20 Years Old And Seeking Advice

[RSaff]

I'm hoping that an experienced physician or someone who has already experienced what I'm going through can give me some advice.....

 

I am 20 years old, I'll be 21 in January. I started noticing my hair-loss just prior to my 19th birthday. It has accellerated quite rapidly. I would already classify myself as a type 3 or 3A on the Norwood Scale (I have lost pretty much all my hair in the temporal area and now my frontal lock and crown are beginning to thin ever so slightly). In my family hair loss is not overwhelmingly prominent, especially in males under the age of 35 or 40, so I'm not sure how much more hair I should expect to lose. It's very difficult for me emotionally to be losing my hair at such a young age and I've decided to do something about it, which brings me to my questions....

 

Considering the information given above, would it be a wise course of action for me to receive 1,250-1,750 grafts to restore my frontal hairline and then take Propecia to prevent any further loss? This might sound drastic but I'd hate to lose more hair due to my inaction which would make me even more unhappy with my hair, and it would make the process of restoring my hairline even more costly. I plan on scheduling a consultation relatively soon. I want to go to Shapiro Medical Group in Minnesota and I live in Illinois so it might be a while before I can get assessed in person. In the meantime, can anyone give me advice. Should I wait to see if my receding hairline subsides or would that hurt me in the long run? Is planning a hair transplant at the age of 20 too drastic? I'd appreciate any comments.

 

Sorry this was so long.

[RSaff]

I'm hoping that an experienced physician or someone who has already experienced what I'm going through can give me some advice.....

 

I am 20 years old, I'll be 21 in January. I started noticing my hair-loss just prior to my 19th birthday. It has accellerated quite rapidly. I would already classify myself as a type 3 or 3A on the Norwood Scale (I have lost pretty much all my hair in the temporal area and now my frontal lock and crown are beginning to thin ever so slightly). In my family hair loss is not overwhelmingly prominent, especially in males under the age of 35 or 40, so I'm not sure how much more hair I should expect to lose. It's very difficult for me emotionally to be losing my hair at such a young age and I've decided to do something about it, which brings me to my questions....

 

Considering the information given above, would it be a wise course of action for me to receive 1,250-1,750 grafts to restore my frontal hairline and then take Propecia to prevent any further loss? This might sound drastic but I'd hate to lose more hair due to my inaction which would make me even more unhappy with my hair, and it would make the process of restoring my hairline even more costly. I plan on scheduling a consultation relatively soon. I want to go to Shapiro Medical Group in Minnesota and I live in Illinois so it might be a while before I can get assessed in person. In the meantime, can anyone give me advice. Should I wait to see if my receding hairline subsides or would that hurt me in the long run? Is planning a hair transplant at the age of 20 too drastic? I'd appreciate any comments.

 

Sorry this was so long.

[Guest]

The fact that you are young and experiencing a significant amount of hairloss is quite worrisome. This can be a sign that you will lose a lot of your hair over the next 5-10 years. The news is not all bad. I would strongly encourage you to talk with an expeienced physician and be conseled on propecia and rogaine. Studies show the sooner you start treatment, the better your results can be. Transplantaion is an option, but you need to be fully educated on the pros and cons of the procedure. I would recommend a conservative approach such as a frontal forelock only. Planting a low hairline or planting in the temporal recessions might lead to problems down the road. Whatever you choose to do, remember to first do your homework. Be thoroughly educated on your options and what the course of action you choose to follow might mean to you in the future.

 

Brad L. Limmer, MD/jal

 

Dr. Limmer

[arfy]

<BLOCKQUOTE class="ip-ubbcode-quote"><font size="-1">quote:</font><HR>would it be a wise course of action for me to receive 1,250-1,750 grafts to restore my frontal hairline and then take Propecia to prevent any further loss?

If I were you, I would get on Propecia right away, whether you get a hair transplant or not.

 

Personally, I think you are too young for a transplant. I know there are many doctors who dislike transplanting guys in their early 20s.

 

The correct hairline from a hair transplant will be recessed and mature looking, something that looks more age-appropriate for a guy in his 30s or 40s. Would you be satisfied with that?

 

If you try to return to your teenage hairline, if and when you continue to lose hair (very likely, almost certain, since you are losing hair so young), a low transplanted hairline will look great at first, and become a nightmare later.

 

(My apologies for posting in the "Ask A Surgeon" forum)

[Guest]

I got an HT at your age. I had mine done about 5 months ago. Like arfy said, the correct hairline is recessed. I went from a system to the HT and I've had a bunch of people tell me I'm balding now or that I'm "growing forehead". So I think my hairline looks OK, it's just a matter of whether or not you can accept that. I know it's tough being 20, cuz I'm the same age. Also, if you progress to a NW 7, you probably would not have enough donor hair to cover your whole head, which is something my doc talked to me about in the consultation. So the most likely end result is hair in the front half of your head and a bald crown. If you can accept those 2 facts: a receding hairline, and a bald crown in the finished product...i think it's ok to go ahead w/ an HT at that age. Of course I'm biased, but I've read that the main problem with the young guys is that they expect to have a 20yr old's head of hair, which isn't really possible. Any responses, guys?

[Dr. Michael Beehner]

I see quite a few young men in consultation like yourself who are devastated by these early signs of hair loss. Although I try not to have a rigid, "line-in-the-sand" minimum age for transplanting, I generally try to get any male at least to the age of 22 with Finasteride treatment, and even Rogaine % topically, if they are motivated enough and have enough extra money to cover the costs. I take good photos at each visit yearly, to follow the progress or, hopefully, retardation or reversal of the hair loss situation. Then, at 22 or 23, those who are still desperately unhappy with the thinning of their hair can have some conservative hair transplanting done.

By slowing the hair loss down and letting the young man become a little older, the patient and the doctor both gain a lot. The passage of time makes the patient wiser and more realistic of what type of a transplant will eventually be done. I agree with Dr. Limmer that a "forelock" approach, which assumes the worst situation, is always the way to go in the male in his 20's who shows signs of significant "horseshoe" shaped baldness, which means they are almost certainly going to some day be a Norwood Class VI ("horseshoe baldness") or a Norwood Class VII (top of the side fringes located down the side of the head). A man who is 20 has a hard time realizing that he very likely has 50-70 years of living ahead of him, and, no matter how much we try to wish it wasn't true, male pattern baldness really is a progressive condition. A 20 year old has no idea how far the front temple hair, including the "sideburn" area, is going to recede back, or how far down the side of his head the fringe on the sides and in the back will drop. I find it useful with younger patients to hold out my two hands and say: "you have two piles here. One is the area of your head needing hair right now, and the other is the area with hair on it. As the balding one gets bigger, the other one unfortunately must always get smaller. If the one gets really big, the other will get really small. As the area needing hair gets larger, the very thing which you need - namely, "native" hairs in the donor area - are diminishing and unavailable for the task you want done. And such a situation down the road in life is the reason for the hair transplant surgeon to always be conservative and concentrate on "framing the face" with a natural looking forelock of hair, that has a "scatter zone" of fine follicular units off to the side (to help blur the space there). This will never look bad, and the wonderful thing about this strategy is that this simple framing of the face means that the patient will never really look bald, and there will not be a "ski hill" of bare skin going up from the forehead. Then, after 10-15 years passes, if the "worst case" scenario didn't prove out and the man actually keeps a lot more donor hair than was anticipated, then a little more aggressive approach can be taken and some more areas of the thinning scalp can be filled in.

Mike Beehner, M.D.

[Lord Rahl]

I'm still in my early twenties with only slight thinning throughout top of my scalp - and I was recently prescribed propecia. Can I use propecia in conjunction with rogain, and how much would it actually help? Also I know it is generally adviced against transplanting to temples - but assuming that the person will always remain at early norwood 3, without further hair loss, can the temples be filled in, and what doctor would one recommend for that unpopular operation?

[Dr. Michael Beehner]

Dear RSaff,

You certainly sound motivated to hang on to as much of your hair as possible (and hopefully stimulate some new growth). I would strongly urge using both products. The Rogaine mainly works to prevent hair loss, whereas the Finasteride does that, but can also result in significant increase of hair in the first few years of use. There has been proven to be a "synergistic" effect of the two.

I have a feeling that you and I are probably thinking of two different areas when the word "temple area" is used. I use it to refer to the front side hair that comes down from the corner of the front hair line vertically. I think you are referring to deep recessions on either side of the frontal tuft of hair in the front center. Sometimes, if that area of recession is deep enough, the outline of a "forelock" project would help fill in some of the deepest aspect of those areas. Most of the time, the man in his 20's wants much more - namely, to look exactly like his peers who have no hair loss. Doing this in a man with early signs of possible later significant alopecia would be very risky and something you would deeply regret some years down the road.

Mike Beehner, M.D.

[Lord Rahl]

what if there would be no significant hairloss in the subject later on - would filling in recessions on the sides still be not a good idea. In other words - is preserving the donor hair the only reason for not transplanting into the temples, and creating a straight hairline?

[arfy]

<BLOCKQUOTE class="ip-ubbcode-quote"><font size="-1">quote:</font><HR>what if there would be no significant hairloss in the subject later on - would filling in recessions on the sides still be not a good idea

Lord Rahl, you said you have diffuse thinning on top of your head, and you are just starting Propecia. So I wonder how you can feel confident that there will be no further hairloss for you? The problem is that you can't. Countless younger guys have gotten touch-up work for their hairline, and have regretted it. For one thing, the surgery can cause "shock fallout" where your hairloss is accelerated after the surgery. There are some people who have ended up with LESS hair after a hair transplant. That's why many docs do not do small touch-up sessions, the risk of "net loss" is not worth the "net gain". The best candidates are guys with a well-defined pattern of hair loss, who have already stopped losing hair with propecia, who don't have unrealistic expectations about what a HT can do for them. None of these things sound like you, to be honest...!

 

Another thing to consider. Your HT hairline will never change...EVER. If a surgeon gives you a straight teenage hairline, or one that looks especially young, it will look bizarre as you get older. Very few men have a "Ronald Reagan" hairline as they become older, and it will not be natural looking. And if you DO continue to lose hair, things will be even worse, because you will have a hairline that "draws a line in the sand" that is too large to fill with in with grafts. You'd have a teenage hairline, and hardly any hair behind it. It will NOT look good!

 

Why does it seem like some younger guys are so upset about losing their hair, that they can't accept the concept of recessed temples? And by the way, another thing you need to understand about a HT... you will most likely have to be satisfied with a bald or very thin crown, eventually. A hair transplant does not leave you with "Elvis" hair, there is not enough donor area. Older guys are better candidates because they are happy just to have a little coverage, evn though it is thin. Younger guys are usually not good candidates because they are trying to "look the way they used to" which is basically impossible for the vast majority of guys, and a big mistake.

 

I hope you will slow down and listen and think, and that you don't actually need to learn these things the hard way. Not only are people on the forum saying this, but now you have doctors telling you too. Although I'm sure that you will be able to find some clinic who is willing to take your money, and give you any hairline you want...

[rossw_88]

But mine is even worse. I just turned 18 this past August and I am pretty bald. I started losing my hair while i was 15 and have been on Rogaine since then and Propecia since 16. Unfortunately neither of these has worked. I would like to have a transplant after I graduate but i probably can't afford it, plus nobody would probably do it on a 18-19 year old. Im sure i wouldn't have a problem with an older-looking hairline. Mine's already worse that that and i have a big bald spot in the back of my head. Now i just shave all my head, but i REALLY wish i could get something done.