Concerned About My Hair Falling Out From a Hair Transplant Procedure
Written by Brandon Ross, MD on January 9, 2009
I have thinning hair on top of my head, not so bad, but bad enough to make me consider a hair transplant procedure. If I were to get a hair transplant on top of my head, is it true that the hair (existing hair) surrounding the transplanted hair will fall out? If so, does it grow back and how long does it take for it to regrow?
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The situation you are referring to is called “shock loss” of hair. That is a side effect that can occur after a hair transplant, but by no means does it always occur. When grafting into an area that already has hair, some of the existing hair can shed shortly after the procedure (usually for up to about a month). The healing process after the surgery causes some degree of inflammation to the scalp. This inflammatory process, in addition to actual damage directly to the existing follicles (known as transection), can result in the loss of some of the existing hair in the recipient area.
Whether or not someone will experience shock loss after their surgery can be difficult to predict. In general, the more existing hair in the area to be grafted, the higher the likelihood of experiencing shock loss. Also, the higher the concentration of miniaturized hairs in the recipient area, the higher the likelihood of shock loss will be. Miniaturized hairs have miniaturized “roots,” and therefore they are weaker and more prone to shedding.
Patients who experience shock loss often feel disappointed, since the goal of the surgery was to add hair rather than subtract. However, usually the amount of hair that sheds is not enough to make a visible difference when looking in the mirror. The only reason that most patients know they are shedding is because of an increase in the number of hairs on their pillow case, shower, etc. The amount of shock loss hair is usually no more than 10% of the original hair in the area grafted.
Hair that sheds often grows back at some point. Unfortunately, the time it takes to regrow can be up to 2 or more years. This delay can be attributed to the fact that most of the shed hairs were likely miniaturized to begin with, and therefore inherently have a much longer dormant phase of their lifecycle. Some people have argued that the shocked hair can be recovered more quickly with the concurrent usage of Propecia or a minoxidil product. This idea makes sense scientifically, but I have yet to see any research studies designed to validate the theory.
Prior to having a hair transplant procedure, it is always advisable to ask your doctor his/her opinion about your shock loss potential. The physician should be able to give you a solid educated guess. However you must remember that every individual is unique. Therefore, it is still possible for someone with many miniaturized hairs to endure very little postoperative shedding and vice versa.
Brandon Ross, MD
Member, International Alliance of Hair Restoration Surgeons
Member, American Hair Loss Association
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