I am exactly four months post-op; still very early for any concerns, I know, but I am still concerned. I am hearing/reading all of these posts with guys who are seeing new hair sprout up every day at 3 months, 2 months, etc. I am at 4 months and I don't see ANYTHING...at least I don't THINK I do. Let me explain.

I am about a 3 - 3A on the Norwood scale, so I still have hair up top. I really had a lot of shock fall out over the past 4 months, and I still pull out 10-20 hairs every day in the shower. Before my HT, I would pull my hair back and say "Man, Im really starting to lose my hair." Now I pull my hair back, and I say "Damn. I lost my hair." I comb my hair forward, and still maintain a somewhat full look with the help of Dermatch, but when I pull it back without the Dermatch, I definitely am very thin in the front portion of my head. Anyway, my questions are the following, and I would love to hear any comments/answers especially from those who have had HTs.

1. How long does the shock fallout last? Like I said, Im can run my hands through my hair right now and pull out hair. Does that hair "really" grow back? Or is that something that the surgeons just tell us.

2. MOST IMPORTANTLY...and this may sound stupid... I can't tell if the hair I have on the front part of my head is new, old, coming or going. In other words, there is still hair on the top front part of my head, but it is very fine baby hair...very thin. And it is the ONLY hair that is left there. Quite simply, I cannot tell if this hair is the hair that I have REMAINING on top, or if this hair is new hair coming in. So is there a way to tell? Does the new hair come in as hard stubble? And I must say if it is the new hair, then I lost ALL of my old hair because it is the only hair I have left on the top front. To make it clear, guys who are completely bald on top can tell when the hair is growing because any hair that shows up is NEW hair. But guys like me, who still had hair on top...we just can't tell what's new and what's old!

I am inclined to say that it is the old hair only because I never noticed any new hair coming in (and I would have had to lose ALL of the old hair and what is remaining would have to be ALL new hair). But this hair is a lot shorter than the rest of my hair, a lot finer, and a lot thinner. But I had hair like that in front before my HT, I think. It was just camouflaged by longer, stronger hair that has since dwindled due to shock fallout.

Please help with any knowledge. Thanks.

Loss of hair after any stressful event including surgery (HT) usually starts 2-4 weeks after the procedure and may last for about 3 months after it starts. Hair regrowth starts usually 1 to 3 months after the shedding of the hair shaft and grows at about 1cm. per month. Any loss still going on 4 months or later after the surgery is probably caused by something other than the surgery, usually further progression of the original process of male pattern hair loss.

Tha regrowth hair, whether it be transplanted or regrowth of the original hair that shed will look the same initially. All will be very fine hair like a baby's first growth of permanent hair. Later you may be able under magnification to distinguish grafted hair vs original hair if the donor hair shaft is somewhat larger than the original frontal hair which was present. This is not always the case, however, since donor and recipient hair shafts can be very similar in diameter.
Best Wishes,
Bob Limmer, MD/jal

Dr. Limmer