Hair transplant - is it too early?

Question

Is it too early for me to have a ht? Id like to have it thicker in the hairline and frontal area but worry that permanent shock loss could occur in the native hairs since they will eventually fall out anyways. The surgeon I saw said it can be done. My father's a level 5, I'm 27, use saw palmetto 320mg, 5% minoxidil once daily. The area I want to thicken is in red and is about 50 cm. Hair looks thicker since I just washed it.I know it is hard to judge from the pictures.i appreciate your help.

Jae Pak, MD · Answer

It is best to see a doctor if you would be a good surgical candidate.  Photos of thinning hair cannot determine if you are a surgical candidate.  Your expectations may be different than what a surgery may provide.  You may have further (future) hair loss that you may have not thought about.  Your donor hair may not be sufficient.

Michael Vories, MD · Answer

A modest procedure to re-establish the hairline can be performed, but I would advise to be conservative with the hairline. In your situation I would seriously consider taking finasteride to conserve the native hair, and remember that a hair preserved is better than a hair transplanted.

Alba Reyes, MD · Answer

For now I think stabilizing should be your main focus. Propecia 1 MG , Minoxidil 5% twice a day and then see what happens over the next 3-5 years.

John Peter Cole, MD · Answer

The key questions of when to begin hair restoration surgery include your age, your family history, how much hair loss you can expect, your donor characteristics, your goals, and products you use to minimize hair loss.  It is never a good idea to begin in your early twenties or younger because individuals who are going to experience more hair loss tend to have more significant hair loss at a younger age.  Your degree of hair loss is not too extreme at this point and seems to be limited to the frontal area.  There is a test you can do if your hair is longer as is your hair called hair check.  If there is a drop in the hair check number across the top when compared to the back of the head, this suggests you might have more aggressive hair loss over time.  If the numbers are similar in the top and crown, this suggests you will not loose these areas for a long time.  One can look at family members that were your age and their hair loss pattern at that age to get an idea of where you might be headed, provided you can find a relative such as a brother, father, mother's uncle, or mother's grandfather.  Your donor area is of critical importance.  If you have a high density and higher caliber, you are a better candidate to proceed.  If you are more conservative in your goals for the location of the hairline, you are a better candidate to proceed.  Remember, that you need a hairline that is going to look good for 20 to 50 years.  If you want a really low hairline location, it is probably better for you to wait until you become more realistic.  Products can help improve your candidacy simply because they slow down the hair loss process; however, we can't be certain that you will remain on them forever so this is perhaps less important.  Some start Propecia at a young age, but begin to have sexual dysfunction after a few years.  This sexual dysfunction can last for many years subsequent to this.  I've seen it break up marriages so keep this in mind.  Minoxidil seems to carry less long term risk, but it's probably not as affective.

Rashid M. Rashid, PhD, MD · Answer

It may be a little early and aggressive to start with a hair transplant. You may want to find a good local hair transplant doctor to talk about less invasive approaches first.

Sumit Bapna, MD · Answer

You may also want to consider the less invasive hair restoration techniques like PRP injections. Also, you should consider taking finasteride to preserve the hair that you do have. Having a hair transplant too early may require an additional transplant at sometime in the future if you lose additional hair and want to prevent an unnatural look.

Brian Goertz, MD (retired) · Answer

You are asking a good question and it is helpful to ask the community for their opinions. 27 is on the younger side but certainly not 18 or 19. In trying to restore your hair it is important to pursue medical as well as surgical options. It appears from you photographs that you are an early Norwood Class IV pattern of hair loss. Your family history on both sides is important to determine where you may end up from a hair loss standpoint. An assessment by a well qualified full time hair restoration surgeon would help to determine whether or not you are a candidate for hair transplant surgery. Please follow link below to try to find a well qualified hair restoration surgeon. Also, please review the consumer alert posted on the homepage of the International Society of Hair Restoration Surgery.

Jonathan Ballon, MD (in memoriam) · Answer

For me, the answer would be an unequivocal "yes" based on your age, your minimal hair loss and potential for ongoing loss, your family history, and the fact that you are not being effectively proactive. (Finasteride is the treatment of choice for male pattern baldness; saw palmetto has been debunked as an effective remedy; and minoxidil needs to be used twice a day by men). In my opinion, you are at an age and a stage where your priority should be stabilization. A helpful question to ask yourself is, "Did I have more hair a year or two ago than I have now"? If the answer is yes, we have to assume that without a good response to standard treatment, you will have less hair in another year or two than you have now, and you could be left with an unnatural appearance without further surgery. Give yourself some time -- you won't be burning any bridges by waiting to see what happens. I hope this has been helpful!

William Rassman, MD (retired) · Answer

With your family history of hair loss, you should be serious about the drugs you use. Saw Palmetto has no value for holding on to your hair, A hair transplant with any reasonable amount of balding can be done bu you should take the drug finasteride to prevent shock loss (see video below).

Hair transplant - is it too early?

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Answers (9)

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