Hair Transplant- Shock Loss?

Question

Does placing donor hair close to or around other hairs (that will potentially fall out) increase the risk that both the native hair and donor hair will both be susceptible to permanent shock loss such as in the yellow triangle of the picture? I was wondering if thickening that area was possible. Lastly,I have developed terrible dandruff in the last 12 months after 8 years of using minoxidil. Is minoxidil with glycerin just as effective? I have read it does not allow for as much penetration.

Jon E. Mendelsohn, MD, FACS · Answer

Thank you for your picture and question.Unfortunately with the way you have your hair combed, it is impossible for me to tell how close each follicles are to each other.I would be more than happy to take a look at your follicles under magnification in my Cincinnati office so I can determine if a hair transplant could be successfully performed without damaging existing hairs etc...

Anil R. Shah, MD · Answer

Surgeons must be careful when placing hairs closer to each other. Shock loss is due to the loss of normal hair whether it is from donor site or recipient area.  It can occur with both FUE and strip procedures.  Usually if it occurs it will take place in the recipient area.  
Shock loss from hair transplant can occur due to the following:
Anesthesia-  excessively long procedures taking longer than 12 hours can induce shock loss more likely.  the repeated use of lidocaine, marcaine, and perhaps most importantly epinephrine can affect nourishment of the hairTraumatic harvest-  In strip surgery, traumatic harvest can induce shock loss.  Recipient area trauma- during the incision making process the hairs are either crushed or cut and damaged during the process. 
Ways to minimize shock loss are as follows:
Improve recipient bed and donor area environment.  Make your recipient environment improved by addition of growth factors and/or PRP to help reduce incidence of shock loss to native hairs.Use of Rogaine and Propecia- can help miniaturized hair become more stable and less likely to fall out during procedure9xRobotArtas-  The latest version of the robot can make recipient sites and can determine angle of existing hair and help ensure that the angle will not damage existing hair.  Especially helpful in patients where you are transplanting hair to create densityMinimize anesthesia time and procedure time- We limit number of grafts to a safe number per session.  Extended anesthesia periods and harvest times can cause patients to have a higher chance of shock loss.  The 9x Robot harvests between 1000-1500 grafts per hour making it superior to previous additions and traditional FUE approaches.Best, 
Anil Shah

Jae Pak, MD · Answer

Shock hair loss after a hair transplant is always a risk so you need to see a doctor for an exam to understand it better for your particular case.  The doctor will take into account your age, hair loss pattern, medication use, miniaturization, and your goals.  Your risk is not based on a simple photo.

Andrew Kaufman, MD · Answer

It is possible that hairs that are "predisposed" to go through androgenetic alopecia may be accelerated into losing those hair from the trauma of placing grafts very close to those hairs. The transplanted hairs will ultimately return or stay, but the hairs native to that area are susceptible to the signals of androgenetic alopecia and may not return. Best option is to speak with a doctor who does hair restoration surgery about whether you are a good candidate for hair restoration surgery. Good luck.

Jeff Donovan, MD, PhD · Answer

Transplanting between existing hairs and at moderate hair densities is one of the most challenging aspects of hair restoration. Small blades, properly cut grafts, and good surgical technique gives the best chance of success. This takes skill. The answer to your question is -  yes. Hair restoration in the triangle increases the  chance of shock loss to existing hair. Shock loss to the grafts themselves is not the right term - it's more that the grafts don't grow as well (the yield is slightly less) if the area is too tight. Is your density too high right now for a hair transplant ? Possibly.  although the wet look makes it challenging to assess fully. Does your current density increase your risk for shock loss and accelerating balding? Absolutely.  You might reduce this risk with use of finasteride and minoxidil. Before considering any such surgical measure, it's important to get the scalp dermatitis / dandruff figured out. That irritation too can accelerate shock loss.

Michael Meshkin, MD - Account Suspended · Answer

One of the risks of having hair transplant is shock loss.  Placing the transplanted hair too,close to the native hair can cause shock loss. If you are concerned you should do an in person consultation to find out more and have your doctor address your concerns.

William Rassman, MD (retired) · Answer

Shock loss comes from an acceleration of your normal hair loss
process. It is usually prevented by the drug finasteride (Propecia). If the shedding is in the transplanted area, the new grafts, when they
grow, may off set it. If the shedding is from all over the front and top of
the head it sounds like shock loss which usually accelerates the hair loss that
you might have seen two years after a hair transplant had you not been on the
drug. If you are developing a more advanced balding pattern with acceleration
of your hair loss, which a Bulk Measurements with the HAIRCHECK instrument can
provide, it will show over a one year time frame, what exactly is your hair
loss (in numbers) and then you and your doctor need to develop a MASTER PLAN
for what may happen to you.

Hair Transplant- Shock Loss?

Answers (7)

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