yet I still do see miniaturizing hairs (either falling out or still in the scalp). Sometimes I think some of the transplanted hairs are definitely being affected by DHT but not all. Sometimes I feel transplants from certain HT sessions didn't survive while transplants from other sessions are still surviving. 
But I just know this, if I pull my hair back (at the hair line) I certainly don't look like someone who's had 6 HTs. I don't see a solid hair line but for some reason the left side looks fuller than the rest of the hair line. 

This is so stressful it's no less than mental torture.

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## Ahab

> 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.
> ...


 I had transplants when I was 29 years old.  A dozen years later, the transplants had noticeably thinned.

By less than twenty years later, the thinning of the recipient sites had continued but also the donor area started to thin such that my barber could no longer cut my hair as short as I would have liked without areas in the back and sides becoming see-through.

And then fifteen years later, my hair started to thin dramatically all over from senescent alopecia.

All in all, I got about two really good years from my transplants, after which things started to slowly go bad again.

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## Jolly

I too had a Transplant around 4 years Back , the 1st year was stellar result , good density and Nice coverage to my Norwood 4 , then since that there has been a steady fallout of the Transplanted hair , why I am so sure that it is Transplanted hair and Not Native hair ? ?  well I had a slick bald area Hairline to mid scalp was Barren , so there were only transplanted hair  in that area and those have been fallen out since the last 3 years to the point that today the density is lost by 50 % and my scalp is visible .
My doctor is not giving me any satisfactory explanation , I stumbled on this Post today and was shocked to see Many guys like me , struggling to find answer to this problem .
also on another famous site hair restore , many guys have reported but there also No One has any clue .
If any member can chime in please let us know the reason for such a phenomenon , as I am Lost for Answers . BTW I have never taken Propecia , yet the grafts ( FUE) grew in beautiful and dense for the first year Post Operation . 
Any senior members like gillenator , spex , tillman pls do respond your take on this .

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