whats the minimun age for hair transplant?

[kiosho]

hello,

i wanted to hear from u guys is there in your opinion a minimun age to have a ht?

how can one be sure that he wont need a second transplant?

thanks

[GoForIt]

1. No minimum age, but mid 20's seems to be many docs cut-off so they can determine the likely extent of hair loss. Also the hairline of a 20 year-old does not look good on a 60 year-old unless you have the density to match.

 

2. You can never be sure you will not want another transplant. Most good doctors will transplant in such a way that you will not be obligated to have another transplant if /when your hair loss progresses.

[Since21]

There is no minimum age, but I'd suggest waiting at least until your mid-30s when your hair loss pattern is more established and determinable. In the meantime, I'd get on finasteride to preserve what you have and slow down future loss (at least in the mid-scalp and crown). That said, I know how self-conscious I was throughout my 20s losing my hair and always hoped there would be some miraculous breakthrough other than surgery that would save my hair. If hair transplantation were where it is right now, I may have went through with it then. Thankfully, something in my gut told me not to do it. I'd most likely be a repair case now.

 

If you can hold off doing it 10-20 years, who knows what they'll come up with and FUE is just going to keep getting better. Let's face it, it's a battle against Mother Nature and one you're not going to win. For me, surgery was the last resort. I held out as long as I could.

[Shampoo]

There is no minimum age, but I'd suggest waiting at least until your mid-30s when your hair loss pattern is more established and determinable. In the meantime, I'd get on finasteride to preserve what you have and slow down future loss.

 

Good advice!

[Blake Bloxham]

I don't believe there is a defined "minimum age" for hair transplant surgery. Most surgeons will reject patients younger than 25 or 26, but each case is unique and exceptions can always be made. There is also nothing to "guarantee" you will not need a second procedure. Preventive medications like finasteride and minoxidil will help - as will undergoing a well conceived procedure at an appropriate age - but hair loss is a progressive and unpredictable ailment.

 

Hope this helps!

[Cant decide]

I would say the cutoff should be 28 unless the patient already has extensive loss before then.

 

Also, and this is just my opinion, NW2s should never be worked on for several reasons.

[Spanker]

Also, and this is just my opinion, NW2s should never be worked on for several reasons.

 

 

I would disagree with this. I was a NW 2.5 (Maybe I wasn't a 2, but I wasn't a 3 either, and approaching my mid-30's. It would have been better if I were in my mid 40's, but I think a person in their mid-30's are OK to transplant if you are tightening up a reasonable hairline in conjunction with fin and they are not showing signs of aggressive loss. I think that mid-20's is ok to transplant as long as you are transplanting them like they are a NW5 plus, meaning a little higher hairline and reasonable on the density. The mid-40's guys and up that are lucky as hell, hanging around a NW2 that want a little bump are pretty fair and safe game IMO. I am also not big on crown restoration unless they have already gotten to where they want to be in other areas and have had extensive restoration like in CD's case. I think blowing 2500 in a crown on a 26 year old is not a good way to go.

 

Basically, the younger you are, the riskier it is. I wish I was 43 instead of 33 when I had my transplant, because it really reduces the need for subsequent procedures due to loss. But with that said, at 35, I think I will be happier hair-wise having pulled the trigger for the next decade then had I not. Keep in mind that each person is different and that there is always a risk. I could look like Cpt Picard with a little transplanted fringe in 5 years, you just never know. But keeping on fin and minox greatly reduces that risk and we just really do what we can.

[Dr. William Lindsey]

This is a good question.

 

I personally don't have a minimum age as long as a few issues are properly covered in planning.

 

First, if someone is younger than 23, (or older too) I encourage parents to come to any preop planning and better yet the initial consultation. This has solved almost all issues of young people getting swept up in the excitement of a hair transplant and booking without thinking it through. I made better decisions at 23 than 21 and even better at 30...so maturity or mature advice is an excellent component of the decision tree for prospective patients.

 

Second, its imperative that a young guy who is thinking about surgery realize that he's buying a hairline that has to look age appropriate at age 30, 40, 50 etc. I can't tell you how many young guys I've seen who A: refused to consider a more mature hairline than all of their peers even though I explained that they will look goofy with a low straight hairline at 50 and B: have come in with horrible hairlines at age 35 from a tragic low straight hairline case elsewhere that might look ok on a 20 year old...and now they are up a creek.

 

Third, if a young guy is reasonable for a case....but his genes suggest that he's going to lose a LOT before he's 30, (still just a guess), I encourage them to wait and do a bigger case, or realize that they may be back sooner rather than later for a second case. I see such a fellow every June who got 1600 grafts to his triangles a week after graduating from college...who was with his 50 year old dad who had exactly those same triangle recessions and no other family history of hairloss. We gambled, and I think correctly, that he's probably not going to need future work, but even if he does, we've built a mature hairline foundation and haven't burned any bridges.

 

Fourth, I see lots of 20-23 year old guys with no significant loss who are stressed and that stress is exacerbated by infomercials... I recommend they simply return yearly, with or without medical treatment, and when its a "fight worth taking" we'll discuss surgery. I'm guessing 10% show back up and who knows how many go on to surgery elsewhere...where a few hairs a sprinkled in that entire frontal 1/3 as a "preventative" transplant. Given that I've repaired 5 of these guys in 2014 and its May, I'm guessing a fair amount will proceed with a different doctor.

 

Fifth, I see a few young guys with class 5+ hairloss, good insight, parental involvement who believe that their hairloss is affecting their social/work life. It may well be. I don't hesitate to offer these guys surgery as long as they are willing to take a mature hairline, and realize that future loss may occur necessitating future surgeries.

 

Dr. Lindsey McLean VA

[Since21]

I made better decisions at 23 than 21 and even better at 30...so maturity or mature advice is an excellent component of the decision tree for prospective patients.

 

This.

 

And even better decisions at 35 than 30 and better still at 40 than 35. When I was 25, I could never imagine being 40, and contrary to what you believe then, life is not over at 40. In fact, it's really just getting started because you have a better sense of self.

 

It's imperative that a young guy who is thinking about surgery realize that he's buying a hairline that has to look age appropriate at age 30, 40, 50 etc.

 

Do you have a general rule of thumb for setting the height of a hairline when considering advancing age? I know each case is different, but say you have a 30 year old patient with all things being equal in terms of his hair loss and progression of loss, where do you set his hairline at 30 while taking into account the future? 7cm? 8cm?

[delancey]

Dr. Lindsey,

 

While future hair loss may be unpredictable and unique to each individual, can you provide us with any statistics and/or information about predicting the future hair loss pattern of patients who already have a Norwood 5/6 pattern at very young age (say between 20-30)?

 

I read that if one's borders are strong (no miniaturization in the donor area) at the age of 30, there is a good possibility that it will stay that way. Would you agree that this is generally true?

 

Also, I started balding at around 19-20. I am almost 29 and am headed towards a Norwood 6 within the next few years. Due to my low color contrast (blonde hair), I was able to hide my baldness until just recently. Is it true that individuals who start balding at a younger age also stop balding at a younger age? In other words, one's final pattern presents itself earlier.

 

Also, do you believe that Norwood 6 patterns make good hair transplant candidates? How many grafts does the average Norwood 6 patient need for full coverage?

 

Thank you very much.

[Dr. Michael Beehner]

I think each hair surgeon has an unofficial "cut-off" age line that he or she is comfortable with. For me it is 23. However, if the front-central framing of the face is disappearing in a 21 or 22 y/o fellow, I will consider placing some FU grafts in the front half of a forelock-type pattern so that his face is somewhat framed. In doing so, I am not cutting across the temples trying to connect to anything on either side.

If there are danger signals that a young man could go on to a Norwood VII (fringes down the sides of the head), then I will only do an oval or "shield" shaped forelock pattern, which mimics a normal stage of hair loss that a lot of men naturally pass through. Those signals could include male relatives with Class VII baldness, "whisker hair" above the ears (curly hairs), indistinct fringe with miniaturization in the upper fringe.

I stay out of the crown/vertex and the side temples area (just above the sideburns) in men under 35, because filling in these areas in a young man could backfire with a very freakish look later in life that the patient would regret.

I certainly agree with the strategy of getting the very young men on both minoxidil and finasteride and have had a lot of very nice results with this regimen. However, if a 23 or 24 year old young man is clearly starting to bald and wants help, I think that, as long as his expectations and general psychological state are reasonable and normal, we should try and help them. But the plan has to be conservative and take into consideration the "worst-case-scenario" for that young man.

Mike Beehner, M.D.