Settling the debate on Hair Transplants for Young Patients

[Fox243]

I’ve heard a lot of contradictory views from doctors about HTs on young patients. In general, the three camps of thought from ethical doctors are 1) don’t have a transplant, 2) have a transplant but only focus on the frontal third, and 3) have a transplant but expect to use body hair grafts and expect light coverage outside of frontal third.  
 

It seems like most forum members prefer option 1, but curious why options 2 and 3 aren’t viable. Why would it not be possible to do a transplant on them assuming that they become a NW7, especially with the advances in transplant techniques these days?

[Melvin- Admin]

Hair loss is unpredictable when you’re young. Take for example me, the first two pictures were in 2009 at 23/24, the next picture is in 2014 just 5 years later. 

If they take hair out of a zone that looks healthy, but will ultimately thin. It would be disastrous. Not only will the hair transplant thin, but the scars will be exposed. That’s why medication is the best option for anyone under 25. 

Not to mention the master plan for someone young, may not be the best plan when they’re older. Had I gone in for an HT at 23, lord knows where I’d be right now. 

2014

[LaserCaps]

The main reason why many doctors do not recommend working on someone very young is because the pattern may not have revealed itself.  If you start transplants too soon, it may force things.  Let me give you an example.  18 YO with a very youthful hairline is starting to mature the corners. He talks the doctor into adding grafts to the corners.  The patient is destined to lose everything.  He will eventually end up with a couple of horns in the middle of nowhere.  Unfortunately, we do not have a hair crystal ball that will give us this info.  Medical therapy is key.

[Z--]

Which doctor have you seen suggest 2 and 3?

Unless you're already a slick bald Norwood 7 by 25, I can't think of a single reason why an ethical doctor would even contemplate operating on a young fellow.  They aren't viable because in case 3) you have limited body hair, and its only good for filling in areas. It'll look weird if all by itself. That's why most doctors who do BHI, do it alongside donor hair.

2) is a good idea only when your pattern is more clearly established when older. If young, then it isn't clear how far back the hairline will recede, so trying to do frontal third when there is going to be a huge area of loss behind it will look strange, no? If the loss is going to be bad, then you're better off with a higher hairline + more hair rather than a low thin hairline and not enough donor to cover the rest. 

[Mike10]

You may disagree but in my opinion it is best to not have a HT under the age of 40. Because then you're in a much better position. I could have had a HT in my early 30s but I wisely choose to wait until my early 40s. 

[Fox243]

Several doctors have suggested this. Eugenix, Bloxham, and H&W said I’m a candidate right now. Konior suggested I wait a few years but said if I really wanted to, I could have one right now just focusing on the frontal third. 

[Fox243]

I don’t really see the point of having a transplant when I’m 40. I’m just trying to have hair until I’m married – in my culture, it’s seen as totally normal to lose all your hair after marriage but it’s taboo to be bald before then. 

[Marko7t4]

7 minutes ago, Fox243 said:

I don’t really see the point of having a transplant when I’m 40. I’m just trying to have hair until I’m married – in my culture, it’s seen as totally normal to lose all your hair after marriage but it’s taboo to be bald before then. 

That’s fascinating. 

[deeznuts]

16 minutes ago, Mike10 said:

You may disagree but in my opinion it is best to not have a HT under the age of 40. Because then you're in a much better position. I could have had a HT in my early 30s but I wisely choose to wait until my early 40s. 

Imo the time value of a hair transplant is super important. I know a lot of guys just rush into it and I don't agree with that at all, but it really is nice to have hair for 10 more years when it matters.

 

12 minutes ago, Fox243 said:

I don’t really see the point of having a transplant when I’m 40. I’m just trying to have hair until I’m married – in my culture, it’s seen as totally normal to lose all your hair after marriage but it’s taboo to be bald before then. 

In North America, we just get fat after marriage

Edited June 24, 2022 by deeznuts

[Mike10]

Just now, deeznuts said:

Imo the time value of a hair transplant is super important. I know a lot of guys just rush into it and I don't agree with that at all, but it really is nice to have hair for 10 more years when it matters.

 

In North America, we just get fat after marriage

Well, with age hair becomes a bit less important so I can see your point there. But hair will definitely still matter to you in your 40s. 

[Melvin- Admin]

19 minutes ago, Fox243 said:

I don’t really see the point of having a transplant when I’m 40. I’m just trying to have hair until I’m married – in my culture, it’s seen as totally normal to lose all your hair after marriage but it’s taboo to be bald before then. 

This is just foolish, if that’s your goal, just wear a hair system until your 40 and take it off after. I’ll be 37 this year, and believe me, hair matters past 30,40, and 50. The thought that you won’t care, is plain foolishness. 

[Fox243]

I don’t think it’s foolish – I guess this really comes down to culture here. In my culture (Indian), arranged marriages are very common. Girls definitely don’t want you wearing a hair system.
 

Personally, the only reason I care about my hair is so that I can get an arranged marriage. I personally don’t mind being bald – I’ve never been one to care about how I look otherwise. 

3 minutes ago, Melvin- Moderator said:

This is just foolish, if that’s your goal, just wear a hair system until your 40 and take it off after. I’ll be 37 this year, and believe me, hair matters past 30,40, and 50. The thought that you won’t care, is plain foolishness. 

 

[Al - Moderator]

On 6/24/2022 at 12:16 PM, Mike10 said:

You may disagree but in my opinion it is best to not have a HT under the age of 40. Because then you're in a much better position. I could have had a HT in my early 30s but I wisely choose to wait until my early 40s. 

 

40!? I would have been a NW 7 for at least 15 years already if I waited until 40.

Edited June 26, 2022 by BeHappy

[deeznuts]

12 minutes ago, Mike10 said:

Well, with age hair becomes a bit less important so I can see your point there. But hair will definitely still matter to you in your 40s. 

Yeah it's more my point that if you're buying a car, you'd rather get 15 years out of it instead of 10 right?

Same with a hair transplant but since they last until you die in theory (ignoring age related thinning/questionable donor hair quality), you can't tack 5 years on the backend... You tack 5 years on the front end by getting it earlier.

But the issue with getting it too early is you're trying to buy a car when maybe you don't know what kinda car you can afford

[Melvin- Admin]

Just now, Fox243 said:

I don’t think it’s foolish – I guess this really comes down to culture here. In my culture (Indian), arranged marriages are very common. Girls definitely don’t want you wearing a hair system.
 

Personally, the only reason I care about my hair is so that I can get an arranged marriage. I personally don’t mind being bald – I’ve never been one to care about how I look otherwise. 

 

Do not get surgery, there are plenty of options where you can still look good without needing surgery. A co-worker of mine (Indian) had an arranged marriage, he was a Norwood 6 at 30. He came back from India with a wife and hair piece. I also met several Indians who wore hair systems when I had my last HT in Eugenix, so I’m not sure it’s against the culture. If you’re going into surgery with a quick fix type mentality, it’s not good. Surgery isn’t a temporary quick fix, it’s a lifelong commitment. Hair fibers work wonders. You can look like you have a full head of hair without surgery or hair systems. 

[Fox243]

Just now, deeznuts said:

Yeah it's more my point that if you're buying a car, you'd rather get 15 years out of it instead of 10 right?

Same with a hair transplant but since they last until you die in theory (ignoring age related thinning/questionable donor hair quality), you can't tack 5 years on the backend... You tack 5 years on the front end by getting it earlier.

But the issue with getting it too early is you're trying to buy a car when maybe you don't know what kinda car you can afford

That’s why I’m suggesting we plan for being a NW7 when getting a HT. I still think NW7 can get a very conservative hairline with light full coverage if using FUT + BHT based on my research.

[Z--]

36 minutes ago, Fox243 said:

Several doctors have suggested this. Eugenix, Bloxham, and H&W said I’m a candidate right now. Konior suggested I wait a few years but said if I really wanted to, I could have one right now just focusing on the frontal third. 

I'm as big a fan as any of the former three, but imo you absolutely need to follow Konior's advice. I speak from personal experience on this one as someone who was young and restless about getting a transplant.

I reached out to Dr. K a few years back and he warned me if that if I were to proceed I'd end up losing more way hair in the coming years, so I should wait until closer to thirty. At first, I was annoyed because other doctor's (some recommended here, no less) assured me that it was safe to proceed. I ended up confused, but heeded the initial warning and waiting the 3+ years before proceeding (this year), and I can assure you that he was 100% correct. I lost a LOT of hair in that time. For context, I had amazing hair at 23-24. 25-26 some noticable diffuse thinning. Around 27-28, I was slick bald in my crown and my front receded. After 28-29, my frontal third is wispy and pathetic; can't even style it well now. You'll really have big regrets shelling out a bunch of money to chase hair loss.  

This isn't a get hair now and be bald later situation because all hair transplants can mess up your donor area, so when you shave it (if and when you decide to want to be bald) it'll be obvious. 

Waiting is never a bad option. A bad transplant will really mess up your 20s (and possibly life). Play it safe and wait.

Edited June 24, 2022 by Z--

[Fox243]

2 minutes ago, Melvin- Moderator said:

Do not get surgery, there are plenty of options where you can still look good without needing surgery. A co-worker of mine (Indian) had an arranged marriage, he was a Norwood 6 at 30. He came back from India with a wife and hair piece. I also met several Indians who wore hair systems when I had my last HT in Eugenix, so I’m not sure it’s against the culture. If you’re going into surgery with a quick fix type mentality, it’s not good. Surgery isn’t a temporary quick fix, it’s a lifelong commitment. Hair fibers work wonders. You can look like you have a full head of hair without surgery or hair systems. 

Interesting – I’m on vacation to india right now and every single relative is commenting on my hair loss, so potentially my experience has been flawed by an older generation.

[BLE123]

41 minutes ago, Mike10 said:

You may disagree but in my opinion it is best to not have a HT under the age of 40. Because then you're in a much better position. I could have had a HT in my early 30s but I wisely choose to wait until my early 40s. 

What happened in those 10 years?

[Al - Moderator]

26 minutes ago, Fox243 said:

That’s why I’m suggesting we plan for being a NW7 when getting a HT. I still think NW7 can get a very conservative hairline with light full coverage if using FUT + BHT based on my research.

I agree if you have enough body hair. If I was starting over I would still do the hair transplant at 22 (I was already hitting NW 6 at that age), but I would use up as much body hair as I could right from the start. Beard and chest hair grow forever, so I think it's a much better donor source then most people think just for that reason. 90 year old men who are totally bald can still grow a long thick beard. Use that if you have it.

[mafpe]

i think everything is back to each people's own situation and culture.

for people who say they want it young and not going to care much when older, the situation is similar as to people having a shredded/jacked body before they are married and have children, and are fine with having a dad bod later on. they'd rather have jacked body still, true, but their priority in life has changed, and they aren't as vain as before since they don't need to be that attractive for a fighting chance in the fighting scene anymore.

you can argue that people would still look since divorce etc are common, but while preparing for the future is good, your enjoyment of life will be less meantime because you keep preparing for a worse future that might not come. i agree with preparing for future but if you don't live in the moment as well

you can ready yourself for the future, i wholeheartedly agree with it, which is why i barely moved my hairline forward instead of another 2cm like how most of my age have their hairline. most likely i'm going to end up as NW6 as the future, that's why i'm only using 3k grafts atm, so i can use the rest when my head bald some more, and i'd have kind of thin but even hair, instead of a shiny platform in the middle if i go greedy.

consider your options, what NW are you gonna be, how good of a candidate you are, are you using medication to prolong your time? do you have body hair to use? make a good plan, so you don't regret it later on the line.

of course you might regret it in the future, but isn't it the same that you might regret not biting the bullet in the past?
if you're to use a hair system, either now or later, that still means you're going to wear it for a period of time. if you are having a bald scalp for 5 years, that means if you want to cover it up, you'll be covering it up for that 5 years anyway, you either do it at your 30 or your 60, you still will need to cover it.

alot of people and doctors put 25 because they "trust" the patient to make enough educated and mature thinking, instead of just jumping on it by impulse, as people would say, younger guys are more 'impulsive' or 'brave', but they didn't think things through as much as an experienced older people would.

people do have different maturity and older isn't always more mature, but the doctor doesn't know if the patient is mature enough or not, so they either put hard limit on age / situation, and or discuss the risk etc with the patient first.

[Adier]

@Fox243I honestly feel if you have enough money , irrespective of your nationality you will be able to marry. Or may be try cracking a govt job. My uncle was a Norwood 3 when he got married at 35 so i dont think it's an issue. Also if you continue being on medications you can maintain whatever you have for a good period of time assuming you are NW3 or less. With proper styling it's easy to get away. I am a NW2 diffuser at 25 and up until perhaps January nobody commented on me getting bald that's all. 

[Adier]

@mafpe100% spot on.

[trynagetaHT]

I'm a NW5 I'd say, so I definitely can't hide it. I tried fin, minoxidil, LLLT, microneedling, and nizoral. Still lost significant ground over the years I took them (went from NW4 -> NW5 over 2 years). 

[Melvin- Admin]

11 minutes ago, mafpe said:

i think everything is back to each people's own situation and culture.

for people who say they want it young and not going to care much when older, the situation is similar as to people having a shredded/jacked body before they are married and have children, and are fine with having a dad bod later on. they'd rather have jacked body still, true, but their priority in life has changed, and they aren't as vain as before since they don't need to be that attractive for a fighting chance in the fighting scene anymore.

you can argue that people would still look since divorce etc are common, but while preparing for the future is good, your enjoyment of life will be less meantime because you keep preparing for a worse future that might not come. i agree with preparing for future but if you don't live in the moment as well

you can ready yourself for the future, i wholeheartedly agree with it, which is why i barely moved my hairline forward instead of another 2cm like how most of my age have their hairline. most likely i'm going to end up as NW6 as the future, that's why i'm only using 3k grafts atm, so i can use the rest when my head bald some more, and i'd have kind of thin but even hair, instead of a shiny platform in the middle if i go greedy.

consider your options, what NW are you gonna be, how good of a candidate you are, are you using medication to prolong your time? do you have body hair to use? make a good plan, so you don't regret it later on the line.

of course you might regret it in the future, but isn't it the same that you might regret not biting the bullet in the past?
if you're to use a hair system, either now or later, that still means you're going to wear it for a period of time. if you are having a bald scalp for 5 years, that means if you want to cover it up, you'll be covering it up for that 5 years anyway, you either do it at your 30 or your 60, you still will need to cover it.

alot of people and doctors put 25 because they "trust" the patient to make enough educated and mature thinking, instead of just jumping on it by impulse, as people would say, younger guys are more 'impulsive' or 'brave', but they didn't think things through as much as an experienced older people would.

people do have different maturity and older isn't always more mature, but the doctor doesn't know if the patient is mature enough or not, so they either put hard limit on age / situation, and or discuss the risk etc with the patient first.

I would say that meme is better suited for this:

”I’m not gonna care what I look like when I’m 40”

40 comes

”I won’t care what I look like when I’m 50”

50 comes “ I won’t care what I look like when I’m 60” 

It never stops. The analogy is also not true about being in good shape when you’re young and not caring once you’re older and married. Fitness is a lifestyle, not a phase. Take a look at @MazAB he’s almost 50, married with kids. He stays in amazing shape, and STILL cares about his hair! Nothing has changed, and will not change. 

This idea is very common amongst unmarried, younger men. They have this narrative that once they get married, they can just forget about looks and let themselves go completely. But I guarantee these are the same guys who will expect their wives to maintain their figure and looks. You can’t have your cake and eat it too. Marriage is work, and let’s face it, looks do matter! Married or not. 

The fact is that if you care about your hair at 20, you will care about your hair at 40,50,60 and so on. Life doesn’t stop at 30. Priorities change, yes, but if looks are important enough for you to consider getting surgery, looks are likely to always be on that list. There’s nothing more foolish than this YOLO mentality, especially with surgery.