Author: Dr. William Rassman

I have a few questions about getting a hair transplant as a 26 year old. Before I get the “just go bald” comments, I’m not gonna do that, so save your breathe. Call me vain or whatever.

Anyway, I’m currently on finasteride, but I started after my temples had already receded and my hairline is just….a mess. I really, really want to get a transplant on my temples/hairline right now, while my looks actually matter to me. I know waiting till I’m in my 30’s makes more sense, since the balding will likely have completed by then and I can repair it all at once, but my looks are important to me now more than ever. It really hurts my self-esteem…

I guess what I’m wondering is, will it be okay to get a transplant on my hairline now and then just get another one when I’m older/in my 30’s to fix the rest once the balding has completed? The finasteride should keep the rest from falling out until then, right? (It’s been working for me thus far)

By this age, you can transplant the frontal hairline. What you need is a Personalized Master Plan for this process. I would do a HAIRCHECK test (https://baldingblog.com/haircheck-test-how-it-is-done-video/ ) to determine your present balding pattern and try to predict your future hair loss pattern. Then I would quantify your donor supply to know just how many grafts you have in your lifetime so that good planning can start now. With this information, you can be intelligent about how many grafts that doctor is going to use up now, and how many grafts your doctor will leave behind. There is an interesting problem that most men don’t recognize. Too many doctors push graft numbers high because they charge by the graft so they profit from more grafts at the time of the surgery. I have seen many patients that had twice the number expended for a frontal hairline and then down the road they might run out of hair. Get a doctor who understands this process and cares more about his/her patient than their pocketbooks. If you stay on finastetride, you will prevent shock loss and hold on to your native hair.

I am 25 years old suffering from hair loss . I had a FUE Hair transplantation of 2000 grafts for the hair line but the results was not full and I believe now that I need more hair in the top and the vertex area. Can I do another hair transplant?

Your surgeon should have made a Master Plan for you knowing your donor density so that your surgeon could then know if your donor density is adequate to support a second hair transplant. Sometimes a strip surgery may be better for the second hair transplant if the donor density appears to be thin from the first surgery?

At 10 weeks, many of the grafts will have shed. This may give the appearance of gaps that may not be real. Wait until the 8th mont. By then, you will see 80% of the growth and know if the gaps are real or not.

It is now three months since my hair transplant was done. Should I have expected growth by now?

I tell my patients that you can expect the growth to start usually between months 3-5 and then grow to styling length in 8 months with 80% of the growth out by then

At 17, I was norwood 0 with a perfect hairline, however by the time I hit 22, I was around norwood 6/7 – around the age of 21 I started to razor shave my head and have done since (I’m nearly 26 now). Now I’m wondering whether my hairloss is considered aggressive and extreme or ‘normal’?

For many young men who inherited advanced balding (Class 7 pattern) find that they get there by the age of 26. That seems like you.

Great change in the hairline in this man.

This young man (Joe) believed that he was starting the balding process that his dad had (a Class 7 pattern of balding). His father was with him today and he told me that he started balding when he was in his very late 30s. That was unusual for a man with a Class 7 pattern of balding (just a rim of hair around the head) as most men achieved that pattern in their 20s. Joe had early recession in the corners of his hairline.

This is what I told him and what I did: “You were concerned about the balding in the family with your father developing his advanced balding pattern in his late 30s (unusual). We performed bulk measurements on your hair today and much to my surprise, the balding you are experiencing is very mild and early with less than 9% hair loss behind the frontal hairline and in the top of your head. At the age of 24, you might be able to hold on to your hair for years if you use the drug finasteride. We discussed the potential side effects of this drug and I told you to call me if you should develop any of these.”

This shows the value of the HAIRCHECK test for hair bulk measurements. Although he thought that shaving his head was a good option and receiving Scalp Micropigmentation rather than face his fading hairline every year, month by month, I felt that he had a good chance to keep his hair and postpone any more thinking about his balding. This is very important for any young man. At his age, thinking too much about his hair replaces the real important things in life. Hair may not be important for him to worry about for years to come.

What I would want to know is your hair character, its thickness and your donor density, all three are determined at an examination. Once I have that, I can determine what it would take to perform a hair transplant in terms of using up your donor supply which is limited. Your pattern of hair loss is a ‘high’ Class 6 pattern which means to me that the sides may come down as you age. It would be all part of my Master Plan to be able to work with you for the years to come as hair loss is progressive and you might not have yet seen where your hair loss will take you. i tell most men that they should not do a hair transplant until they are at least 25 years old and clearly you are older than that so that your present hair loss pattern is now evident? The key here is to set realiztic expectations with your surgeon.

No one ever gets back their normal density. The question that should be answered is did you meet the expectations that you are your doctor set at the time of the surgery?. . Maybe your hair was fine or that the number of grafts were insufficient or you had less than good growth. In any event, you must o back and meet with your surgeon if you are unhappy