20 and Considering a HT

[baldboy123]

Hi everyone,

 

Im 20 years old and suffering tremendously from MPB. I have been losing hair since I was 17-18. Now I really cant take it anymore. I'm balding in the the crown and my hairline is receding pretty bad. It's pretty obvious I will end up like my dad who is completely bald. I have been on propecia 6-7 months now. I believe it has slowed down my hairloss alittle but hasn't really thickened my hair. Hopefully itll start working alittle better in the coming months. Anyways, I have been to a very good HT doc (on the coalition) and he recommended that if i really wanted a ht to take propecia for a year and see if it will benefit me. If its successful, he'd agree to the ht. All i would like to do is fix my hairline. I really would like to look my age again and I think lowering my hairline will give this effect. On the propecia, I am hoping itll thicken up my crown a bit more as well. What are your thoughts? Do you think I should go through with a HT? I'd appreciate any comments or suggestions. Thanks.

[thanatopsis_awry]

Tough to say if you should or shouldn't get the HT; it's really an informed decision that you need to make with the best doc out there for you. It's especially tough to even make a call without seeing any clear pics of you.

 

You're really young, so your margin for error is extra-slim. People your age do get quality HTs, though rare (especially when you factor out uber-hacks like MHR, Bosley, etc). Just really inform yourself -- the big thing is that you'll be "committing" to a multiple procedures....and depending upon your donor, you might not be able to get a full-coverage, full look...

 

*which you may still prefer over the alternatives!

[Marvin]

Well, if you fix your hairline now, and then continue losing hair to the tune of a NW6-7, then you are going to end up looking quite unusual, right?

 

Sadly, it seems that HT's are not likely to be the answer for guys like us who start losing early.

[aska]

I think people ca had an HT on the 20's, but ONLY wen the meds works tremendous.

Like myself, i was o propecia for 3 years before the HT, and my hair is much better now than it was 3 years ago. Propecia really stooped my balding.

I have no sign of thin hair on the temples neither on the crown, where i was used to have.

So, if you answer to the meds like myself, i think you can have an ht.

If propecia just slw down and u can notice that your hair is still thining i thing you better not do, cause you'll have to go to another procedure in a short time.

[Marvin]

But there are people for whom meds stop working.

[Raphael84]

Phil Harmonic, my opinion happens to differ from your own. Whilst it is obviously an extra risk, when considering a HT in a patient so young as 20. But it wont be a first and without seeing pics, its impossible to tell. If he has extensive recession and thinning in the crown, he is already minimum 3V on a Norwood, which at his age suggests that he would probably progress into an N5/6. Therefore, with this knowledge, a project with a mature yet full hairline could be achieved without exagerated risk.

 

I understand the theory of waiting until older, but this is not necessarily the case in all candidates. Otherwise, why not tell everybody to wait until they are 40, just to be sure.

 

Get in touch with a coaltion Dr. who is far more educated and experienced than ourselves, and get their view on things. Then and only then can you begin to make a realistic long term plan. Be very careful every step of the way. Good luck!

[MikeTheDane]

Like it has been said, it's a tough decition to make, and you're likely going to commit yourself to successive procedures. It's expensive, and theres still the risk of not having enough donor until old(er) age.

 

From the heart: first try shaving down, i did that for 3 years until taking the plunge. If you don't like it, well..

 

I'm 23 and have had 2 procedures, might need a 3rd one (small session) but i'm only 8 months post op of my 2nd so it's hard to say.

 

For me, it's been a lifesaver. I feel so much more like my peers now, less alienated, much more calm inside. If i run out of donors in 10-15 years, i think i'll just shrug, shave it down, maybe some fue into the scar and call it a day. I actually don't mind people seeing the scar as much as i mind them seeing my receeding hairline.

 

Just a word from the other side of the river..

[aaron1234]

Baldboy. You will likely need more than one procedure, especially if you start losing this early. I'd stay on the meds and shave for a few years. Who knows, by the time you are thirty, you could be a full blown NW 7. I know some NW 7's before they hit 25 and they started to lose at about 19 or 20.

[HairIsThere]

Baldboy, IMO I think that if you want an HT I don't see why you shouldn't do it. Sure you may have future hairloss, but any way you slice it, with an HT you WILL have more hair than you would if you just didn't get one at all. I personally think that people put a little too much emphasis on the whole "future hairloss" idea before gettin an HT. If you think about it, even all of us guys who are on meds could very well still have future hairloss...they could quit working at any time I suppose, or people could just quit taking them due to side effects, financial situation, etc... Every single one of us who get a hair transplant are taking this gamble. You do what YOU wanna do and feel is right at the time. I'm 22 and had my first HT back in May. I couldn't imagine going through my 20s without hair. The worse that could happen to you is you get a procedure done now, 10-15 years later you lose the rest of your hair (which could potentially happen to all of us even with the meds), so you shave your head..ok big deal..if you wouldn't have had an HT you would have lost your hair and probably shaved your head anyways. Sure there is money lost there but there's not just a whole lot of things you can spend your money on in this world that are guaranteed in the future - present day TVs, comps, and phones are always days away from being obsolete, cars break down and clothes go out of style. If you go to a recommended doc who will use your donor hair wisely then go for it...I don't care what age you are. Just my opinion man hope this helps!

[thanatopsis_awry]

What are some of the worse potential happenings?

[HairIsThere]

Phil, I have no idea what you are talkin about. Obviously, if you go to a hack then yeah worse things could happen like severe scarring and things like that. But as I said in my post, if you go to a recommended doc, as on this site, then they are well respected in the field of hair restoration and will do a good job. I have done my research and if you think he should wait til he's 30 to get one then you clearly haven't done yours. In ANY situation in life there are always what ifs, what if this happens, what if that happens. That's life and there's no guarantees with anything. If he wants some hair back right now then I see no reason why he shouldn't go through with the procedure. Everyone of us with an HT are risking "looking weird" later on down the line with future hairloss - meds or no meds. Mother nature will not bring back our hair with MPB - so that can't be your argument.

[Raphael84]

HairIsThere - I happen to support you first post. I think the concerns are a little deeper but Im right there with you man.

 

Aaron - Yeah you are right, some guys begin recession at 19 and are NW7 at 25, but most, the majority are not. I began recession at 16, and IMO see myself as having an aggresive pattern. But with meds, at 25 Im NW4 pushing 5 but holding out the last 2 years.

 

Hope is not lost. Each case is entirely unique, as long as you are aware of each and every possible evolution and effect, then you can make an informed decision for YOU!

[Raphael84]

Phil,

 

One question for you mate. After 2 HTs let say from now until 25. How is it possible to be back to square 1 at 30?

[Speegs]

Its a personal decision ultimately but be advised that most doctors won't work on a patient under the age of 25.

 

I you are a 3a or 4a norwood pattern I would have no qualms with you reframing your face but you must be advised that thinning may still occur even after the surgery but at least you'll get to enjoy the aesthetics of a framed face in your youth and not have to hide beneath a hat or wait until 25 to 30 to enjoy the cosmetic benefit.

 

Your call, gauge your thinning, stick with finasteride, research laboriously, if you haven't spent six months to a year looking at surgeons then you are playing roulette with your scalp and money.

[HairIsThere]

Lets take your version of the "worst case". Sure, its taking a chance, but if he waits, there will be less chance of looking weird and more money saved. But it seems there's little concern with the younger guys here about the long term, only with the short term and instant gratification. But hey, its only money. So what if he blows 20 grand only to be back at square one at 30 or 35 years old - sorry, but that's just very myopic planning. Not everyone can be so laissez-faire financially. Lets say you've got a guy that's headed for an Ed Koch style level of baldness early on, then HT is not for him. Ever. And when did I say mother nature would bring back your hair? - that was never my argument.

 

I'm saying that your argument cannot be that due to the fact that mother nature will never grow back our hair, every single one of us with an HT - no matter the age - are risking "looking weird" years on down the line if our native hair for whatever reason decides to fall out.... so I'm still waiting on your argument for why he should wait til he's 30 - TEN years from where he is now?! Also, if he goes with a top doctor from this site, what is your definition of a "worst case" scenario? No doc from this site would do a procedure or 2 on him now only for him to be back at square 1 at 30-35. The only way that would happen is if he is just physiologically prone for that to happen - but every single one of us are potentially wired for that to occur..it's once again a gamble we ALL take.

[splitting hairs]

OK, sit back and take a deep breath. I think you've done the right thing by getting on propecia, but give it some more time to work.

 

I'm 23 and am receding, approaching a Norwood 3, although my crown is fine. Last year I was desparate for a Hair transplant, I very nearly got one with a UK doc who is a butcher. Since then I have sarted propecia, which has stopped my loss.

 

I have decided not to pursue a HT for the time being because I did my research on this forum and realised it is not in my long term best interest. Why? Because propecia loses its effectiveness after a few years and my hairloss will progress. I dont want to be left with a tuft of hair at each temple.

 

Having looked at Hasson and Wong's results, I know that later on in life I can get a decent head of hair.

 

The best advice I can give you is: stay on propecia, try using some nanogen fibres and get creative with your hair (I use a faux hawk which is good for receders). When your hairloss progresses, you'll be in a better position to get a hair transplant that will look natural later on in life aswell.

[HairIsThere]

Because propecia loses its effectiveness after a few years and my hairloss will progress. I dont want to be left with a tuft of hair at each temple.

 

 

There is no definite evidence that Propecia will for a fact quit working in everyone that takes it after "x" amount of years. It's different for everyone and for many it works for a lifetime. Also, you won't just have a "tuft" of hair left after all the rest falls out - if it does. You can attack the front now (which is the most important for everyone due to that framing the face) and save a few thousand grafts to tackle the middle/crown when and if you need that later on. Check out Eman's hairloss blog...he went from being quite bald to having an insane head of hair and 1000-2000 grafts left to do the crown later if he needs it. Let ALL his native hair in the recipient area fall out - it would make no difference at all because that great head of hair is ALL transplanted which will never fall out. Check on Bill's weblog..he has ZERO native hair left. Sure the transplant planning depends on how many grafts you have available, but I don't know just a whole lot of guys who would choose to use their few grafts on sparse coverage only to once again get the "bald guy" look over a dense front. Life's just too short to wait to do what you want to do.

[splitting hairs]

Hair is there, I can see what you are saying, but, I think it is naive to believe propecia will work forever. This is a graph from the 5 year propecia study. Findings are AVERAGED:

 

 

Hair counts fall after year one, although they are still above baseline (where you started). You say that 'IF' he loses his hair in 10-15 years - his family history is not favourable as he said he'll end up like his dad, which means he has a very high chance of future loss. Also, even when on propecia, some guys report loss of effectiveness after 1 year, 3 years, on average 5 years, but a few 7 or 10 years. It also depends on how early you start it. The fact is, even if he gets a HT at 20, he could be looking at more loss by the time he is 23 or 24.

 

It's important to plan a hair transplant properly, going for a mature hairline. Ideally, I would say that the only time a hair transplant is appropriate in a young guy with a family history of advanced hair loss is if they are on meds, and they require 3000 grafts to the front third (like thana did). That way, when hairloss progresses, the guy is still left with a natural pattern.

propecia.bmp

[Dr. Ricardo Mejia]

I usually put patients on meds rogaine, Propecia and wait at least one year. I generally am very cautious for anyone under 25 and would rather patients wait. You may find priorities change as youget older where all of a sudden you find perhaps you do not want one, you get married and no longer "need" one, you shave your head and more comfortable with a shaven look. Things change and better to wait.

[Sere]

This is perhaps repeating what some have said here, I read part of what was written and not all.

 

I don't think there is anything wrong with a younger guy getting a HTP at all. If you go to a recommended surgeon from this web-page, he will know about placement and which extraction areas to take from etc so that you do not end up looking weird if the rest of the top goes as you age.

 

When I had my work done at 25, Dr Wong and I talked of future hair loss about my family history etc and planned accordingly with my newly transplanted hairs.

 

I am not going to act like I know its worse for certain people, but loosing your hair in your teens-twenties is in my mind far more devastating then loosing in your 30-40's. Thus the first group is much more inclined to take action then the latter.

[baldboy123]

thank you all for your suggestions and comments. I truly appreciate it. I have been researching and educating myself on treatments and the consequences or benefits of getting a ht at my age. Being on propecia for alittle over 6 months now, I havnet seen much improvement nor much hair loss. All I really desire right now is to fix my hairline as it will give me more of the youthful face I should have at 20. I am almost confident that I will need more procedures in the future. With the help of propecia and future hair loss advancements, I am hoping this will delay or negate the need for my future ht(s). This is probably the most important time in ones life to look "your best." In college, in the dating scene, and soon to graduate and find a job, I have found that my hair loss is really hurting my confidence. So I think I am going to be taking the step for a ht on my hairline within the coming months. I would appreciate anyone's comments or opinion.

 

thanks again

[Atomic]

baldboy,

 

Although i never reccomend a young guy under 30 getting a HT, In your case it may be the thing to do short of shaving your head.

As you said, you want to fix your hairline which can make big difference in your appearance giving your confidence a boost.

Go to A doc with a good Reputation & get his/her advice.

Good luck to you & don't let hairloss ruin your life. There are other afflictions much worse than hairloss that people live with everyday.

 

Atomic

[HairIsThere]

baldboy,

 

I think it's a great idea! Go with a good doc from this site and I know you will be happy when it's all said and done.

[maxhair]

baldboy - I agree with most everything said here. But let me throw this out there. If money wasn't an object, and I was you (and I don't know what you look like), I'd stay on propecia and get the biggest mega-session I could. Worry about 30 when you're 30. Who knows what advances will happen between now and then and at the least, just get another HT done later.

 

That may not be the most PC of answers but it's probably what most of us would do if we could.

[TC17]

I can't sit idly by when maxhair is advocating such an irresponsible course of action. baldboy, if you fall into maxhair's myopic approach to hair restoration, I do not think you are psychologically a candidate for surgery.

 

You must keep in mind that anything you do today as a young man with moderate balding, must look good when you become a middle aged man with advanced balding. Sacrificing the future for the present is not the proper approach, and no doctor who is at all ethical would do so. There have been many examples of "older" patients on this forum who have stated unequivocally that they care about their appearance today, just as they did when they were 20. It's one thing to be OK with less hair in your older years, it's quite another thing to be OK with a freakish hair pattern caused by irresponsible surgeries.

 

The problem with undergoing a "mega session" at your age is the unpredictability of your future pattern. Sure, you can get 5,000 grafts in one sitting and have a great head of hair for a few years, but WHEN your baldness progresses, and your sides drop lower, and your donor is too thin to keep up, you will look terrible. Make no mistake about it, donors do thin, and the length and width of a strip needed to harvest 4,000 or 5,000 grafts in a single setting, has the potential to become visible in a thin donor.

 

You're young, and you're losing your hair, it sucks. You've had some advice that is in my opinion, too optimistic considering your age. There is a reason why many doctors feel uncomfortable in transplanting a man under the age of 25. Go look at Dr. Mohmand's or Dr. Beehner's work on NW 7's and ask yourself if you would really like that look at age 23. Ask yourself why those two highly respected doctors cannot get more coverage, or more density on those NW 7's. I'll think you'll find that the answer is that the limitations of the patient are too great. Contrast those with the results of very bald young men and then finally ask yourself what happens to the young men who are destined to become NW 7's when their hair restoration pattern is more aggressive than the frontal forelock pattern.

 

I'm 26 years old and will most likely end up at least a NW 6. I flat out refuse to go for strip because of the fears I've outlined on numerous posts already. I recommend that you consult with a number of physicians and try to see if there is a consensus on the proper approach. Some will be more aggressive, others will be more conservative, but just remember that none of them have crystal balls, and at the end of the day, it's your scalp and your physical appearance.