Is hairline lowering surgery suitable for my age of 20? Is hair transplantation permanent and safe? (Photo)

Hair transplant is safe and permanent in general.  Before considering hair transplant, you need to be examined by a doctor for an evaluation of your hair loss.  Your doctor will give you treatment options which may or may not include surgery.  

I'd stick with meds and even consider PRP (platelet rich plasma) for a few years to preserve and/or slow down loss as much as possible.  Then at the age of 24 or 25 revisit the idea of a transplant.  Any earlier and you may not have an optimal outcome if hair loss creates an obvious transition zone between native hair, bald or thinning area, and transplanted grafts.

In men who have hairline lowering surgeries, the
risk of male pattern balding is always there regardless of the family history
you have. This is the reason I don't recommend a surgical hairline lowering
procedure in young men, but rather a hair transplant lowering procedure which
can be just as good, but if balding or thinning should occur after the
procedure as a result of genetic balding, more transplants can follow it back
easily. Even in your situation, a hair transplant may become your next step.
See our gallery below on over 1000 men who had this done one way or the other.

At is stage you may still continue to lose hair since hair loss is progressive. Therefore it is advisable to wait a few more years.

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.



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Being a young male who is actively losing hair, makes you a non-candidate for hairline lowering in my opinion. Also, transplants should be considered only after a few more years.