How likely is "shock loss" after FUT?

[Siberian]

I had a 1,500 graft FUT done two days ago:

How likely am I to lose the existing hairs in the middle/top areas due to this "shock loss" thing? If there is a loss, do they start growing back in three months along with the transplanted hairs?

On a side note: has anyone noticed that minoxidil caused the transplanted hairs to appear before the usual 3-month waiting period?

 

[RaginDemon]

From what I learnt in this site, the hair fell from shock loss will most likely grow back, I am not sure how long it will take to grow back though.

I am not sure about the speeding up your growth with minoxidil question, maybe someone like saf can answer you.

post some pics after 8 months, we wanna see some great after photos.

 

[Guest]

That's just it. Shockloss is very unpredicatble. You did not have a large session and thanks for the pic. From your pic it looks like most of the grafts were situated ahead of your hairline so hopefully you won't have much shock. It's really the scalp's reaction to the trauma from the recipient incisions. The larger the incision, the more invasive it is and resulting trauma. The closer they are situated, the more trauma it can cause as well. The weaker the exisitng nautural hair is, the more volatile it is to shock.

Minoxidil post-op can help jump start the growth. but like anything else, it varies. If you do sustain some shockloss, yes most of it should grow back because it does not appear real diffused. Remember though, if some of the exisitng natural hair goes into shock, those follicles enter telogen and will rest for roughly three months before growing again.

Happy regrowth and hope to see more progress pics!

 

[RaginDemon]

That's just it. Shockloss is very unpredicatble. You did not have a large session and thanks for the pic. From your pic it looks like most of the grafts were situated ahead of your hairline so hopefully you won't have much shock. It's really the scalp's reaction to the trauma from the recipient incisions. The larger the incision, the more invasive it is and resulting trauma. The closer they are situated, the more trauma it can cause as well. The weaker the exisitng nautural hair is, the more volatile it is to shock.

Minoxidil post-op can help jump start the growth. but like anything else, it varies. If you do sustain some shockloss, yes most of it should grow back because it does not appear real diffused. Remember though, if some of the exisitng natural hair goes into shock, those follicles enter telogen and will rest for roughly three months before growing again.

Happy regrowth and hope to see more progress pics!

great info for me too, that's why I like this forum.

Thanks

 

[Siberian]

From what I learnt in this site, the hair fell from shock loss will most likely grow back, I am not sure how long it will take to grow back though.

I just hope it won't fall out at ALL, lol.

I was already on Propecia for like five years, then switched to Dutas and oral Spironolactone for about 16 months now... and even added Fincar back into the mix last month (I know it's redundant with the Dutas, but I don't entirely trust Dutas). Point being that the hair on top of my head is very much terminal and healthy, so I HOPE it's better able to resist the shock.

Plus, I've since been Googling around, and it seems having used finasteride MIGHT help reduce the chances of shock loss.

I understand that the baby hairs in temples are more likely to be lost though.

post some pics after 8 months, we wanna see some great after photos.

Oh I sure plan to! I haven't been active on this site for a LONG time, but it's the least I can do after all the help and info I've found here.

And for what it's worth, the drugs DID work for me (Propecia especially), halting any further loss and regrowing some over the years. It's just that my situtation is kinda unusual... as I needed/wanted much more hair NOW than the drugs could ever give.

 

[Guest]

Well I am happy to hear the meds are working well for you!

 

[HT55]

You probably could have decreased the chance for shock loss by shaving your head down for the surgery in the recipient area. Who did the surgery ?

 

[Guest]

You probably could have decreased the chance for shock loss by shaving your head down for the surgery in the recipient area. Who did the surgery ?

Absolutely agree hair transplant!!!

If you can deal with your head being shaved, do it!!!!

Shockloss is very real and very unpredictable, but using meds for at least 6 months prior seems to help out as well.\

Plan on having shockloss, then if it doesn't occur yippee!!!!!
Jason

 

[Siberian]

You probably could have decreased the chance for shock loss by shaving your head down for the surgery in the recipient area. Who did the surgery ?

Absolutely agree hair transplant!!!

If you can deal with your head being shaved, do it!!!!

Shockloss is very real and very unpredictable, but using meds for at least 6 months prior seems to help out as well.\

Plan on having shockloss, then if it doesn't occur yippee!!!!!
Jason

How will cutting one's hair reduce shock loss? I don't understand? I thought shock loss was caused by tissue trauma and/or cutting into healthy follicles during implantation?

I can't cut it though anyway, as I'm living as a girl

 

[HT55]

When you shave your head it makes it easier for the Dr to place the transplanted hairs between the native ones so shock loss is a lesser problem

 

[Guest]

Shaving the recipient area will in fact make it easier to create the recipient incisions so as to not transect the existing hair, but has nothing to do with reducing the trauma caused by the incisions. Shaving the recpient area does not decrese shockloss or the likelihood of it.

 

[HT55]

Shaving the recpient area does not decrese shockloss or the likelihood of it.

Maybe you better run that by Dr Shapiro and Dr Hasson (as well as Jotronic and Bspot) both of whom told me it decreases shock loss and neither would do my hair transplant without shaving .

 

[HT55]

1

 

[Siberian]

OK, now I'm sorta freaking out...

I had my stitches cut out yesterday (day 8). That meant I was finally able to gently shampoo the transplant area today (day 9) and let the shower hit it, instead of just pouring shampoo over it from a cup and rinsing with the same way. Most of the scabs finally came off today (I hasn't lost any scabbing until today).

And I found many more hairs (existing, not transplants) in the sink after brushing it today, on my hands when removing tangles, etc. It's not paranoia, it was kinda scary. I hadn't noticed any loss until today, so obviously either cutting the stitches out or shampooing the transplants dislodged the hairs. I don't mean hundreds and hundreds of hairs in the sink, but definately more than I've seen before.

But does that mean it's the beginning of shock loss? Or is it just more likely hairs accidentally snipped when removing the stitches and/or hairs that were already damaged during the transplant... and it just took a real shampooing to dislodge them? Meaning... hopefully now that they're gone, that's the only loss I'll see?

I feel really stupid that here I have a hair transplant... and now I'm worried about losing my hair

EDIT: Incidentally, my surgeon told me yesterday that shock loss would show up within a week or two, and he didn't see any signs of it, so I should relax now. Is that true?

 

[Guest]

Siberian,

Everything sounds right on track for you. Yes by the eighth day post-op, the recipient area is ready to be gently massaged with shampoo for the specific purpose of removing any lingering crusts.

You apparently can see the difference between the loss of existing natural hair, and the shedding of the grafts. The loss of existing hair, as small as it is, is no doubt some shockloss. Shockloss of existing hair in the recipient area usually sets in around 2-3 weeks post-op. Obviously there are some minor differences between patients, and I do believe you are seeing the intial effects of this.

Hair does not shock out all at the same time. They enter the telogen phase intermittently. Let us know how things go for you.

 

[Siberian]

Siberian,
Shockloss of existing hair in the recipient area usually sets in around 2-3 weeks post-op. Obviously there are some minor differences between patients, and I do believe you are seeing the intial effects of this.

Hair does not shock out all at the same time. They enter the telogen phase intermittently. Let us know how things go for you.

Thanks gillenator!

Ah OK, so IF it happens, it's going to be a gradual thinning over the next few months? I can deal with losing SOME hair, with it becoming a bit thinner... but my terror is that the entire top of my head will fall out. That would be awful. I just keep telling myself the top hair is very terminal and healthy, that my 1,500 grafts wasn't all that dense, and that the pharmacy of anti-androgens I'm taking (spironolactone, dutas, fincar, estrogen) will protect it somewhat?

I'm also debating minoxidil to speed things up, but I didn't much like reading that it too can cause shedding in the beginning. But I'm wondering if it's blood-flow effects might help heal the tissue damage and help prevent problems?

Thank god, the next two showers shed only a couple hairs... perfectly normal. Nothing like that first shower after the sutures came out and I shampooed for the first time since surgery and found hairs *everywhere*. THAT was scary.

So from what I've read though, I can't really relax until 4-5 months? That is, if any shockloss occurs, it's likely to be over by then?

 

[Guest]

HT55,

The primary cause of shockloss is the trauma to the area caused by the incisions. Incisions are incisions. Shaving the recipient area does not change the the fact that many recipient incisions will be made. Shaving the area does allow the surgeon to better follow the angulation of existing hair so as not to transect it when making incisions that close to them.

I know in my own recent case with Shapiro that he did shave my recipient area, but that had no impact on shockloss for me. He would have made the same number of incisions whether he shaved the area or not. It would have taken him much longer to perform my procedure without shaving the area first. The blades he used were custom sized and no doubt less invasive than the first procedure I had in 1996. No one used custom sized blades back then and the recipient sites were larger and more invasive back then.

Basically, the smaller blades allow for dense packing and obviously smaller blades are less invasive thereby reducing the level of trauma to the recipient area. For the most part, less trauma equates to lee shockloss. See what I mean?

I have read and obsereved procedures done with custom blades and there is no question that the tiny blades allow for placing the recipient icisions much closer to each other than what was traditionally done prior to that.

I have seen many pics of H&W dense packing, mostly examples that Jotronic put up. And many of you no doubt remember how many of the docs began to follow suit by employing the use of custom sized blades. It was the talk of the forums in 2002 and on. It seems like mega-sessions and FUE were the two hot topics in the forums back then. Many patients were posting their desire for the "mega-session" which dense packing with the blades provided.

I have also observed that many patients who had dense-packing with micro blades experienced less shockloss even though in many cases their respective graft counts were higher. I still see it today. Grafts are cut and dissected to match the mm size of the blades. Some communities refer to it as "ultra-refined" follicular unit grafting techniques.

So in conclusion, it is my opinion and continual clinical observations that it is the tiny "less invasive" lateral slit incisions that reduce the level of trauma and corresponding level of shockloss, not the factor that the recipient area was first shaved down. The incisions to accomodate the single hair grafts on my hairline did not even scab or crust. I could not even see the slits on some of them the very next day.

In my own situation. shaving my recient area made absolutely no difference in the level of shockloss. Dr. Shapiro did in fact inform me that he would not have been able to do as large of a session had I elected to not have my recipient area shaved down based on a time factor. And for the record, my area was not shaved, he simple cut down the length of the existing hair. The areas was not shaved nor buzzed. He used a sciccors.

My level of shockloss was minimal and I attribute that to the small blades. I virtually had very minor swelling post-op as well.

 

[Guest]

Also, I would love to hear the explanation or basis from any of the indivduals you mentioned to support why shaving the recipient area will reduce shockloss. Maybe there is something I am missing or something new for me to learn.

 

[Guest]

Siberian,

Don't worry. You won't lose everything to shock. Not all of the follicles enter telogen from the trauma. Some do, some don't. It's unpredicatble. Also remember, shockloss is intermittent. They don't all enter telogen at once.

The other thing is those follicles that do shock have it occur in a rough timeframe of say 2-4 weeks post-op. Then it subsides. Yes our hair follicles continue their normal cycling pattern, and that fact supports the basis of why it takes 12-18 months post-op to attain the matured visual result of the procedure. Any of the follicles that were shocked out from the surgery have cycled back to anagen (growth) by then. The ones that do shock will rest for 3-4 months and begin growing hair again. That's when the fun begins. The best is yet to come Siberian!

Keep us in the loop!

 

[HT55]

OK, now I'm sorta freaking out...


EDIT: Incidentally, my surgeon told me yesterday that shock loss would show up within a week or two, and he didn't see any signs of it, so I should relax now. Is that true?

My shockloss was from weeks 4-6 post op