Category: Hair Transplantation

My grandfather’s has what you call a Class 7 pattern and the hair around the back and sides is very thin. I asked him if his hair was always that thin and he replied that when he was my age, his rim hair was much thicker. He became bald in his later 20s. Is the donor hair really permanent?

The donor hair around the sides and the back of the head in some men is not permanent.

I have seen men like your grandfather in my office and their donor density is very low, but as they are usually coming for a hair transplant assessment, I, of course, turn them down. There is some miniaturization in the donor hair in these men and I suspect that the miniaturization process that impacted their original frontal hair extends to the donor region. These men are clearly not surgical candidates.

On very rare occasions (about once every few years) I see someone who lost hair bulk in the transplanted hair. These men have a drop in donor density as well, so I must assume that these men are losing this sacred donor hair. This introduces two more risk for patients who have transplants: (a) the loss of some of the transplants over time as the donor hair dies off, or (b) the hair becomes finer with age (a common finding). The few who I have seen that reported transplanted hair loss to me, fortunately did not lose all of their transplanted hair, but it is a risk. I have only been doing hair transplants for 20 years, a relatively short period of time in the life of my patients.

Amongst those men I have transplanted above the age of 70, they never showed miniaturization in the donor area and they behaved like the young men I transplanted. One of my most unusual patients who came to my office frequently during our Open House events, was a Class 7 patient who received 9900 grafts over 9 years and he maintained his donor density through the entire process without miniaturization. He was 74 years old.

Doctor, I’m having the worst time of my life and I’m hoping you’d take the time to answer my question.

I’ve had 5 HTs over the past decade all in the frontal area totalling around 4000 grafts including one at NHI back in 2000. The problem is I keep losing more hair in the area and it keeps getting thinner. My last 2 HTs were done by a very reputable doctor here but when I went to see him last time to get his opinion he said I am apparently one of the rare cases where transplanted hairs end up dying over time. This was a complete shock to me. From what I see, there seems to be very gradual loss -in an area that I think is totally made of transplanted hairs- over time but then at one certain time I lose a whole bunch of hair in a period of 1-2months. I am told that there’s no point of getting more HTs because they’ll end up dying. I am devastated and don’t know what to do. Am I really out of luck ?? Is there anything left for me to do?? I’ve been using Fin and minox for a long time.

I’m going crazy looking for an answer. I’m thinking about FUEs to fill in the thin areas but don’t know if I should do it. I hope that you have the time to reply to this as this doesn’t seem to be a common problem here. I appreciate it.

As a former patient, I feel compelled to answer your question. There are rare cases where transplanted hair is lost over time. On the few times I have seen it, I really do not have an explanation.

It is possible that you could have a telogen effluvium or a more diffuse type of hair. Your donor hair should be having the same process going on so the presence of miniaturization in the donor area may point to a clue for a diffuse type of hair loss like diffuse unpatterned alopecia (DUPA)… but without examining you, I can not tell you much.

There may be other options, as there may be other causes (metabolic abnormalities, dietary deficiencies, the existence of hormonal problems, etc), and these are things that I would want to know and would ask that if you visited me in Los Angeles.

hello doctors,

im 21 yo this year and had my hair transplant 3 days ago. when i was sleeping last night, i accidentally scratched the area where it was transplanted and soon it started to bleed, i went to check in the mirror, and noticed significant blood and a single hair was dislodged on my forehead. i just want to know if there were more then just one hair graft dislodged? as i have checked and seems that theres only 1 hair graft that is missing. will it affect other hair graft too?

I remember a patient who had 3 transplants and seemed to love to scratch his head while he was sleeping. He lost some grafts (as did you). I told him to wear a boxing glove, which seemed to stop the late night scratching as he fought with himself at night.