When is it appropriate to go under the knife

[NateDog]

Im just wondering opinions on when are you too young to have a Transplant

 

How long should someone wait (how thin do you need to be really)

 

I dont understand how a Doctor can do surgery on a twenty two year old guy knowing the high risk he will be a NW6+

 

All the videos of people I see that are super satisfied have undergone surgery when their hair loss was very stable and they appear to be older but I notice alot of young guys doing FUT sessions like no tomorrow and I wonder how many might regret that as they age or whether thats just not the case (Im hoping its the latter im thirty three)

[Atomic]

Nate, I think the longer you can hold out the better. Some guys are to young & will have problems in the future. I speak from experience as I am 52 years old & continue to loose hair. I had my HT about 3 years ago. I really didn't have much to loose at that point. Thats the best time to get a HT.

[Dr. Glenn Charles]

There is no perfect age. When hair transplants are considered in younger patients they should be done very conservatvely. A long term plan should be established between the doctor and the patient which should take into consideration the good possibilty of continued hairloss/balding. I always discuss the worst case scenario with the patient, that they will go on to a stage 6-7 and are likely going to want additional procedures in the future. I also try and assure that if the patient does have more hair loss and for some reason cannot do more surgeries, that the first procedure will look acceptable on its own.

[EpilepticSceptic]

I think even more important than age is being on Finasteride for a long enough time pre-HT to know that you are one of the fortunate good responders to it without any intolerable side effects.

 

I have photos of my hairloss condition 11 years ago, and today it is almost exactly the same. I'm 41 now. The crown loss has not progressed at all, and actually looks to be even better. My forelock has thinned a bit more, but for 11 years the loss is very stable and very slow. I started Fin. 11 years ago, but never really took the 1mg dose everyday and was very inconsistent with refilling prescriptions cause it was so expensive back then. But still when I look at those 11 year old photos it is very clear that my loss has stabililzed tremendously over that period of time.

 

I think the guys who are at greatest risk of dissapointment are the ones who cannot verify that they have halted the loss, or who have only been on Fin. for 6 months to 1 year and have no idea how it will pan out in the long haul.

 

So if you were 33 and had been on Fin. since 23, and if you know for sure it has halted your hairloss, then you are probably fairly safe to go under the knife IMO.

[mahhong]

As most people have suggested, not an easy question to answer!

 

I'm not a doctor so I can't talk with any authority here, but my personal opinion is that most balding men, no matter what age they are, should ultimately think of themselves as an NW6 in the making, and all treatments/surgery should really begin from that perspective.

 

If you think about it, with the treatments we have today, no hairloss can be truly "stable", unless it's actually reached the end result of its genetic pattern. The drugs available today can halt hairloss for 5 or 10 years, maybe even longer, but ultimately they are only really slowing down the process or halting it for a short period of time.

 

To that extent I would say the aim of any hair transplant is to add density to bald or thinning areas (in a cosmetically suitable fashion) whilst slowing as best as possible further thinning. Therefore most men may get a period of 5 or so years where the combination of a good HT(s) and drugs gives them a good head of hair. They will then likely find they need a further procedure at some point; either just because they want more density or they have to now address other areas or further loss in transplanted areas.

 

In other words it would appear to me hair restoration is effectively a case of doing what you can with the donor supply whilst minimising the loss of native hair and balancing those two things. Eventually, however, it would seem nature will take its course. That's when your HT surgery has to come good, because when you've finally lost all your genetically susceptible hair and had all the surgery you can have, the results have to be pleasing.

 

But that's where things get tricky I suppose! If you're young and only been losing a relatively small amount of hair for the past 3-4 years, for example, no good doc will want to pack 6,000 grafts around what's there. That having been said, what's the cosmetic or financial wisdom in having maybe only 500-1000 grafts spotted in amongst your existing hair? The results won't be easily appreciable, the cost will be comparatively high and you'll likely lose as much hair in the next 3-5 years as you gained.

 

Overall I reckon you need to be late twenties minimum and really to have tried all the drugs for a good length of time and be in the first "stable" period from them (say a year to 18 months on). At that point, if you stay on the drugs, you can probably justify doing a good HT (1,000-3,000 or more grafts) in the affected areas (most likely start by building a good hairline). All being well if you're say 30 when you have the transplant, you might not need to start thinking about a second until your later thirties. By then you'll be older, more mature, and can take the next step with your donor hair to create additional density (or replace lost hair) and start shaping a good looking but more mature head of hair.

 

I reckon at 33 you're a candidate for an HT, providing you meet the other criteria. If your hairloss is stable you and your doctor can probably think about making the first transplant and, with any luck, you'd have a stable head of hair for 3-5 years. It's almost a definite, however, that you'd need to commit to a further HT at some point in the future, and possibly one or more after that. If you start young you just have to think that way I guess!

Edited July 21, 2010 by mahhong

[Mp96]

There is no perfect age. When hair transplants are considered in younger patients they should be done very conservatvely. A long term plan should be established between the doctor and the patient which should take into consideration the good possibilty of continued hairloss/balding. I always discuss the worst case scenario with the patient, that they will go on to a stage 6-7 and are likely going to want additional procedures in the future. I also try and assure that if the patient does have more hair loss and for some reason cannot do more surgeries, that the first procedure will look acceptable on its own.

 

 

 

 

Dr. Charles, thanks for clarifying your opinion and your approach to your patients. I envy your ethics!!