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  1. #1
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    Default Question regarding getting a HT young?

    Heres the thing. I am 21 and losing hair...prob a nw3. Propecia works well for me and rogaine is ehh. I am considering a hair transplant. I know they say getting one young is bad since hairloss progresses. The thing is i only want hair in my 20s. I dont care if i have to shave my head when im 30 or so because its more common. Would it be dumb to have a HT this early to just live my 20s to the fullest with a decent head of hair and shaving it down the line when it gets worse?

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    Yeah I've wondered the same thing. Why can't the Dr. just fill in the spot that is thinning or balding & then the Fin/propecia stop any further loss? Or why can't the Dr. just predict how the loss is progressing? I mean just looking at where mine is thinning I can see where I will need it if it keeps falling out.

  3. #3
    Senior Member PayDay's Avatar
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    Quote Originally Posted by john2399 View Post
    Heres the thing. I am 21 and losing hair...prob a nw3. Propecia works well for me and rogaine is ehh. I am considering a hair transplant. I know they say getting one young is bad since hairloss progresses. The thing is i only want hair in my 20s. I dont care if i have to shave my head when im 30 or so because its more common. Would it be dumb to have a HT this early to just live my 20s to the fullest with a decent head of hair and shaving it down the line when it gets worse?
    If you are a Nw3 at 21, and you believe Propecia is working well for you, than having an hair transplant might be ok. You should not go for a strip at your age and you really need to understand the limitations of HT surgery. You might find it difficult to find an really top surgeon who is willing to work on you but I guess if you are a good candidate, it might be a possibility.

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    Quote Originally Posted by PayDay View Post
    If you are a Nw3 at 21, and you believe Propecia is working well for you, than having an hair transplant might be ok. You should not go for a strip at your age and you really need to understand the limitations of HT surgery. You might find it difficult to find an really top surgeon who is willing to work on you but I guess if you are a good candidate, it might be a possibility.
    Im def thinking of Dr. Wesley for scarless surgery so when i have to shave my head i wont have a scar.

  5. #5
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    Quote Originally Posted by PayDay View Post
    If you are a Nw3 at 21, and you believe Propecia is working well for you, than having an hair transplant might be ok. You should not go for a strip at your age and you really need to understand the limitations of HT surgery. You might find it difficult to find an really top surgeon who is willing to work on you but I guess if you are a good candidate, it might be a possibility.
    What are some of the limitations? Is there a chance the donor hairs won't take or are you speaking in terms that you only have so much donor hair to begin with? The more I research this stuff the more questions I have about the entire process.

    I'm 28 & have thinning hair on the crown & I feel because of the limitations with age & the degree of loss I'm just stuck with it looking this way.

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    Senior Member PayDay's Avatar
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    Quote Originally Posted by john2399 View Post
    Im def thinking of Dr. Wesley for scarless surgery so when i have to shave my head i wont have a scar.
    I don't think that Dr. Wesley has fully refined his "scarless" surgery yet. I think Spencer Kobren said it might be a year before Dr. Wesley starts to offer it to all of his patients. I think they are still working on it and plan to present it at one of the hair conferences in the fall.



    Quote Originally Posted by pensfan View Post
    What are some of the limitations? Is there a chance the donor hairs won't take or are you speaking in terms that you only have so much donor hair to begin with? The more I research this stuff the more questions I have about the entire process.

    I'm 28 & have thinning hair on the crown & I feel because of the limitations with age & the degree of loss I'm just stuck with it looking this way.
    There are lot's of limitations. You only have so much donor hair so you have to choose where it is placed wisely. Most people your age probably should not start transplanting in the crown in case you need to fill in your hairline in the future.

    There is really lots to know.I suggest you tune into The Bald Truth show on Tuesday nights. This is where I've gained a lot knowledge. Spencer Kobren explains things much better than me, so you should try to call the show.

  7. #7
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    Quote Originally Posted by pensfan View Post
    Yeah I've wondered the same thing. Why can't the Dr. just fill in the spot that is thinning or balding & then the Fin/propecia stop any further loss? Or why can't the Dr. just predict how the loss is progressing? I mean just looking at where mine is thinning I can see where I will need it if it keeps falling out.
    The Dr isn't a physic
    No one can predict with absolute certainty how much hair you will lose, how fast you will lose it, where you will lose it etc etc

    Get a HT at a young age , and then in " ? " years as you lose more hair you will most probably require another HT to fill in what you lost or it will look like you had something done

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    My advice is to plan for the worst. At 21, there is no way to really predict where your hair loss will end up and if you're already a NW3, there's a very good chance you will lose more hair in the future. You can't count on taking Propecia forever, nor can you count on its continued efficacy long term even if you do continue to take it. If you are destined to be a NW7, you will eventually get there even if taking meds (though it could take decades. If you get get a HT now to fill in your hair line and then do not have enough donor hair to fill in the rest of your scalp, you risk looking pretty funky. You'd be OK if you get a truly "scarless" procedure and are OK with shaving your head at some point, but I don't think any doctor would guarantee you no scars.

    With all that, I say wait at least until your late 20's to see if your can stabilize your hair loss over a period of time. By then, the procedures will be even better and hopefully there will be more effective treatments that could help you avoid surgery altogether. And by the way, if you think it won't bother you once you hit 30, think again. I thought the same thing and hair loss bothers me just as much now in my mid-30's as it did when I was in my early 20's. Don't make a permanent decision based on how you're feeling right now.

  9. #9
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    Quote Originally Posted by john2399 View Post
    Heres the thing. I am 21 and losing hair...prob a nw3. Propecia works well for me and rogaine is ehh. I am considering a hair transplant. I know they say getting one young is bad since hairloss progresses. The thing is i only want hair in my 20s. I dont care if i have to shave my head when im 30 or so because its more common. Would it be dumb to have a HT this early to just live my 20s to the fullest with a decent head of hair and shaving it down the line when it gets worse?
    I can relate to what you're saying. I began losing my hair early on and it seemed as if part of my life was missing in my 20's and 30's. I viewed myself as 20 going on 40. Most hair transplant doctors won't perform surgery on a patient until they are about 29 years old.

    Several years ago, I knew a guy in his late 30's who progressed to a severe Norwood 7. He had about an inch of fringe left on the back and sides of his head. His was an extreme case, but if he had started hair transplant surgery in his 20's, he would probably have scarring in his donor area to deal with. Neither strip or FUE are scarless. Some of Dr. Cole's patients wear a high and tight military haircut (shaved back and sides) and the FUE extraction sites are difficult to find and not noticeable. Other patients get some hypopigmentation and need to wear their hair a little longer at the back and sides of their head. We have seen ACell at the very least, help reduce hypopigmentation. As a general rule, hair loss moves to the higher Norwood categories when it begins at an early age. Currently, even a Norwood 6 with decent donor characteristics can usually get some acceptable results from hair transplants by framing their face. The top and back receives thin coverage.

    The main issue most hair transplant doctors have with performing surgery on a 21 year old is the inability to predict the future extent of hair loss with 100% accuracy. The "Hair Check" system helps, but it's not perfect.

    35YrsAfter works at Dr. Cole's office.
    Last edited by 35YrsAfter; 02-23-2015 at 09:34 AM.

  10. #10
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    Most ethical docs want young men to wait and see how/where their respective hairloss progresses until they at least reach their late twenties or so. This makes sense for the obvious reasons. And they encourage these young guys to get on finasteride soon and then wait and see how they respond to low dose finasteride. If they do not respond favorably, then surgery can potentially be a trap and disaster.

    IMHO, family history is still the best long term indicator of where one's MPB is headed. Sure, most of our older family members did not have low dose finasteride and even minoxidil at their disposal and many of them did not use the initial prescription form of minoxidil when it first was introduced to consumers approximately four decades ago. Yet today I know of countless men that have the upper classes of hairloss in their family histories and continually have been able to greatly slow down the rate of loss because of finasteride.

    Since 1980, an extremely high percent of men that I have dialogued with who began experiencing hairloss in their late teens and early twenties regretted starting HT surgery. Many of them were "sold" into having surgery and not informed of future loss and the fact that they would run out of donor. And yes many of them did not take any hairloss meds until the late nineties when Propecia was approved and released for treating MPB which has made a more stable platform for them.

    Many of them had low hairlines established and had open donor (plugs) when they still were in the lower classes of hairloss. Then, as their native hair was lost over time, the plugs stayed and they had a real dilemma on their hands. Many of them sustained massive visual scarring and many are still seeking corrective measures.

    It addition, it comes down to one's own hair quality. I know of guys who hit Norwood class 6 but had outstanding hair characteristics with "superb hair caliber". Some had a nice wave or curl which also helps with the illusion of coverage. Hair caliber is the most single critical factor considered in attaining the visual illusion of coverage.

    There are more and more guys experiencing long term efficiency with low dose finasteride. Without question this has IMHO allowed more guys to sustain their restored appearance for much longer time periods than the distant past.

    And along with a very conservative hairline frame to start with, restoration is indeed more viable with todays technology and techniques including FUE. Still, it is highly advisable to keep the density at a lower level to start with and even lower as the coverage is transitioned from the frontal zone to midscalp.

    How does your crown look? You probably would want to leave the crown alone for now. Undoubtedly at your young age, you will need multiple procedures as you get older.

    If it were me, I would still wait it out. There are definitely more options today that there were in times past. Just make sure your goals are conservative, always planning for future loss and keep your expectations realistic.

    Be sure you understand the risks as well as the benefits regarding HT surgery!
    "Gillenator"
    Independent Patient Advocate
    more.hair@verizon.net

    NOTE: I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice nor are they the opinions of the following endorsing physicians: Dr. Bob True & Dr. Bob Dorin

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