I’m a board certified cosmetic surgeon and I’ve been performing hair transplant for 20 years in Manhattan and Long Island. The expectations of hair transplants are very often not met because of overselling or aggressive marketing combined with the reality of the limitations of the donor area. The top of your head needs a certain number of hairs but unfortunately, the donor area at the back of your scalp does not have enough hairs. In addition, the rate of progression of your hair loss is too fast. There have been many patients who tried to have transplant in their 20s to compensate for the hair loss. By the time they hit their mid-30s, they really look like they didn’t have transplants and still have thinning hair. Many people have tried to use drugs like finasteride that is an effective drug for male patients whose hair is DHT-sensitive. Finasteride is an oral medication that inhibits an enzyme called 5-alpha reductase that facilitates the conversion of testosterone to dihydrotestosterone (DHT). The challenge is that many people don’t respond because their hair follicles are not responsive to DHT. Therefore, there are a lot of unknown factors that are also contributing to hair loss outside of DHT. There have also been numerous chromosomes associated with hair loss which are approximately 11 of 23 pairs. In our practice, we have been very excited to help patients using a non-surgical option called Hair Regeneration. This was an accidental discovery using a wound healing material called Acellular matrix in a hair transplant that appeared to make thinning hairs to look thicker. Over several years, we developed a system and process of doing an injection as an alternative to transplantation that reversed hair thinning. It’s important to have this treatment soon after your onset of hair loss. The rate of your hair loss progression is also a factor that affects how well the treatment works. The treatment has been close to a 100% beneficial for male pattern hair loss. There are occasional patients who don’t respond to the treatment but that is a very small group. We have not yet been able to figure out how to predict that, but close to 100% of male pattern hair loss respond. It has been a huge success for patients who come to us from around the world. We have reached a point where we are now scaling this treatment to try to bring it closer to people and the company we started is called Trichostem® Hair Regeneration. Hair Regeneration is a onetime treatment. In some patients after a year, we’ll do a second injection to build upon what we’ve done. In someone like you, with your level of hair loss, you would probably get a second treatment. With 3-5 years of data, we have been able to show no significant regression with this treatment. From my experience, it far exceeds the benefits of a surgical transplantation which has to be done every 3-5 years until you run out of donor area. In someone in their 20s, we try to avoid surgical transplantation altogether. I hope that was helpful, I wish you the best of luck, and thank you for your question. This personalized video answer to your question is posted on RealSelf and on YouTube. To provide you with a personal and expert response, we use the image(s) you submitted on RealSelf in the video, but with respect to your privacy, we only show the body feature in question so you are not personally identifiable. If you prefer not to have your video question visible on YouTube, please contact us.