Hairline lowering surgery is probably not appropriate for you. When you have a hairline that’s thinning and receding, you’ve got a moving target. You fall in a category of a more aggressive early onset of male pattern hair loss. The Rule of Decades states that when you’re 20, 20% of your contemporaries have hair loss. Unfortunately, that means 80% of your contemporaries have lots of hair. As you hit your 40s or 50s, it becomes closer to 50%. The age of onset and rate of progression is critically important when making a decision about a surgical treatment for hair loss. For years, it was always discouraged to transplant men in their early 20s. The reason is that there was a mismatch between the amount of hair you can transplant and the desired result. When you are in your 20s, you want a lot of volume. But if you’ve lost a lot of hair, the limited donor area prevents you from getting that volume that most of your contemporaries have. In contrast, older men are satisfied with a definition of a hairline and coverage of the mid-scalp area. In this country, there are two medications used in treatment of hair loss: one is finasteride and the other minoxidil. Finasteride is an oral medication that’s used to inhibit an enzyme called 5-alpha reductase which interrupts the conversion of testosterone to dihydrotestosterone or DHT. There are specific hairs that are sensitive to DHT. Many younger men who take finasteride who have aggressive hair loss may not respond to finasteride compared to a male in their 30s or 40s. Unfortunately, there are concerns of the long-term sexual side effects of finasteride. In our practice, any man who comes in their 20s and 30s usually doesn’t want to take finasteride at all. We have men in their 50s and 60s who’ve been taking finasteride since the 90s and they’re fine. In our practice, we developed a method called Hair Regeneration to treat people with actively thinning hair. Combining platelet-rich plasma with a material called extracellular matrix, we have successfully been able to develop a formulation, a method of delivery that helps male and female pattern hair loss, which is also referred to as androgenetic alopecia. A lot of our patients come in are able to save a lot of their thinning hair by stopping thinning while the hair gets thicker. We have up to 5 years of data to support the longevity and it’s been successful for patients who come from all over the world. For someone like you, that’s exactly what we would recommend. We would do a full examination, look at your hair with a microscope and identify the thinning hairs. Most likely there’s going to be a large volume of thinning hairs. We do the treatment and follow you to 3 months. The results can take to 12 to 18 months but they can be quite dramatic and in many cases, look more natural because it is your own hair. The volume can be greater than a typical hair transplant which is remarkable and really makes a big difference. Many people still do choose to have a hair transplant, depending on the degree of progression and how much we are able to restore. We usually tell people to not do a transplant first. We suggest for them to do Hair Regeneration and allow the full 18 months to go by before deciding on getting a transplant. At this point, we have made Hair Regeneration a real viable alternative to hair transplantation. Not only are we treating men and women who have thinning hair, but we are treating men who have had a transplant. We are also treating people who are looking for an alternative to a second transplant. They come in and we look at them with a microscope and see that there are thinning hairs that we can salvage - we thicken those hairs and they avoid doing a transplant. Another group of patients are people who have had transplants and want to help and improve their transplant’s yield. They maximize the volume by reversing the existing thinning hair, healing the donor area and the growth of the transplanted hair. We always encourage people that once they start noticing thinning, the sooner they come in because we have more hair to work with. We can’t save hairs that are lost, but thin hair that's almost disappeared does come back thicker and fuller. I think you would first need to stabilize your hair thinning. With proof of that stabilization, having a rational plan for transplantation for definition is very reasonable. But understand the limitations as the donor area is very small. Although, people go outside of the donor area, those hairs are destined to thin out and that’s a big problem with follicular unit extractions (FUEs) - they have to be taken in a much wider area than the limited donor area in order to yield enough grafts for transplantation. So that’s what makes Hair Regeneration a really significant way to help people with thinning hair before undergoing transplantation. 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.