There is much debate about hair transplants in men under 25 but I think it is an important topic. I have hair loss and I am 24; are there programs your clinic provides to help #1 prevent further loss, and #2 create a plan for multiple transplants with respect to our donor areas. — C. Y.

As a general rule, we like to wait until a patient is 24 years old to perform surgery. This applies to patients with typical male pattern baldness. Every individual situation can differ. When a clear pattern of loss has developed at an earlier stage and it is easy to predict the final hair loss pattern, exceptions can be made.

In most case involving young patients with male pattern loss, a careful approach to the surgery with a conservative hairline is usually the best option. Other types of loss due to traction or an accident can also determine if a patient can have surgery before the age of 24. Preventing further hair loss for a young patients is often the number 1 priority. Your use of Propecia is a general recommendation to most patients with hair loss.

Creating a plan for surgery for young patients is basically the same for any patient. We access the donor area and final hair loss pattern to determine what can be accomplished to provide the best cosmetic result for now while taking into account this result must stand the test of time and will look good many years down the road. When using Propecia combined with our technology and skill, often times one surgery may be enough. Many patients today have 1 or 2 surgeries as opposed to several in years past.

If you have other questions or would like a free hair transplant consultation, please submit a hair loss consultation form.

Jerry Wong, MD

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I am turning 20 in a couple of months and have been experiencing hair loss for a year now. My temples are slowly receding and my hair is becoming flimsy and thin. My hair loss is at a point where it is only really noticeable to myself and I comb my hair in a way that hides it. I have hair loss on both sides of my family with the most extreme form being type Va. What can I do at this point to help my deal with the hair loss? I will need a transplant one day, but right now I still have hair on my head, although I can tell its thinning and I will eventually lose it. Is there any way that you can predict a patients hairless while they still have enough hair not to be considered bald? I don’t want to wait until I am completely bald to fix my hair. — M.S.

Thanks for the question, M.S. It is difficult to predict the eventual state of your hair loss. You may follow the pattern that other family members experienced but it isn’t necessarily the case. The best course of action at your age is to see a doctor about a prescription of finasteride. Finasteride (Propecia, Proscar) slows or stops thinning in the mid-scalp and crown and may also promote some regrowth in those areas. It is only occasionally effective for slowing hair loss in the hairline. After taking the medication for a couple of years, a hair transplant doctor will be in a better position to know whether surgery is a good option for you. For now, you’ll have to wait and see.

— Victor Hasson, MD.

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I had a question regarding one of the patients in your photo gallery. In number 37, the patient had 1,200 grafts to the crown only. How old was that patient? I am experiencing hair loss similar to him (i.e., my hair loss is limited to the crown so far). I am 27 years old and have been on Propecia for 1 year. I also use Rogaine. I think I have maintained over the past year, but would like more density.

I understand everyone is different (with respect to density, laxity, etc.), but generally speaking, would it be reasonable for someone my age to have a hair transplant in the crown? I have read, in the past, that most doctors will not transplant the crown first in men under 30.

By way of background, my father (54) has significant hair loss in the crown, but maintained his hairline. Also, I have an older brother (29) that is experiencing hair loss in the crown only. However, I do have uncles (on both sides) with varying degrees of hair loss in different patterns.

If you think it would be reasonable for someone my age with my family history to have a transplant in the crown, I will likely submit the necessary information for an online consultation. — B.A.

Thanks for your question. Patient number 37 was in his early 30′s at the time of surgery. Whether it is advisable to have surgery in the crown in your cases depends on a few factors, some of which you have touched on:

1. You have sufficient donor reserves should you eventually need transplants to the frontal zone. This on its own would be enough to justify crown work.
2. You are taking Propecia. This would be advisable but it alone would not justify working in the crown.
3. You likely are following in the hair loss pattern of your father and older brother. This would be a plus and if the situation was borderline, it may be enough to make a case for reconstructing the crown.

It is a reasonable assumption in your case that a transplant in the crown would be safe based on your information. In the end, it comes down to the donor area. The better the quality and supply, the more options. If you would like to send photos, submit a hair loss consultation form. Please follow our photo guidelines before submitting the form. The photos and detailed history should provide us enough information to determine if you are a good candidate for crown reconstruction.

— Victor Hasson, MD

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