Hair Transplant Surgery: Avoiding Shock Loss of Existing Hair

Shock loss (postoperative telogen effluvium) is a phenomenon that really varies from practice to practice as well as from patient to patient and tends to affect women more than men. In our practice, we generally state that significant shock loss is seen after about 40-50% of female cases and 10-15% of male cases. When it happens, it occurs 2.5 to 3 weeks after a session, but grows back 2.5 to 3 months post-operatively. In an area that has been treated, 1 to 3 out of every 10 hairs may temporarily fall out before regrowing.

The greatest emphasis should be on creating the recipient pattern to avoid transection of existing hair. Now, that’s not to say areas of future hair loss (e.g. your widow’s peak) should be avoided. Quite the contrary, actually. It’s essential to treat the areas of future loss so that patients are never obligated to return for a follow-up session in order to simply make it look natural again. For example, not treating a tuft of hair in a patient’s central hairline would ultimately leave an unnatural bald patch after a patient has progressed with their normal course of androgenic alopecia (pattern balding). They would then have to return to treat that in order to simply look normal again.

The key is simply attention to detail and taking a good 2+ hours when designing the pattern in order to carefully navigate through areas with pre-existing hair that requires thickening. This enables the recipient sites to be carefully created at the exact same angle and direction of the pre-existing hairs (even if there are sudden changes, as seen in a cowlick). Rushing through this process, like an automatic sewing machine, increases traumatic follicle transection which may not always be temporary. Fortunately, the hair restoration physicians recommended on the Hair Transplant Network are great and don’t rush this process. But, as a patient, please don’t be afraid to ask your surgeon how long it takes them to create the recipient pattern.