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Is 25 too young for a hair transplant?

So I can currently see some of my scalp and gave receding hairline at the temples. Is it too early to try transplantation? I’m thinking Rogaine alone should be enough to get more volume in the scalp but it only seems like it will buy time until you need surgery I also heard that you can still do FUE transplants after FUT, but can’t do FUT once an FUE has been done

If your pattern is clear and you have a doctor who can build a Master Plan for your balding future, 25 is a minimum age to do a hair transplant as long as you know what is going to happen to you. A good doctor will help you with that process. Here is a good example of what you don’t want to happen: https://baldingblog.com/had-a-hair-transplant-at-21-now-at-22-he-has-more-hair-loss/


2021-02-04 07:29:20Is 25 too young for a hair transplant?

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Is DHT Essential For Genital Function?

Is DHT essential for proper genital tissue structure/function?

(more detailed: could lack of DHT lead to decreased AR expression in penile tissues & nitric oxide production… leading to tissue changes, ie fibrosis/collagen deposition which cause such shortening/lack of bloodflow?)

I know there is relevant posts to this issue where you dismissed finasteride in relation to a change in penis + testicle size but i thought it was important to bring forward my case to show that there is definately some relation with finasteride and penis size *in a flacid state*, aswell as testicle size. I am a 20 and a half yr old male who has been on propecia since about 19.

id like to point out im not saying that my penis has actually reduced in physical size due to finasteride, but in its flacid state it now resides alot different to how it use to – doesnt hang as much, looks like ive come out of a cold shower – which in turn gives the apperance of a smaller penis.

what ive experienced:
– testicle/scrotum shrinkage. they are no longer hanging as low as they use to, they are now tight and pulled very close to the body. scrotum could almost be described as empty and wrinkly
– reduction of how penis resides in flacid state. In the flacid state my penis is ALOT smaller then usual. penis doesnt “hang” nice and soft and move around loosely as it once did when to flacid. penis is now retreated /retracted as if in cold water, its almost withdrawn and seems it is lacking circulation/blood flow. penis once hung lower than the bottom of my testicles but is now actually pushed up and forward by how tight the testicles now are, and how reduced the size of flacid state is.

i found another person who experienced similar side effects to me. he stated he experienced:
– penile/scrotum shrinkage, loss of length/girth
– loss of morning/spontaneous/nocturnal erections
– empty/wrinkly scrotum
– penis constantly retreating as if in a cold pool
– loss of sensation/numbness to both penis shaft and scrotum, both feel lifeless/not pleasureable
– penile tissue changes: narrowing, curvature, darkening, emergence of numerous varicose veins along shaft

now i have not experienced the severity of his symptons, or his loss of size during erections, but it is quite alarming there are others out there who have experienced this issue and there isnt any warnings out there regarding this alarming side effect

after reading through several links below, one must question – is it possible that lack of DHT leads to decreased AR expression in penile tissues & nitric oxide production… leading to tissue changes, ie fibrosis/collagen deposition which cause such shortening/lack of bloodflow???

the links:
https://finasteride.jconserv.net/viewtopic.php?t=146
https://www.asiaandro.com/1008-682X/5/33.htm
https://finasteride.jconserv.net/viewtopic.php?t=346

thanks for any input you can share on this topic!

DHT is very important in the first trimester of pregnancy when the testicles and penis form. If DHT is not present (mother on finasteride or born with a defect where the fetus does not make DHT), then a hermaphrodite will probably develop. For more on hermaphrodites, see:

It is true that being exposed to DHT blockers before puberty can negatively affect the development of the male external genital system and other secondary male sex characteristics (beard and body hair even after puberty). DHT is essential for development and growth of the male genital system before they are completely mature and reach their final size. Our current understanding is that the use of finasteride after puberty when the amount of testosterone is very high with corresponding high DHT levels, should not impact these secondary sex characteristics and will still allow the penis and testicles to reach their maximum size. There is not much information on the use of this drug in young teenagers and I suspect that prior to the age of 16 when balding may start in a select number of boys, the decision to use finasteride is easier the further into the teens the person is.

You have referred to a study done on 3 groups of young rats. This study has shown that a lack of either testosterone or DHT can affect the growth and development of the external genital system negatively.

In the studies done on humans, there was no report of similar or any other negative changes on the external genitalia in adult men or boys in their late teens. I have been recommending and prescribing Propecia to a good portion of my patients, and as of yet have not heard any such complaints with regard to impact on penis size once the penis has grown to its final adult size. You have to remember that this medication has passed all clinical phases and was proven effective and safe for treatment of male pattern baldness (in adult males). If you are still concerned with the changes in your genitalia, you can see a urologist to make sure you don’t have any other medical problems that have been causing this issue.

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4 years on finasteride (photo)

The picture is worth 1000 words so that there is little I can say other than compliment this man for staying the line. Whatever you do, just don’t stop the finasteride as you will lose it and go back at least to where you were when you started.


2020-05-31 13:20:314 years on finasteride (photo)

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Is FUE Worth Doing?

If you are considering putting hair back where you lost it by having a hair transplant, the big decision is to take the step of finding a caring, competent doctor working with an experienced team, followed by scheduling a hair transplant. For most men, scheduling a hair transplant is the greatest step, in other words, to fix a problem with a surgical solution.

Fortunately, the hair transplant procedure has been made absolutely undetectable today, contrary to the 1990s, when everyone could see a hair transplanted patient and know it was not normal. Today, normalcy is the rule in the hands of an excellent hair transplant surgeon who has developed an excellent surgical team that has been fine-tuned over many years.

Most cosmetic surgeries only require the skills of a single surgeon, but all hair transplant surgeries require the skills of a great surgeon who built a great team to work with. A great surgeon with a poor team will produce poor results. A bad surgeon with a great team will also produce poor results. Why am I saying this when everyone thinks that the surgeon is the key to a good hair transplant? It is because a good hair transplant requires a skilled surgical team that understands quality control systems, similar to great manufacturing operations. When the team produces 2,000 grafts, it is a team effort that works under strict quality systems rules.

Once you take the plunge in deciding if you should go for a hair transplant, the next step is to find the best doctor with the best team that knows how to work together. Then, you need to decide if you should want a strip surgery (FUT) or FUE.

The FUT procedure (Follicular Unit Transplant) harvests a batch of hair by cutting a strip from the back of the head. The strip of hair is then dissected into their natural family groups with a large team of technicians working with high powered microscopes. Both I and my wife and daughter-in-law had strip surgeries, and we have undetectable scars.

On the other hand, the FUE procedure (Follicular Unit Excision) is a hair transplant procedure that harvests the hair follicles in singular hair groupings. FUE is a great procedure that I pioneered. But contrary to most young men’s belief that FUE is better than a strip procedure (FUT) because it does not scar, this is not the case. Many doctors would like you to believe that FUE is a scarless surgery, but take a look at the type of scars a large FUE session can create. Scars are a complication when FUE is performed on a person with low donor density and is unable to support a large number of FUE grafts. Many patients found out the hard way by getting 3,000-6,000 FUE grafts without having an assessment of their donor density performed prior to their surgery. As a result, over-harvesting has become far more common than you might expect. I love doing FUE and half of all of the surgeries we do today are FUE hair transplants, but for those of you who are reading this post, please note that anything done well in moderation may be good/ . Likewise, FUE done in moderations is a great surgical hair transplant procedure. However, when done in excess, the patient pays the price with ugly scarring that may never have been anticipated. Certainly, the unfortunate man in the photo below had no idea that his FUE was a massively scar-producing surgery because his doctor over-harvested grafts.


2018-06-22 11:39:06Is FUE Worth Doing?

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5 Months After My Transplant, Nothing Has Grown In and Now I’m Losing Hair All Over!

Hi Dr. Rassman,

I find your blog to be incredibly informative and helpful to those with concerns after their hair transplants. I decided to undergo a transplant exactly 5 months ago as preventative maintenance. 1,700 grafts to fill-in the thinning top portion of my head. I still have hair on my head, but under direct light you could visibly see through to my scalp. I followed my doctor’s instructions and had no major issues after the surgery.

At 5 months, the incision scar is still pink and I have occasional pimples on the top of my head (with what seems to be a noticeable increase in grease on my head). Also, after the surgery I had shock fallout. But it seems that ever since my surgery for the last five months my shedding has been consistently increased. Not just from the top of my head, but all over (sides and back). I have yet to see any growth from the grafts. But I have noticed white streaks in my hair. I have pitch black hair, and there are now random strips of white developing throughout my hair (I had never had white hair before the surgery). Is it possible that the shock of surgery would cause some of my hairs to begin to turn white?

And I’m also concerned at this point that my grafts will not grow in and that I will continue to get thinner and thinner since my fallout has increased. Thank you for your input and advice.

In my practice, we never recommend a hair transplant surgery for “preventive maintenance”, mainly because most patients would not likely see much of a result as they continue to bald and run the risk of being worse off. There is also a good possibility that the surgically induced hair loss might make it look worse, something we call “shock loss”.

If you are really losing hair on the sides, maybe something else is going on like diffuse unpatterned alopecia (DUPA). Shock loss doesn’t usually cause hair to fall out from the back and sides of the head. White hair does appear with stress on some people, but I really do not understand the cause. It sounds like you need a good doctor to talk with and be examined by. Perhaps the surgeon that did your transplant would be a place to start.

In general it takes about 6 to 8 months before you can see results and I tell my patients that most people can see 80% of the impact from a hair transplant in 8 months. You should notice growth beginning about now and see improvement in the next 3 months. If you are young and had the transplant without taking the drug finasteride, and assuming that your preventive hair transplants were not really needed, then you will most likely not have as much hair as you did before the transplant (based upon what you are saying here). Hopefully though, over the next 3 months you’ll see some gains.

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Is Male Pattern Baldness Not Genetic At All?

There was a study done by a Cornell University professor named T. Collin Campbell in conjunction with Oxford University entitled “The China Study”. It’s an entire book, but basically he says genes are expressed by nutrition, and many of his arguments revolve around animal based protein v. plant based protein and cholesterol, cancer, heart disease — not necessarily balding. But this peaked my curiosity. Can male pattern baldness not be genetic at all but instead the balding aspect is expressed by some type of diet balding men eat whether that diet is heavy in red meat or whatever?

I have been aware of this thesis for some time and one has to give it credibility. There is no doubt that diet does play an important role in one’s health. It is classic “nature versus nurture” type of argument, but things are not so simple. I did not read The China Study book, so I really cannot comment on that, but with respect to balding, although it is genetic, diet may very well influence the ‘expression’ of the process. Some people ascribe diet as a cause of the racial differences in balding when comparing Asians (in Asia) with Caucasians in America, but the science for this is clearly not available.

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5 months on finasteride (photos)