Why is there a stigma against HT for young patients

[Fox243]

I was wondering why there’s such a stigma to get a hair transplant for young patients who have noticeable balding (NW4+) and have very conservative requirements (Ie high hairline, lower density in mid scalp and crown, willingness for use FUT/BHT if needed). Maybe this would make sense 15 years ago, but with the advent of techniques from clinics like hasson and Wong, Eugenix, Zarev, Hattingnen, etc, it seems we can even get a NW7 to have a reasonable hairline and density. 

[digi23]

25 minutes ago, Fox243 said:

I was wondering why there’s such a stigma to get a hair transplant for young patients who have noticeable balding (NW4+) and have very conservative requirements (Ie high hairline, lower density in mid scalp and crown, willingness for use FUT/BHT if needed). Maybe this would make sense 15 years ago, but with the advent of techniques from clinics like hasson and Wong, Eugenix, Zarev, Hattingnen, etc, it seems we can even get a NW7 to have a reasonable hairline and density. 

NW7 with a "reasonable hairline and density" is pretty much one in a million. The ones with extremely good density in their safe zone, thick diameter of the hair, a sick beard to harvest from, potentially good donor hair on their chest is the ones who you see miracle NW7 stories from.

NW6 is a little less complicated and it can be reveresed for many more people, but still is difficult. 

Generally why it is much more risk for younger patients, for example 25 years of age with significant loss, NW4+, is that it usually means you will only continue to lose hair so you will potentially end up in a bad situation with much loss, no donor to harvest from and scars, with no option but to shave it down and get SMP.

Thats why for younger patients its crucial to try Finasteride, still Finasteride will not stop the loss, just slow it down.

Edited December 24, 2021 by digi23

[Fox243]

I’m not referring to a miracle NW7 story but even a NW7 -> NW2.5 with low density and SMP to add density.

[Rahal Hair Transplant]

It's not necessarily a stigma against young people having hair transplants.  It's just that there are many additional risks related to young people having them.  For instance, young people still typically have a lot of hair to lose and unless it's been put under control with nonsurgical hair loss medication such as Propecia, it will likely continue and subsequent hair transplants will be necessary to keep up with the loss.  Secondly, young people typically have unrealistic expectations and think more short-term than long-term.  Just the faintest amount of thinning in the crown area often triggers the desire to fill it in with as many grafts as possible so there is no appearance of thinning.  While this could be done early on, it's simply not practical.  Let's say 3000 grafts are used to densely pack a moderately thinning crown on a 23 year old male but he only just started experiencing hair loss.  In a couple of years, he will have a halos of baldness around a tuft of transplanted hair in the crown because the hair loss in the crown worsened and widened.  And since donor hair is limited, it must be used wisely and the doctor and patient must work together to plan not only for the result of a single procedure, but for the long-term.

Often times you see young patients post years later saying they are dissatisfied with their hair transplant (even though they were at first) because they had a lot more hair loss.  But frankly, if the doctor/clinic are doing their due diligence, they will be educating each patient about what to expect not just after the first year, but after 3 years, 5 years and even 10 years.  If future hair loss is predicted and/or expected, discussion about subsequent procedures should occur before even undergoing the first hair restoration procedure.

All the above to say, there are certainly cases that can be made for younger patients undergoing hair transplant surgery.  But it's crucial that every patient (especially young ones) develop realistic expectations early on and not to expect a "one and done" procedure.  This is simply unlikely for a young patient.

Best wishes,

Rahal Hair Transplant

[HappyMan2021]

13 hours ago, Rahal Hair Transplant said:

It's not necessarily a stigma against young people having hair transplants.  It's just that there are many additional risks related to young people having them.  For instance, young people still typically have a lot of hair to lose and unless it's been put under control with nonsurgical hair loss medication such as Propecia, it will likely continue and subsequent hair transplants will be necessary to keep up with the loss.  Secondly, young people typically have unrealistic expectations and think more short-term than long-term.  Just the faintest amount of thinning in the crown area often triggers the desire to fill it in with as many grafts as possible so there is no appearance of thinning.  While this could be done early on, it's simply not practical.  Let's say 3000 grafts are used to densely pack a moderately thinning crown on a 23 year old male but he only just started experiencing hair loss.  In a couple of years, he will have a halos of baldness around a tuft of transplanted hair in the crown because the hair loss in the crown worsened and widened.  And since donor hair is limited, it must be used wisely and the doctor and patient must work together to plan not only for the result of a single procedure, but for the long-term.

Often times you see young patients post years later saying they are dissatisfied with their hair transplant (even though they were at first) because they had a lot more hair loss.  But frankly, if the doctor/clinic are doing their due diligence, they will be educating each patient about what to expect not just after the first year, but after 3 years, 5 years and even 10 years.  If future hair loss is predicted and/or expected, discussion about subsequent procedures should occur before even undergoing the first hair restoration procedure.

All the above to say, there are certainly cases that can be made for younger patients undergoing hair transplant surgery.  But it's crucial that every patient (especially young ones) develop realistic expectations early on and not to expect a "one and done" procedure.  This is simply unlikely for a young patient.

Best wishes,

Rahal Hair Transplant

great explanation. 

Also younger patients generally have less disposable income, and combined with having a shorter/narrower vision and being less risk averse and a lack of awareness of consequences compares to older patients, younger patients may be more likely to go to a hair mill or the local plastic surgeon who offers hair transplants as just one of his many services.  

Also younger patients will be more naive and may think just because someone is a medical doctor they are automatically in good hands. When in reality at the end of the day being a doctor is just a job like any other profession, and has its fair share of low-quality characters and doctors who frankly don't care about their patients and are only doing hair transplants because they think its easy money. 

Edited December 24, 2021 by SadMan2021

[deeznuts]

I think the general rule is to wait until 25 or even 30 so that the doctor can have a good idea of where you're headed. So I've definitely noticed a few people who are under 25, with significant loss, and an almost desperate attitude towards getting a transplant. Combine that with low disposable income and you have a recipe for disaster. And for a lot of these guys it's like the end of the world for them.

The reason you want to wait until you're 25 or after is because hair loss can be quite unpredictable before then.