Hair Transplant Blogger Hair transplant and hair loss answers from Hasson & Wong

When Is the Right Time for Hair Transplant Surgery?Posted by admin (on behalf of the doctor) on July 9th, 2009

I’m a 26 year old male who just recently realized I was thinning on the top of my head. It’s only slightly noticeable in the front at the moment, but I can tell that some of the hair on the top is thinner than the rest of the hair on the sides and back of my head. I was wondering when was the right time to consider hair transplantation? Some have said that the right time to consider it is when the hair loss is unacceptable to each individual person. My hairline is relatively in the same place it was when I was 18, but I’ve noticed the corners have went up probably like an inch or so, and the front has started to thin. I’ve noticed I can’t style my hair the way I’ve been styling my hair for the past 8 years or so. Would it be too early for someone such as myself to consider a transplant? I’ve been taking Propecia for about three months, but I also know that Propecia is not proven to work too well on the hairline, and this is where the hair loss has really been bothering me. Also, it seems that the hair on the front of my head grows extremely slow, or possibly not at all. Thanks so much for your time. You guys do great work.
— Anon

Thanks for the question. The right time for a hair transplant is dependent on many factors, including the individual need and the doctor’s medical opinion and experience. First, how old is the prospective patient? If the patient is quite young, 20 for example, and has relatively little loss or a slight amount of recession at the corners, most doctors would agree that prescribing a medication (such as Propecia) to halt hair loss, then waiting to see what the effects are is the best approach. We all worry about our appearances, but many young men, after noticing a normal recession (natural as we transition from adolescence to adulthood), tend to panic and begin obsessing about their appearance — sometimes to the point of counting errant hairs left on the pillow after awakening each morning. Some temple recession and frontal hairline recession is normal for males as they mature and does not necessarily indicate male pattern hair loss. Some experience this recession earlier and will not recede further. I’m not suggesting that this is your circumstance, but it is worth pointing out. I tend to advise young men such as these to take a medication and wait and see. Hair loss is progressive, and many young men have unrealistic expectations about hair transplant surgery. Many with normal recession, want their hairline restored to that which they had at age 18. This, of course, would not look right on mature men and would not be prudent. They don’t understand that hair transplant doctors have to safeguard against future loss, in essence, plan for it so as to leave enough donor hair for the possibility of future surgery. If there is no need for future surgery…great but if there is a need then there is something left for the doctor to work with. Better safe than sorry.

Ultimately when we are dealing with patients such as yourself that have strong remnants of your original hairline we need to place the new hairline at a height that may be higher than what you are used to. This is because your original hairline will continue to recede and the new hairline we create will be in a better position to represent what is typical for an adult male. If we were to place the new grafts into your existing 18 year old hairline remnants then the graft count necessary for a natural appearance would be in essence a case of robbing Peter to pay Paul in that there would not be enough grafts to address possible aggressive future loss. Again, and to reiterate, this may not necessarily be the case for you but is a general guideline for cases such as you have described.

Without the benefit of photos, it does sounds like recession and thinning has begun for you, but it is hard to say how far it may progress. If you have a history of hair loss in your family you may guess at the future state of your hair. You are an adult, and seem to have been doing research. You don’t seem to be apt to make a decision hastily in a state of panic as some younger men may, thus you are reading about hair transplants and posting to find an opinion. This is a good sign. The best thing you can do is submit your photos and receive a hair loss consultation. Your photos will reveal much about the current state of your hair loss.

— Victor Hasson, MD

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