Hair transplant to reduce forehead size?

[wavypaint]

My whole life my hairline has been extremely high up my forehead, making the upper third of my head look far out of proportion with the lower two thirds. It pretty much resembles the shape of a receding hairline which makes me look like a 50 year old if I have my hair up. This means I always have to style my hair in a way that covers my forehead. I’m getting pretty tired of it and now I am working full time I don’t really want to be in a position where I’m constantly worrying about my hair anymore. Having done some research, it appears there are two options, forehead reduction or hair transplant. However, since forehead reductions tend not to be appropriate for men, I am hoping a hair transplant could lower my hairline by about 1.5cm so that it balances my facial proportions better.

I am only 22 (soon turning 23) which I know is likely to be controversial in my decision, but having done much research and thought carefully about it, aside from my age I believe I am a good candidate for a transplant. I still have very thick hair all over including my donor area. I am a good respondent to finasteride, which I started taking at age 19 after feeling some minor thinning at my temples and didn’t want to take any chances. My hairline hasn’t changed since. I’ve uploaded some photos here to show my hairline currently (wet in photo), which is pretty much identical to the one I’ve had since I was a child. Obviously in my case, adding further medications such as minoxidil isn’t going to bring the hairline any further forward. I plan on taking finasteride indefinetly, and if my hairline were to eventually receed, I would move onto DUT to prevent further loss.

Based on my photos, how many grafts do you think would be required to provide sufficient density? I would want to match my current hair density as closely as possible whilst still being sensible as I obviously would want to keep grafts left over in case a future transplant was needed. Based on similar cases I’ve seen, is 2000-2500 grafts a good estimate?

The thing I’ve been struggling with the most is how to decide what clinic I should go with. Don’t think I can trust anywhere in Turkey to be reliable enough to consider. Also, I am based in the UK and It’s very difficult to determine what clinics are worthwhile here. Some of Dr Arshad’s results impressed me, but I have also found a number of cases where transplants from him have failed which makes me a bit apprehensive, and I am not really impressed by Dr Farjo. I am potentially open to the idea of travelling to Europe for one since I’ve seen good results from the clinics recommended on this forum, although the wait lists seem to be quite long. If I was hoping to get a transplant in late spring 2023 is it worth me enquiring now to get added to the waiting list? Even then how long could I expect to wait?

Also would any clinics outright reject me due to my age, or is it case dependent? Would the fact that my hair has been stabilised on finasteride be sufficient for them to consider me?

Would be grateful for any advice.

[NARMAK]

42 minutes ago, wavypaint said:

My whole life my hairline has been extremely high up my forehead, making the upper third of my head look far out of proportion with the lower two thirds. It pretty much resembles the shape of a receding hairline which makes me look like a 50 year old if I have my hair up. This means I always have to style my hair in a way that covers my forehead. I’m getting pretty tired of it and now I am working full time I don’t really want to be in a position where I’m constantly worrying about my hair anymore. Having done some research, it appears there are two options, forehead reduction or hair transplant. However, since forehead reductions tend not to be appropriate for men, I am hoping a hair transplant could lower my hairline by about 1.5cm so that it balances my facial proportions better.

I am only 22 (soon turning 23) which I know is likely to be controversial in my decision, but having done much research and thought carefully about it, aside from my age I believe I am a good candidate for a transplant. I still have very thick hair all over including my donor area. I am a good respondent to finasteride, which I started taking at age 19 after feeling some minor thinning at my temples and didn’t want to take any chances. My hairline hasn’t changed since. I’ve uploaded some photos here to show my hairline currently (wet in photo), which is pretty much identical to the one I’ve had since I was a child. Obviously in my case, adding further medications such as minoxidil isn’t going to bring the hairline any further forward. I plan on taking finasteride indefinetly, and if my hairline were to eventually receed, I would move onto DUT to prevent further loss.

Based on my photos, how many grafts do you think would be required to provide sufficient density? I would want to match my current hair density as closely as possible whilst still being sensible as I obviously would want to keep grafts left over in case a future transplant was needed. Based on similar cases I’ve seen, is 2000-2500 grafts a good estimate?

The thing I’ve been struggling with the most is how to decide what clinic I should go with. Don’t think I can trust anywhere in Turkey to be reliable enough to consider. Also, I am based in the UK and It’s very difficult to determine what clinics are worthwhile here. Some of Dr Arshad’s results impressed me, but I have also found a number of cases where transplants from him have failed which makes me a bit apprehensive, and I am not really impressed by Dr Farjo. I am potentially open to the idea of travelling to Europe for one since I’ve seen good results from the clinics recommended on this forum, although the wait lists seem to be quite long. If I was hoping to get a transplant in late spring 2023 is it worth me enquiring now to get added to the waiting list? Even then how long could I expect to wait?

Also would any clinics outright reject me due to my age, or is it case dependent? Would the fact that my hair has been stabilised on finasteride be sufficient for them to consider me?

Would be grateful for any advice.

Having a higher hairline placement naturally can make you feel self conscious and i completely get that, but you're still only 22 and it's hard to see from wet hair pictures how things stand and whether there's going to be further hair loss, even with Finasteride but you smartly identified that it could help you stop or slow further loss. 

In your situation, i would personally stay on the Finasteride and start saving up for a great clinic and doctor for when you turn 25. This is the age the majority of places are willing to consider you and if you can show photos and evidence you haven't lost ground whilst on Finasteride, they'll be open to lowering your hairline enough. 

I have to warn you though. Hairline lowering with a hair transplant carries with it the risk of losing hair behind and playing a game of catch up and losing if your hair loss is aggressive and you run out of grafts for full coverage. 

Do yourself a favour, get like an eyebrow liner pen and scrunch your forehead muscles, draw the hairline design you want and take pictures. You can also maybe try scrunching your forehead and doing it on the editing freehand but up to you. 

Personally i think to get a full and proper density, you will be looking at approximately 2-2.5k grafts to lower it down to where i have a strong suspicion you probably want to end up at. 

[WhereIsMyMind]

well, being 23yo and lowering your real hairline is the textbook definition of DON'T DO IT in these forums im afraid.

your natural hairline will start maturing like any human, and this new hairline will be behind your new transplanted hairline, and you will need to fill in the gaps

all in all, its very risky business, you should consider it when older.

Another choice is to literally lower your forehead with surgery, without wasting grafts (forehead reduction surgery)

Im not 100% against surgery though but I would definetely go on the safest side... something like 1500-1800 grafts just to lift your hairline self-esteem and get in touch with how HTs work, without sacrificing too much donor for future, could be fine. Just buying a bit more time until you are in your 30s and you are 100% sure of your hairloss status. I think like a full blown proper hairline transplant (2.5k+ graft) is def a mistake.

 

Just imagine this scenario (which would be my scenario if I did what you want to do): 

You are 31 years old. Your whole crown and top is suddenly thinning, when it never did (only temple recession until now). You need at least 3.5k frontal grafts and 3.5k crown grafts to have good decent coverage... but... turns out you decided to lower your hairline below at 23yo and now its impossible!

This is an example of someone who had early transplants and how he ended up looking years later after his whole head thinned down (forget about the fibers magic part 😁)

 

Edited December 10, 2022 by WhereIsMyMind

[NikosHair]

You need to carefully consider the direction of travel with your hair loss.

Is there any high Norwood balding in the fam?

 

[Al - Moderator]

You have a very high hairline. I think lowering it slightly would be OK. Don't lower it too much. You want to lower it just enough to make a small improvement to make yourself feel better about it. You need to make sure that if you start heading towards NW 6 later, your hairline will be high enough to work with to be able to cover the rest of your head with your remaining donor.

 

[Berba11]

These photos aren't the best. Would be more useful to see a frontal shot that doesn't cover the distances between your chin and nose, upper lip/nose and glabella, and of course glabella to hairline. That way we can see how much higher or out of proportion your top third is compared to the other thirds. I don't think anyone here should be telling you that your hairline is high without actually seeing in within the context of the 'rule' of thirds. I doubt your hairline is too much out of whack when viewed in context and I'd be very reluctant to advocate surgery if you haven't actually lost any hair at your age (I know you're on finasteride).

[Dillpickle123]

Don’t think many clinics will reject you if during the consult they see no signs of further thinning I’m 23 and did mine but luckily the surrounding hair, crown and midscalp had no thinning under microscopic analysis, also it would take a lot of grafts for your maybe even half your donor there’s a recent case here where a guy did 3k grafts to lower his naturally high hairline and it turned out great but he wasn’t suffering from MPB 

[Gatsby]

It's difficult going by the photos that you have provided @wavypaint. Are you able to upload some with pictures of the back donor area, etc? I strongly recommend that you forget about a forehead reduction as it will leave you with a scar from one temple to another and if you bald like I did you will look like a flood tide marker. The question is your age, will you continue to recede and will finasteride hold out over the lifespan? I too had a high forehead and I hated it in my late teens but the best thing I could have done in hindsight was to have done nothing. If you have a hairline constructed lower you will want temple points built to match it to a degree. Now if you lose ground in your years ahead you will be chasing that new hairline and it will be like trying to hold a tiger by the tail. I strongly suggest that you speak with a dermatologist and ethical surgeons recommended here on the forum to examine you hair. Unfortunately at 22/23 now is not a good predictive time. However it's great to hear that you are a responder to finasteride. All the best!

[Doron Harati]

@wavypaint, 23 years old is way too early for HT procedure, DO NOT do a procedure right now, at this point you can take your time to do a detailed research.

Most paitents we don't reccomend them to lower their original hairline, however we do some exceptions by lowering only around 1cm.

Edited December 11, 2022 by Doron Harati

[A Fue Good Men]

22 years old and you’ve already seen miniaturization at the temples? You need to seriously reassess the situation. I doubt any ethical surgeon will take you on for hairline lowering to any significant degree.