Planning second hair transplant for mid scalp and crown at 25? (Photo)

I had lost almost 70% of my hair at 23 so went for a hair transplant for the hair now I want to ask is should I go for another session for my crown and mid scalp? I am also on propecia and rogaine for 2 years? Is my pattern stable?

Doctor Answers 7

At 25 wants a second hair transplant

Stability never happens in a 25 year old but if you stay on Propecia, you will be as stable as you can be. Many people do the front first and then follow-up with the top and crown in a second session. Be sure to stay on Propecia for the rest of your life. 

Los Angeles Hair Restoration Surgeon
5.0 out of 5 stars 27 reviews


Did your first surgery meet your expectations?  You have had surgery, you should know what to expect.  You're not a novice anymore.  The decision to have a second surgery is up to you and understanding what your doctor can provide.   Don't rely on others to make a decision for you.

Jae Pak, MD
Los Angeles Hair Restoration Surgeon
5.0 out of 5 stars 90 reviews

Hair loss at younger age

Since hair loss is progressive you may still lose more hair in the future.  For our younger clients, we do hair transplant in the frontal region but we hold off doing hair transplant in the crown area.  I suggest you wait longer For your hair loss to stabilize and meanwhile stay on your medical regiment. 

Michael Meshkin, MD
Newport Beach Hair Restoration Surgeon
4.8 out of 5 stars 27 reviews

Crown surgery at a young age with aggressive MPHL?

You have aggressive hair loss so you might have to wait to see if your pattern has truly stabilized.  Midscalp surgery could still be considered, but I'd still advise you to wait if you can.  Generally speaking you should conserve as much of your donor area grafts as possible, because as you age the crown usually seems like less and less of a priority.

Go for the trifecta!  Finasteride, minoxidil and LLLT (+/- PRP)!

Good luck!

Sara Wasserbauer, MD
Walnut Creek Hair Restoration Surgeon
5.0 out of 5 stars 8 reviews

Consider PRP

Option 1) Wait a few years before another transplantation and stick religiously with Propecia and Rogaine, 2) Hair transplantation (conservative) 3) PRP (platelet rich plasma).

Option 3 may be reasonable because you are still relatively young.  PRP contains growth factors and other elements to restore injured tissue (and presumably injured follicles from DHT).  It is injected or rolled into the scalp. 

Tim Neavin, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 42 reviews

Hair loss for crown - wait!

Seek out 4 or 5 opinions and you'll likely (hopefully) hear a consensus: wait until the mid 30s before addressing the crown with surgery. 

The mid scalp could be addressed earlier with a conservative number of grafts. 

Men with early hair loss need to plan for more hair loss - and keep in mind the possibility of advanced hair loss patterns as well as limited donor hair. It may look like you have alot of good quality donor hair, but young men should plan for well under 5000 grafts available to move. Making sure there's appropriate amount for the front is key. The crown quickly uses up massive amounts of grafts

A small (very conservative session) in the mid scalp could be done. But medical options (minoxidil, finasteride, laser and PRP) are essential to figure out if you want to use them as part of your overall plan. 

Jeff Donovan, MD, PhD
Vancouver Dermatologist

Second transplant

This would depend on the donor area which we cannot really see from the pictures but likely is good.  You should be doing all of the "medical" therapies as well 1)minoxidil twice daily 2) propecia 3) laser 4) supplements.  Lastly, I would consider PRP injections for someone your age and hair loss pattern

Kenneth Sanders, MD
Shreveport Facial Plastic Surgeon
5.0 out of 5 stars 1 review

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.