I'm 28 yrs old. Is it too early for me to have Hair Transplants FUE? (photos)

Question

I am 28 and looking to get hair transplants, I have lost some hair on the top and there is a lot of thinning on the front of my head. My hair is very thick on the sides and at the back of my head, I have been quoted 3000-3500 grafts FUE . My question is that I am not sure if it is not to early for me to have hair transplant? Also I still have some existing hair and not sure if transplants will effect the existing hair ?

Ken Anderson, MD, FISHRS · Answer

Dear Bronik29,
Thank you for posting this question. There are several ethical guidelines that should be adhered to when considering any patient for hair restoration surgery. Transplanting into the crown area is not advisable in any male patient under the age of 25. The simple answer is that we don't know where you're going to "end up" with your hair loss.  Since a hair restoration procedure of any type, whether it's an FUE or FUT, is merely a re-distribution of whatever hair remains, it is entirely possible to "run out" of hair to transplant over the course of one's life. Remember that hair loss has no cure, and is progressive in nature. Also remember that as a circle expands, due to pi r squared, the area of that circle increases exponentially. Since the results of a hair restoration procedure are permanent, and we don't know how far along the scale you're going to go in your lifetime, I don’t consider it ethical in our specialty to perform hair restoration into the crown area on a man under 35. There are many clinics who will take your money and perform the procedure, but that does not make it ethical not acceptable.
This is an ethical issue that arises at nearly every hair restoration meeting that I attend.  It's a real problem, because younger men are most sensitive to hair loss, and most likely to do anything, including having a hair transplant procedure, to lessen the social stigma of having hair loss at such a young age.  The consensus among dedicated hair restoration surgeons is that it's simply too young.
This is particularly true given the other new technologies and procedures developed over the past few years to slow the progression of hair loss, and in some cases, especially in young men who are 20 (e.g.: young men) can reverse the hair loss.  These treatments include:
1) LLLT (low level laser therapy)
2) Platelet-rich plasma (PRP) treatments. 
3) finasteride
A good course of action would be to schedule a meeting with a dedicated hair restoration surgery physician who practices nothing but hair loss medicine and hair restoration surgery for an opinion on this important decision. I hope this information is helpful to you.
Kind Regards,
Ken Anderson, MD, FISHRS
Dear Bronik29,
Thank you for posting this question. There are several ethical guidelines that should be adhered to when considering any patient for hair restoration surgery. Transplanting into the crown area is not advisable in any male patient under the age of 25. The simple answer is that we don't know where you're going to "end up" with your hair loss.  Since a hair restoration procedure of any type, whether it's an FUE or FUT, is merely a re-distribution of whatever hair remains, it is entirely possible to "run out" of hair to transplant over the course of one's life. Remember that hair loss has no cure, and is progressive in nature. Also remember that as a circle expands, due to pi r squared, the area of that circle increases exponentially. Since the results of a hair restoration procedure are permanent, and we don't know how far along the scale you're going to go in your lifetime, I don’t consider it ethical in our specialty to perform hair restoration into the crown area on a man under 35. There are many clinics who will take your money and perform the procedure, but that does not make it ethical not acceptable.
This is an ethical issue that arises at nearly every hair restoration meeting that I attend.  It's a real problem, because younger men are most sensitive to hair loss, and most likely to do anything, including having a hair transplant procedure, to lessen the social stigma of having hair loss at such a young age.  The consensus among dedicated hair restoration surgeons is that it's simply too young.
This is particularly true given the other new technologies and procedures developed over the past few years to slow the progression of hair loss, and in some cases, especially in young men who are 20 (e.g.: young men) can reverse the hair loss.  These treatments include:
1) LLLT (low level laser therapy)
2) Platelet-rich plasma (PRP) treatments. 
3) finasteride
A good course of action would be to schedule a meeting with a dedicated hair restoration surgery physician who practices nothing but hair loss medicine and hair restoration surgery for an opinion on this important decision. I hope this information is helpful to you.
Kind Regards,
Ken Anderson, MD, FISHRS

Jae Pak, MD · Answer

You need a diagnosis and an understanding of what your hair loss pattern will be or how much more hair  you may lose.  Only then you can consider a treatment plan that may or may not involve surgery.  Hair transplant is not always the right answer.

Tim Neavin, MD · Answer

I'm not sure you need that many grafts to give you a nice hairline and restore lost density.  It would be helpful to see more photos. I would consider NeoGraft hair transplant to eliminate any linear scars.  Be sure you see someone with experience in aesthetics and understands the art of hair transplantation. Doing it right and wrong could mean not only a cost issue down the road for touch ups and scar revisions (as in case of strip method), but also give you longevity to the transplant by proper blending, follicle orientation and distribution.

Toby Mayer, MD · Answer

You should wait until your limits of your baldness are clear. Your donor area will be quite small and you should probably only have the frontal area done if you choose grafting. You should look into the Fleming Mayer Flap as an alternative to hair transplants.

Jeff Donovan, MD, PhD · Answer

This is one of the most important questions in hair restoration. In general, one must be very careful about transplanting the crown too early. At age 28, further loss in the area of the crown is guaranteed. So all discussion must center around that. Further loss in the crown has a high chance of leading to the effect of having a transplanting area in the center and no hair outside. Should you choose to transplant now, you should be prepared to return in a few years for one (or more) sessions when the area expands. One can not predict how much expansion will occur. For that reason many surgeons are cautious about transplanting the crown before the mid 30sOverall the numbers could be OK, with 1200-1500 for the front and 1500 plus for the back. You will certain affect existing hairs during the procedure with a high chance that miniaturizing hairs will be damaged or subjected to shock loss. Overall, please get a few opinions. Transplanting the front and back are very different discussions. Because you only have a finite number of donor hairs, you want to make sure you move them wisely. At 28 it may look as though you have endless hair to move, but one can't predict what you will look like at 60 Medical treatment (minoxidil, finasteride, laser and platelet rich plasma) should be discussed in great details.

William Rassman, MD (retired) · Answer

Your balding
should be predicted and you may be able to predict the final pattern at the age
of 28 with two measurement of your hair Bulk data one year
apart while you are on the drug finesteride.. Don't jump to a hair transplant
too quickly as you might find out that you might reverse the process on medications like Propecia alone. 3500 grafts sounds like too many transplants for what I see. Of course, 3500 grafts make the doctor a lot of money, but do you need that many grafts if the drug reverses it within a year.

Michael Meshkin, MD - Account Suspended · Answer

From looking at your picture, you are a grade three the Norwood Scale of hair loss and your donor hair that is in the back of your head looks nice and dense, and you are a good candidate for surgery. To cover the areas of your concern you need at least 2500 grafts.   Each graft may have between 1-3 hairs, so for 2500 grafts you may get close to 6000 hairs, each unit is then placed in the recipient areas according to its size.   If the hair is harvested from the safe donor zone then it will remain as long as the donor area in the back exist. However you May lose the native hair that you have in the front. You can start using a medical regiment to slow down future hair loss and do the hair transplant to regain your lost hair.

Sheldon S. Kabaker, MD FACS (retired) · Answer

At this time in your life hair transplantation should be done to maintain and improve the front. If some of your native balding hairs are shocked by the procedure so be it. It appears that you will lose all the hair on the top of your head. There may not be enough donor hair to cover the crown however if you have in the front done you will not be a Identified as a bald man.

I'm 28 yrs old. Is it too early for me to have Hair Transplants FUE? (photos)

Answers (8)

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