Minor hairline hair transplant in 23 year old

[johnyboy9]

Hi,

I am a 23 year old male seriously considering a hair transplant. I am a norwood class 2 w/a naturally high hair line and diffuse thinning and recession in the temples about an inch back and slight thinning and recession in the front (minor). I have been on finasteride for 2 years and rogaine foam (on the hairline) for 2 years. I also use 2% nizoral 2x/wk. I have a few uncles on my mom’s side who are norwood 5’s and some uncles on my dad’s side who are norwood 2’s and 3’s. My dad is a norwood 2a. I have been to two hair transplant surgeons who both said I was a good canidiate because I have good donor hair and I’ve halted/slowed my hair loss with finasteride. The surgery would be a conservative approach to establish a mature hairline. I’m not trying to get my adolescent hairline back. They each recommended btw 800 and 1000 grafts via the strip technique. I know I am young but what do you guys think? Will I regret this in 10-20 years? Is shock loss a major concern in my case? Anyone with a similar experience?

 

Thanks.

Edited October 18, 2011 by johnyboy9

[Blake Bloxham]

Johny,

 

The textbook answer is simply "you're too young." Various factors come into play when transplanting hair (especially in the hairline) in such young patients - most significantly, the fact that, at this point in time, you simply do not know how your hair loss will progress.

 

However, I've actually heard highly respected experts discuss the fact that the age of a hair transplant patient isn't as important as the preventive measures taken to ensure a lasting result. In your case, the fact that you're utilizing a proven regimen of preventive hair loss solutions is a good thing and is likely to increase your chances at a successful hair transplant at some point in time.

 

Because I've offered two differing opinions, I'm going to give both my opinion and a suggestion:

 

First, I highly recommend consulting with a proven, screened hair restoration physician. These doctors are truly the "experts" described before, and I'd take their advice very seriously. If a physician of this caliber believes the preventive medications and conservative approach make you a good candidate, then you should feel comfortable moving forward with this type of recommendation. However, if one of these doctors agreed with the "you're too young" assessment, I'd keep stabilizing the loss until a more appropriate date.

 

Second, in my opinion (which remember does not constitute any sort of medical advice), I do think you're still a bit too young for a hair transplant procedure. I'd recommend utilizing the preventive medications for a few more years, truly halting the hair loss, and seeking consultations with hair transplant surgeons at that time.

 

I hope this helps! Good luck!

[johnyboy9]

Thanks for the quick response. The doctor I would likely go to is Dr. Aronovitz, who I believe is one of the doctors supported by this forum. When I consulted with him he emphasized that as long as my hair transplant is conservative I am not too young, especially because my hair loss isn't very severe and I've been on finasteride for 2 years.

As of now, I think I am going to take the plunge and get a transplant. Anyone else have any comments/words of advise?

[rhof625933]

Thanks for the quick response. The doctor I would likely go to is Dr. Aronovitz, who I believe is one of the doctors supported by this forum. When I consulted with him he emphasized that as long as my hair transplant is conservative I am not too young, especially because my hair loss isn't very severe and I've been on finasteride for 2 years.

As of now, I think I am going to take the plunge and get a transplant. Anyone else have any comments/words of advise?

The other consideration is that all of the work is in the front. The front is the most important hair to your appearance therefore at your age I would strongly recommend that you keep all the work in the front even if the crown begins to thin. This way if you have substantial hair loss in the future you will have a nice front hairline and at the worst a "bald spot" in the back.

[johnyboy9]

Good point rhof625933. Thankfully I don't have any noticeable thinning in my crown at this point but yes, the hairline is what everybody sees the most.

 

I'm scheduled to get a transplant in 1.5 months but I haven't paid anything yet bc honestly I'm nervous about shock loss (since a good portion of the transplanted grafts would be placed in frontal and temporal regions where hair still exists). Also, I do have some miniaturized hairs in the temple region (and some in the front) that would most certainly be lost due to shock (or so I think). Anyways, I seem to go back and forth on whether or not to go through with this hair transplant based on my good and bad hair days. As of now The idea of getting a fuller looking hairline is SO tempting! I think I'm driving myself crazy lol. Any more advise would be greatly appreciated.

Edited October 25, 2011 by johnyboy9

[Shadow of the EMpire State]

Good point rhof625933. Thankfully I don't have any noticeable thinning in my crown at this point but yes, the hairline is what everybody sees the most.

 

I'm scheduled to get a transplant in 1.5 months but I haven't paid anything yet bc honestly I'm nervous about shock loss (since a good portion of the transplanted grafts would be placed in frontal and temporal regions where hair still exists). Also, I do have some miniaturized hairs in the temple region (and some in the front) that would most certainly be lost due to shock (or so I think). Anyways, I seem to go back and forth on whether or not to go through with this hair transplant based on my good and bad hair days. As of now The idea of getting a fuller looking hairline is SO tempting! I think I'm driving myself crazy lol. Any more advise would be greatly appreciated.

 

It's an easy call. Operating on a 23-year-old NW2 is madness. You haven't even cleared the stage at which the mature hairline develops. No transplants before 27, at the earliest. After 30, would be better, and after 35 would be best.

Edited October 25, 2011 by Shadow of the EMpire State

[Dr. William Lindsey]

I have no problem with your age IF you are an informed patient, and you plan to avoid the 3 mistakes of hair surgery.

 

1. big scar....pick someone who tends to get decent scars in most cases

 

2. hairline too low....this can be a real issue in guys your age. You need to plan on a hairline that will look ok at 45, not 25... so avoid pushing for a transplant with a hairline that will not age with you... and its conceivable that you may not need much or anything done yet... again as Blake says, consult with someone who has a track record on sites such as this and you'll likely get a pretty honest opinion on this issue.

 

3. too little hair on too much bald head. lets say you get 1500 now but due to your genes, you wind up a class 5. Well, depending on your hair characteristics, you probably have enough donor hair to nearly cover all the hairloss (behind your current transplant) pretty well, with additional surgeries. But if you turn out to be a class 7....well you may only have enough hair to adequately cover behind the current transplant back to near the crown. Don't spread it around trying to get a little coverage...you end up no better off than not doing anything.

 

Good luck to you. Make sure you plan for future loss, and hope you don't have any and this is it for you.

 

Dr. Lindsey McLean VA

[johnyboy9]

Thank you Dr. Lindsey and Shadow for your responses.

 

So I went to see Dr. Didocha for another opinion and he said that a major flaw w/my hair loss strategy was the fact that when I cut up proscar into 5 pieces (and take 1 a day) I am destroying the protective outer coating of the pill. This, he said, ultimately results in significantly less absorption of the drug. Therefore, he advised me to switch over to 1mg propecia (or 1 mg finpecia). By doing so, he said that I will likely see a "noticeable difference" in 6 months and should try this before considering surgery. Has anyone heard this before? I guess I'll try it and reassess my situation in 6 months. Why not?

[Sean]

Thank you Dr. Lindsey and Shadow for your responses.

 

So I went to see Dr. Didocha for another opinion and he said that a major flaw w/my hair loss strategy was the fact that when I cut up proscar into 5 pieces (and take 1 a day) I am destroying the protective outer coating of the pill. This, he said, ultimately results in significantly less absorption of the drug. Therefore, he advised me to switch over to 1mg propecia (or 1 mg finpecia). By doing so, he said that I will likely see a "noticeable difference" in 6 months and should try this before considering surgery. Has anyone heard this before? I guess I'll try it and reassess my situation in 6 months. Why not?

 

 

I am actually taking 1.25 estimated dose of finasteride by cutting up a 5 mg proscar pill. I heard the same thing before and would like to know if someone can clarify this for once and for all. I too have heard from some people that 1mg is the way to go and that due to cutting up the pill, the oxygen makes the pill less efficient?

 

Are you switching to the 1mg propecia?

[johnyboy9]

Hey Sean, yes I have decided to switch to 1mg propecia and then switch to the generic version in 2013 when it's available in the US. Also, the theory on why cut up proscar isn't as effective as intact propecia/finpecia is due to the following: the coating protects the pill's active ingredient (finasteride) from being degraded/inactivated in the stomach by acids. This allows the drug to reach the small intestine (where the majority of the absorption occurs) in its active form. Of course the film coating has more than just this function (i.e. decreases absorption through skin via handling the drug; remember it's teratogenic to pregnant women!). This is my basis for making the switch. If any docs would like chime in feel free.

And spex, yes I agree that finpecia is a solid choice for ease and cost.