Hair Transplant and Young Men: Safety First

Male hair transplant procedures for young men is perhaps one of the most important if not the most important article I will be writing in this blog series, especially considering the preponderance of young men who are on the Internet searching for solutions for their hair loss. With my YouTube channel, I have personally encountered the same question asked over and over again, which I have responded to in a video format (see; Hair transplant for young men video) but thought that this written article would help to close the gap for those who may not have seen my video. The question posed is simply, “Can I have a hair transplant?” asked by a 19-year-old man. The answer is most likely, “No”, from me but I want to explain why. Unfortunately, many physicians will operate on a very young man either out of greed or lack of knowledge. This article will help to empower the consumer by increasing their understanding of this sensitive topic and what thought processes go through my head when I undertake an aesthetic consultation for hair transplant for a younger gentleman.

What constitutes too young for a hair transplant?

That is a hard one that has no fixed answer. It involves a combination of many factors: degree of baldness, family history, rate of hair loss, donor density, donor hair caliber, curl, and color, age of the patient, when hair loss began, etc. So many factors enter into a decision on the part of an experienced and ethical hair transplant surgeon when deciding on the candidacy of a young man for hair restoration. Despite not being able to give a hard and fast rule here, I would venture to proffer that someone under 30 has some real risk of undertaking a hair transplant procedure and someone under 25 has exponentially greater risk.

What then is the risk? It is not risky to undertake the procedure. It is risky in terms of how that transplant may age over time for a given individual. Let’s explore this point more in-depth. When a young man of say 22 years of age is beginning to experience hair loss, there is a good chance that significant more hair loss will occur over his lifetime just given the life expectancy for him and the progressive nature of hair loss. That being said, hair is harvested from a dwindling pool of usable donor hair into an increasing expanse of baldness. Put another way, I am using up finite paint to paint a canvas that is ever expanding. Accordingly, a hair-transplant procedure into a very young man carries several risks, the biggest one is “Will I have enough donor hair to cover the ongoing hair loss over time so that the result will still look aesthetically pleasing and also natural?”

What compounds this problem is that many young men want a hairline to match that of their peers, i.e., very low and straight with no fronto-temporal recession. This type of hairline may look good on a 22-year-old but how would that hairline look in someone who has now matured to 50 years of age? Now consider that that hairline no longer looks natural for another reason: there is so much hair loss behind the original hairline that the pattern of hair loss does not resemble one that occurs in nature. Can you think of anyone with a low straight hairline but with significant crown and midscalp baldness? The answer is no because it does not exist in nature and may look unnatural to the casual observer even though there is no reason that the onlooker can articulate as to why.

A point of clarification the degree of baldness in general is not the problem. It is the associated age of a person with that level of baldness due to future baldness that may occur. As contrast, a 40-year-old gentleman with extensive baldness but with excellent donor hair is a much safer candidate; and with good donor density I can cover a tremendous degree of baldness and feel more comfortable about future hair loss. In summary the older you are and the less hair loss you have the safer you are; the younger you are and the greater the extent of baldness you have may put you at a higher risk profile owing to the need for further sessions and the risk that I will run out of usable donor hair to cover my tracks. In general, I say 35 years of age is a good cut off point for when my feeling of safety increases exponentially. Early 30s I am ok with so long as the person fits the right criteria. Someone in his late 20s I am particularly cautious about and may wait sometime before I decide to operate on him. Someone in his early 20s is a very big red flag and I have only operated on a handful of them with a lot of factors weighed together before I decide to perform their surgery.

If surgery is then not a great option for someone in his early 20s then are there any solutions for their hair loss? Medical solutions for hair loss like finasteride (marketed as Propecia) and minoxidil (marketed as Rogaine) are very important, potent medications that can slow down (but not entirely stop) and even somewhat reverse some of the hair loss but they should be started as soon as you can. Interestingly, even though an older gentleman can be a better candidate for hair restoration, he may not be as good a candidate for medical treatments because his hair loss may be more advanced. These medical solutions truly work the best in someone with early stages of hair loss because they act to slow down the hair loss but cannot regrow a head that has advanced baldness. When the scalp has even lost its remaining peach fuzz of residual hair and becomes “slick bald”, these medications offer almost no advantage. Therefore, starting these medical treatments as early as possible can yield the greatest advantages. However, the one big negative of these medications is that once one decides to stop taking them you will lose all the hair you preserved or regrew during the time you were on them. I still recommend using these medications during an important period of social adaptation that a young man goes through in his twenties. This article is too short to cover the risks, benefits, and limitations of medical options. Other articles that I have written do a decent job of that and so does my Web site (hairtx.com) but I will explore these medications more in-depth in future standalone articles.

Finally, an answer that may not be great but at least was unavailable twenty years ago as a style option is to shave one’s head. If I believe that I would perform either unsafe hair transplantation for an individual or leave them still with a very large bald area, I usually recommend shaving the head as an option for a man under 40 years of age. Many men in their 50s are comfortable and desirous of keeping a fringe of hair in the back and for them I offer both the shaving option and to restore the hair in a more limited fashion. However, for young men in whom I cannot attain an adequate hair transplant result I oftentimes suggest shaving their head rather than giving them a suboptimal transplant result.

Although this article is clearly just a brief introduction to the complexity of judgment that goes into deciding on how, why and when to perform a hair transplant on a young man, it hopefully will at least help prevent men in their early 20s to seek out anyone to put hair grafts on top and live to regret that mistake 10 to 20 years later—a problem that I have had to work to fix on many of my colleagues’ work from eons past.

Please visit the following links t0 learn more about male hair transplant, male pattern baldness, or to view male hair transplant videos and hair transplant before and after photos, or call 972-312-8105 to schedule a consultation.