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Physician Answered Q & As

Is It Normal To Experience Hair Loss After a Hair Transplant?

I recently had a hair transplant with a very reputable doctor. I am about 3 months into the process post op and have noticed some hair loss in the frontal area. Surgery was easy, recovery excellent, but loss of frontal area is noticeable, in spite of continued use of both Propecia and 5% Minoxidil. The doctor did seem surprised, but said both grafts and original permanent hair should grow back. Should I be concerned? And, what else can I do? – Michael

Shedding of some of the patient’s existing hair in and around the area of a hair transplant is a relatively common occurrence and should not be a cause of concern. The mechanism appears to be a normal physiologic response of the body to the stress of surgery – i.e., site creation, adrenaline in the anesthetic etc. Some doctors claim that their techniques are so impeccable that their patients do not experience shedding. This is clearly a false claim. Although using very small recipient sites and limiting the use of epinephrine may mitigate shedding somewhat, shedding is a normal part of the hair transplant process and is unavoidable.

It appears that transplanted hair and non-miniaturized hair is somewhat less subject to shedding than hair undergoing the miniaturization process. In addition, if transplant hair or non-miniaturized hair is shed, it will grow back. If miniaturized hair is lost, however, it may or may not return.

Since both finasteride and minoxidil reverse the miniaturization process, they should decrease the amount of hair at risk from shedding. This has been our clinical experience, but it is important to note that as yet there have been no scientific studies to support this view.

At this time there is not much you can do except to be patient and wait for the newly transplant hair to grow in and for the shed hair to return. Of course, make sure you continue to take finasteride and minoxidil.

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The International Alliance of Hair Restoration Surgeons is a consumer organization that selectively screens skilled and ethical hair transplant surgeons. The IAHRS does not offer an open membership policy to doctors practicing hair transplatation, and is the only group that recognizes that all surgeons are not equal in their skill and technique. Its elite membership seeks to represent the best in the discipline, the true leaders in the field of surgical hair restoration.