Author: Dr. William Rassman

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

You could do Scalp Micropigmentation (see here: https://scalpmicropigmentation.com/thinning-hair-gallery/) or a hair transplant like I did for my hair.

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.

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.

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 26 and I lost a lot of hair giving me a huge forehead. How many grafts will this take?

First, what I need is a frontal picture with your hair pulled back and your eyebrows lifted high so that your forehead creases. That shows me the anatomic point that allows me to determine the proper place of the hair line. Once I know this, I can give you a recommendation on the number of grafts you would need for a hair transplant. Keep in mind that fine hair takes more grafts than coarse hair. In addition to the picture, I would want to know the thickness of the hair in the back of your head.

If the finasteride has not solved the problem by this time in your crown and you have some hair present you have three options.
1- Do nothing and live with it
2- Get a hair transplant which may solve the problem as that is what I did. My bald crown is now full looking
3- Get Scalp Micropigmentation which will make your thin crown look full as shown in this website photo below (click image to enlarge)

You need to sit down with a good doctor and get an examination that might predict your hair loss pattern. If that can be predicted (I often do this with the HAIRCHECK test), then your course after a single hair transplant might be anticipated. There is never certainty as I use the tools I have to give people the best assessment of their course over time. At our Monthly Open House events we have patients who had one or two hair transplant sessions and did not need anything after. If you come to one of these events, you can meet these patients one-on-one. The older you are when you start, the more predictable the risks, but if you wait, then you will learn to live with balding while you are younger, something most men who see me don’t want to do.

Considering a hair transplant but thinking about long-term commitments post-op from tressless

Yes, at age 27 with a Class 3A pattern of balding, you are an excellent candidate for a hair transplant. I would think that it would take about 2000+ grafts (less if it your hair is coarse, more if it was fine hair).

At your age, you might find that you could lose some of your existing native hair following the transplant. From the pictures, I see a low crown balding area which suggests that you might develop an advanced balding pattern in the long term. The use of the drug finasteride reduces this risk, but balding in men is progressive. Ask your doctor where your balding pattern might end up. Find out what your donor density is, so that some calculations of your reserve donor hair can be made now, before you start your transplants. Keep the hair transplants to the frontal area only, because if it goes into the crown, then you will be caught in a conundrum with patches of hair transplants in the front and in the crown will leaving you not normal looking. These steps will be the best approach to minimizing the risk of getting into multiple hair transplant surgeries as you lose more hair, which you should expect to happen. Your goal should be that just a single surgery will stand on its own and that is why I am suggesting that you only transplant the frontal area at this time.

Is it worth getting a HT? from tressless