Why Hair Transplants for Men in Their 20s Don’t Work Out, and Restoration Treatments at This Age

Why Hair Transplants for Men in Their 20s Don’t Work Out, and Restoration Treatments at This Age


Thank you for your question. You submitted your question with an image
of the top of your scalp. And you state that you’re 26-years-old and you are trying to
make a decision whether or not to do FUT or an FUE for hair transplant procedure. And
you state that you have friends who did FUEs who did not appear to have the most optimal
outcome so you’re looking for some guidance. Well, I can certainly share with you how I
counsel patients like yourself in my practice when it comes to hair loss management strategies. A little bit of background, I’m a Board-certified
cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have
been in practice in Manhattan and Long Island for over 20 years. I am also the founder of
TrichoStem™ Hair Regeneration Centers, a system we developed to help people with male
and female pattern hair loss, treat hair loss non-surgically, has been quite a significant
option as an alternative to hair transplant particularly for people who are younger. So
I think it’s important to understand a couple of things and I think it is very challenging
when people who are in your age group deal with hair loss. In terms of hair loss, the incidence of hair
loss in different decades of life for men basically referred to as the Rule of Decades.
So in your 20s, only 20% of men have hair loss while as you get into your middle to
later decades, your 50s and older, well then 50% have hair loss. The challenge with hair loss in your age group
and your degree of advanced hair loss is what do you do to manage your hair loss before
you move forward with a hair transplant. It is a common story that I get to hear in our
practice when people come to me somewhere in their 30s and they’ve already had one
or two transplants in their 20s. Unfortunately, the hair loss progressed and they have only
some isolated transplants. And further, those transplants are not anywhere close to enough
to provide a significant amount of coverage and so they end up in their mid 30s and beyond
not looking like they had a lot of hair even though they underwent anywhere from 2 to 4
surgeries. The challenge really is to manage hair loss
before doing surgery and I think it’s very important. It’s also important to understand
that hair loss is progressive and having an early onset puts you in a more aggressive
category. Basically, when it comes to this Hair Regeneration treatment that I mentioned
earlier, we developed a system based on our experience first doing hair transplant. We
were trying to help our transplant patients get a better yield of their grafts as well
as improve the healing of the donor area which was this strip method. What we also got to
see was that thinning hairs in a lot of patients became thicker. Move the clock forward, over several years,
now going on close to 8 years, I developed a system to address patients with male and
female pattern hair loss. Further, I was also able to identify essentially through a lot
of challenges and obstacles and setbacks that certain categories of patients have more aggressive
hair loss than others. And so we developed a classification system and that classifications
system has to do essentially with gender, age of onset, degree of hair loss, rate of
progression as well as other medical issues that are important to understand. So one of the things I would say to most of
my young patients, patients who are in their 20s, is that almost by definition, having
an early onset, that it’s already obviously hardwired in your DNA but I would propose
that you also have a higher DHT sensitivity, dihydrotestosterone, which is essentially
one variable that is important in the progression of hair loss. So a lot of my patients who
are in your age group, I counsel to consider strongly to take a DHT blocker such as finasteride.
Of course, people looking in the internet are very often afraid to take finasteride
but I try to put things in context of current clinical knowledge and the fact that this
drug has been around since 1997. We try to put things in perspective and look at every
patient individually but I do routinely prescribe this drug as another tool to help slow down
progression. In addition, we also do a treatment called
Hair Regeneration. What we’re doing essentially is reactivating hair that is not currently
growing which by definition is due to androgenetic alopecia where the thinning hair actually,
the growth cycles get shorter and the resting phases get longer which means there’s fewer
hairs that are actually present. In addition, we also find that thinning hairs get thicker
as well as the prolongation of the hair growth cycle. Occasionally, when we see our patients, we
are essentially seeing them in a snapshot and there’s no way to know whether they’re
in a stable or relatively stable phase of their progression or whether they’re on
their way down. And so sometimes, a lot of these patients who are younger who have more
advanced hair loss, their thinning hair is almost, if not certain percentages, are already
at the end of the growth cycle and never to grow again which means they can still progress
before they stabilize and before we can manage maximizing their growth cycles to as long
as possible and using a combination of a DHT blocker and injection is a way that we are
trying to help them combat a very aggressive DNA program. So I would say that it is important for you
to think of stabilization and management before you do surgery. I think that we have enough
experience to know that a lot of people go through surgery at a young age will later
regret it because they still progress and now they’re stuck with a certain look that
doesn’t really work that very well for them. So think about the seriously before you make
this decision between FUT versus FUE. There’s a mismatch between the amount of scalp that
needs coverage and the amount of hair that’s available in your donor area. Yes, more aggressive
or more ambitious patients will undergo body hair transplants which is a valid choice but
you should also think of how to maximize the lifespan of your existing hair for as long
as possible to minimize and delay hair transplant. At least from my perspective, I think that
makes more sense than just doing transplant after transplant. So I hope that was helpful, I wish you the
best of luck and thank you for your question.

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3 Replies to “Why Hair Transplants for Men in Their 20s Don’t Work Out, and Restoration Treatments at This Age”

  1. Hi sir , iam about to hit my 23 and have lost both of corners of my head and loosing rest of hairs so rapidly , I guess it's genetic as I started taking generic Finpecia a week ago , iam thinking about hair transplant in next couple of years . I wanna know does taking finasteride effect on bodybuilding and does masturbation decreases the effectiveness of finasteride , should I go for prp as well to stop my remaining hair falling out ? Please do reply sir. Thank you.

  2. Hello and great video. I was wondering if a male has already had a hair transplant and wants to take creatine for bodybuilding does it cause hair thinning in the front of the scalp. I have read that creatine boost testosterone levels which may convert to dht which causes balding. I also take finesteride and propecia currently. Thank you in advance.

  3. Hey I have a question as well over genetics. My hair is thinning on one side of my head.One of my corners of my hairline is beginning to receded on one side of my head. I can't do comb overs so I have to slickback my hair. My scalp is visible when my hair is wet.
    Both of my grandpas have male pattern baldness and they are in their respected ages of 60s. They are not completely bald but semi bald.
    My dad and his siblings still have their hair intact but theirs is thinning out. My dad grew out his hair back in 2014 and has not cut it. His mane is long still but thin. His scalp is not invisible yet. One of my dad's brothers lost his entire front( No hairline and just average island size of hair over his forehead) but still has hair on top of the middle section of his scalp and back as well.
    My mom's brothers still have their hair intact as well. My hair started to thin out at my age 18 and I started using multi-vitamins. I still have hair as in right now. Just wondering if the progress of male pattern baldness will accelerated on me. Also what appropriate age should I get a Hair Transplant? What type of hair transplant should I get.

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