27 days later, bald spots in donor areas, hair seems to be growing in transplanted area, do you have any advice? (photos)

Question

It is 27 days since FUE with 3300 grafts transplanted to the front and top. I have noticeable bald spots on the sides which look really shabby. My clinic is telling me that it is normal. I want to ask the experts in this forum anyway. 1. The transplanted hair appears to be growing. Is this normal? If it is, is there a chance that they will not fall out at all? Or will they surely fall soon? 2. I believe the donor area has been overharvested. Do you agree? Thank you.

Jon E. Mendelsohn, MD, FACS · Answer

It appears that the hair in the donor site has gone into shock loss. This sometimes can be a result of over harvesting of the donor site.
95% of my patients will start Laser Cap Treatments starting around day 10 post procedure. This treatment will speed up the healing and growth process while increasing blood flow to the existing follicles.

Jamil Asaria, MD · Answer

At 1 month post op shedding is typically occurring.  The full results of hair transplant are seen at 12-18 months post op so be patient

Jae Pak, MD · Answer

If you are having issues after your surgery, the best person to ask is your surgeon who knows the specifics of your surgery.
Shock loss is always a risk and it is difficult to assess this on the Internet or with photos.  You need a before and after comparison.  You need an examination.
Often, the transplanted hairs will shed 2 weeks following surgery. This is normal. Similarly, some patients don't shed their transplanted hairs.

Miguel Mascaro, MD · Answer

Thank you for your question and your pictures! Its a little early to say whether or not the donor area was overharvested or the punch size too large causing shock loss.  It really does take around 3-6 months to start to evaluate where you are headed.  The best thing to do is exactly what you are doing - keeping your hair clinic up to date on your progress such that they can monitor how your scalp is behaving and whether or not there needs to be anything done.  Best of luck.

David Deutsch, MD · Answer

It is too early in the process to say for sure but your donor area does appear to have been over/poorly harvested.It will take 3-6 months to see if those areas fill in.In the meantime you could consider applying Minoxidil to the donor zone twice daily in the event that this is shock loss.

Neil Verma, HBSc, MD, FCFP - Account Suspended · Answer

To minimize shock loss post op it is recommended to use finasteride and topical minoxidil. Both can help with early hair growth.

Cory Torgerson, MD, PhD, FRCSC - Account Suspended · Answer

You are still very early in the process. This all looks like it is not out of the normal expectations. Doing 3300 grafts at one time is alot and may reduce take rate and lead to areas of over-harvesting. But you just have to give it at least 6 months before you can make any decisions.

William Rassman, MD (retired) · Answer

Your Donor area appears over-harvested and this reflects that either the FUEs were taken too close to each other for the density of the area, the punch was too large or just that your donor area could not support 3300 FUE grafts.  It is possible that the donor area is undergoing shock loss, but only time will tell you this.  Read reference below

27 days later, bald spots in donor areas, hair seems to be growing in transplanted area, do you have any advice? (photos)

Answers (8)