Hair Loss, Young Men, Desperation, Finances, & Ethical HT

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This podcast was stimulated because this morning I had a patient that wanted to have a consultation with me because he has saved up his money for a hair transplant. He’s bothered by the crown, and he doesn’t want to do something where he has to pay for ongoing medical therapy. The problem with this, he’s a young gentleman in his twenties and he thinks that a hair transplant will cure all of his problems and he will just need it once and he’s done, and then he doesn’t need medical therapy. And I think this podcast is really focused, particularly on the young gentlemen who don’t quite understand all of this. Haven’t necessarily watched all my thousands of videos on this subject, but I think it’s important for them to understand a few important things. So the first thing is that medical therapy is the most important thing, because if they let’s say they do a transplant in the crown and that crown expands twice the size, which it obviously will, it will progress. 


And it will progress the point where potentially they won’t have enough hairs to compensate for that hair loss. So they said, well, you know, I only saved up for this hair transplant. I don’t have enough money for medical therapy. Well, it should be the exact opposite because after you’ve done the transplant, guess what’s going to happen in two years. If you’re not on medical therapy that crown’s gonna open up and then you’re gonna need a lot more transplants in the crown, and you probably don’t have enough hairs to cover it. Especially if you do FUE. FUE in an expanding crown, it not only violates how much hair that you need over time, but you also start encroaching on the same donor area where you’re going beyond, which is saved. Now, what is defined safe, our hairs that are genetically programmed for loss. 


So if you start pulling FUE grafts closer to the fringe of the current crown and that crown expands, those grafts disappear and you have exposed scar. So there’s so many issues. And so the biggest issue is not even just a progression. It’s a fact that, that you will run out of grafts. There’s no way if you start doing a medium-sized crown on a young gentleman in his twenties, that that crown doesn’t expand and you don’t have enough grafts to cover it by 10 years. So that person is now who says, Hey, I don’t have enough money to spend for hair loss medications. Now, as a crown three times, the size they’re spending 10 times more, the transplants cost tens of thousands of dollars. They need multiple transplants. So now they’re into the 50 to a hundred thousand dollar range. Whereas medical therapies are fraction of that cost and they don’t even have enough grafts to cover them.

So what they don’t see in the future is that that hair loss is going to progress in the crown. Why is the crown a dangerous area to transplant in many 20 year olds? I’ll give you a simple formula, PI R squared. I talk about this in other podcasts. I encourage you to listen to it, but the radius is of a circle. If you double it, it requires two square, which is four, 4 times the graft coverage. It’s incredibly hard to cover the crown. So there’s near-sightedness of not thinking about what that crown is going to look like in 10 years, look like that in five years, maybe in two years. And let’s say I transplant that crown looks pretty darn good for a year or two, and then it expands. You’re getting another transplant. I I’m going to run out of hairs. 


And you’re eventually going to have a weird looking circle of hair on the back of your head with a step off around it. The real problem is a vast majority of surgeons out there are not skilled to do hair. Don’t understand the long-term issues and are unethical. And that will just sell you a transplant because they want to make a dollar. I just saw a patient that from, I believe a reputable colleague of mine in Houston that was sold an FUE-FUT combination. And at a safe age, I think he was in his forties or late thirties, but his entire donor area was completely just destroyed. I mean, whether he actually has what’s called a Dupa or diffuse on pattern loss, where he has so much loss, that he should never have had a transplant to begin with or if that’s over-harvesting either case he should never had a transplant or should not have another transplant. 


And he was told that to come back and get another FUE. I don’t even understand how he can do that. There’s no hair back there. He’s going to have a completely scarred up and open backside. So this is the problem is that right now people asking for transplant will be offered the transplant because they’re meeting with salespeople to sell them a transplant because they don’t care what they look like in two to five years. They don’t care if that transplant is going to cost them 50 to a hundred thousand over the next five to 10 years, they don’t care if they don’t have enough hairs to fix their problem, because they’re going to be done and gone. And so this is the issue of understanding safety. And young people watch my YouTube video that I shot many years ago on this. And my passion is to help these young individuals that are getting ridiculous transplants. 


I saw another gentleman just last week that had a irregular hairline. That was way too wide. It was done by someone that didn’t know how to design a hair transplant. And he had to shave all of it off. And the hairline was too low asymmetric, not just mildly asymmetric, grossly tilted and extending way passes lateral canvas, which is the outer part of his eyes. So this hairline just looked absolutely insane. And it’s very hard to fix that. You know, how do you fix that? It’s not easy. Sometimes it’s not fixable. You have to use tattooing scout, micro-pigmentation various other methods to improve it. So my biggest thing is really educating especially the young men about safety. It is not just a monetary thing today that you saved up enough for the transplant. I’m talking about long-term issues that really become problematic, where you can’t even begin to conceptualize it. You don’t have enough hair to cover this. And medical therapy really is the cornerstone. It’s so important to understand that.