Physician Answered Q & As

How Young Is Too Young To Have A Hair Transplant?

How young is too young to have a hair transplant? I am currently 20 years old and have lost about 40% of my hair. I just began taking Propecia which seems to be working for me so I was wondering if it were possible for me to have a hair transplant to fill in what I have lost these past 3 years?

This is a really sensitive topic and a difficult decision to make, with very differing doctor’s opinions. The easiest and most ethical decision for the physician to make is not to treat a young patient at all. However this decision will not relieve the young patient from his suffering due to his early hair loss. In determining whether to treat or not to treat a young patient, it is important to know if he is not traumatized too much by his hair loss. This could possibly manifest in a lack of self-confidence, in social withdrawal or sometimes even in suicidal thoughts. Young men suffering from Alopecia Androgenetica are usually estimated to be much older and are also considered to be less attractive by society. Even professionally, people are judged by their appearances for a large part. Some men can deal easily with their hair loss others cannot and search for an enduring solution. I attempt to offer people who consult me the possibility to feel better about themselves. Of course I would first consider if a medicinal therapy would be an appropriate treatment for the patient. Using a medicinal therapy such as Finasteride (Propecia®) or Minoxidil (Rogaine®) could diminish further hair loss and could buy time for patients with a severe form of MPB.

As for you the therapy with Propecia seems to be working well and will probably prevent further hair loss, but nevertheless it will never regain all the hairs you have already lost. When you are planning to undergo a hair restoration procedure, the cause and pattern of your hair loss should be determined by the physician. The location as well as the degree of hair loss are decisive in choosing a surgical treatment plan. Your future hair loss may in no case exceed the donor capacity when aging. It is a fact that the hair loss pattern could take a change over the years:

You should also understand that hair loss is a lifelong process that will not cease after undergoing a hair restoration treatment. Furthermore it is extremely important that your expectations of the overall result are realistic. It is known that young patients are often the most demanding patients as they usually expect to gain an extremely dense coverage after surgery as well as a low hairline. In favorable cases this could be realized but unfortunately in most cases young patients have to settle for less. Moreover it is important to accept that it is impossible for the physician to foresee the further process of your hair loss or to predict your final balding pattern, it is only possible to assess your future hair loss scenario.

The following key concepts are in my opinion of overriding importance when planning a young patient‘s hair restoration treatment:

- Extensive consultation
It is extremely important to have one or even several extensive consultations with the young patient. I always try to meet a young patient for a second consultation after a couple of months in order to see if it is not just an impulsive decision for him to undergo surgery. It will also be possible to determine how fast the hair loss is progressing and if the medicinal therapy has been effective or not.

- Degree of MPB
A young patient suffering from an advanced degree of hair loss (Norwood IV – VII) or a patient with a family history of severe types of MPB should be advised against a surgical hair restoration at a young age. However a young patient with a minor degree of hair loss and a good donor capacity could certainly consider the possibility of a surgical solution after he has been informed and is fully aware of all risks of having a hair restoration done at a young age.

- Long term result and hairline design
The physician should explain the young patient the benefit and value of a more conservative hairline, a hairline that would be accurate now and after many years. There is less expanse to cover in case of a higher hairline, which means there will be more donor hair saved for additional procedures. It is significant to know that once a young patient has started hair restoration, future procedures will probably be required to keep up the natural appearance. Besides if no more hair is lost in the long run, one could easily lower a high hairline.

- Sufficient density
If sufficient density cannot be guaranteed in the first place, a hair restoration treatment should be renounced by all means.

- Choosing the appropriate technique
Choosing the appropriate technique for hair restoration is always a very important issue, but definitely in the young patient. Based on my personal findings, FUE procedures offer best alternatives for younger patients, especially with Norwood types I-III. If, in the worst case scenario, FUE patients would ever run out of donor hair in order to keep up the natural looking aspect or if they do not want to continue with further hair transplants, they have the option of shaving their hair and do not have to deal with strip scars. They always leave the possibility open to remove the grafted hair with treatments such as laser hair removal.

The decision whether a hair restoration procedure could or should be executed in a young patient can only be taken in a personal consultation and after an elaborated physical and emotional examination. Each case has to be evaluated individually and requires serious thinking. In the end the ultimate decision depends on the above arguments


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