Background
I have had 4 hair transplants (three strips and one FUE) sum totaling north of 10k grafts over the last 10 years. I was also on Propecia. I was pretty happy with my hair post HT #3, however I always had the jitters in public. Due to a temporary health issue I had to stop Propecia because it significant diminished ability to recollect memories while on the medication and I decided to stay off completely. Fast forward to today and I again was not happy with my hair. I have always hated the balding look; I want either a shaved head with no hair, or hair. Due to the strip scar shaving my head was no longer an option. I have been wearing a hat 90% of the time when going out of the house for the past 3 years.

I had seen pictures of SMP and did some casual research a couple of years back. However, in January, I decided to go forward with SMP. I live in San Diego so I visited two clinics, a non-medical place and then Dr. Pak at New Hair in Los Angeles and both a few miles from each.

I visited the non-medical place and spoke with practitioner there, a very nice guy who actually sold me on the procedure (he had it done himself). He did remind me more of a tattoo artist than a medical professional. He instructed me that there would be two 4 hour sessions to achieve good results and also gave me a price.

I also saw Dr. Pak, who was also very pleasant, but wasn’t necessarily positively on SMP. He answered my questions, showed me some results, and told me that it would take 2 to 3 sessions to achieve good results. Unlike the first place, Dr. Pak’s sessions took 6-8 hours each.

I was really leaning toward the non-medical place because of the years they have been in the business. However, I decided to go with Dr. Pak (even though he was more expensive) because of two reasons: (1) it was a medical office (vs a nice tattoo parlor) and (2) I have the option of anesthesia.

I shaved my head a few days in advance and one of my daughters commented that I looked like I was wearing a bald cap (even with 10,000 grafts placed there over many years). Honestly, I was really shocked by the width of my scar.

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I’ve currently been on Finasteride for 3 months now, and Minoxidil for 5. My hairline is starting to regrow extremely slowly, but at the same time i’m not sure it will come back. I also would like to see if it would be possible to lower my hairline with FUE procedure as well as filling in a bit of the horshoe pattern as well that is receding. I contacted a facility in Miami, FL on Saturday I believe and was wondering how long it usually takes to schedule a consultation etc etc… I do realize i’ll probably have to get 1-2 or even 3 more hair transplants by the time i’m 40 but right now at age 20 my only fear is that when I go to college started this year, i’ll have missed out on my college social life due to my insecurity of my high and receding hairline.

At 20, you shouldn’t get a hair transplant. Medication is better. The reason is simple, you are very early in a progressive process and if you start now, you may end up chasing the balding.  Any doctor who does surgery on a 20 year-old male is after the money and not the welfare of the patient.

Is it normal for hair to thin towards the root in a single strand during the balding process?  Looking at the photo below, can you tell if there any miniaturized hairs?

Let’s say the hair is on average 10 inches long and that you can easily tell towards the root it is a lot thinner than at the tip.  You can also see there is a lot less pigmented towards the root.

You are very observant. The thinning hair closer to the root may be the effect of early miniaturization.  This occurs at the most recent part of the hair that is growing. I believe if you observe this over time, more and more hairs will become miniaturized and reflect the genetic balding process that is taking place. Of the two hairs in the photo, the one on the right is miniaturized.  It is thinner and has less pigment in it.  I am fairly certain that it took longer to grow as well because miniaturized hairs grow slower and then either fall out or stop growing altogether.

 

As men get older, the risk of producing children with a variety of defects rises e.g. Autism, Schizophrenia. Although this risk doubles, it is still very small (in the order of 1 percent rather that 0.5 percent). To balance this negative, men over 40 are likely to produce children with larger brains. Having older parents may also be beneficial as the maturity of older men may provide children with a more stable home environment. Also, the sperm of older men may have mutations and may possibly play a role in the evolution of our big brains. We have also recognized that children with autism have bigger brains, suggesting greater processing power.  But autism has significant defects in using this greater power with a significant decrease in social skills.

This article was taken from a feature article in New Scientist Magazine, written by its editor Michael LePage.

Okay, so I am sure all of us have heard this theory before: “Masturbation contributes to hair loss”. I have done a significant amount of reading on this and to be honest, it is hard to know for sure. Different sources are saying different things. Some say that masturbation/sex accelerates male pattern baldness and others say it does not play a role at all. Putting aside everything I have read elsewhere and looking at my own experience with hair loss, I struggle to accept that masturbation has been a causative factor. I am 24 now and only began experiencing hair loss last year. So from the ages of 15-22, I was masturbating A LOT and didn’t experience any hair loss at all. So how could masturbation be a causative factor? I am curious to hear other peoples thoughts.

Your genes almost certainly kicked in causing your hair loss. Your years of masturbating have nothing to do with building up of stress, if anything it reduced your stress.  You are, most likely, just developing a genetic balding process.

I would like to keep hair forever. But you don’t understand balding in the early 20s. Your choice of women falls greatly. I shaved my head once and got less attention from women. I look better with hair makes me look young because I am. I just want to enjoy life right now and if I lose hair in my 30s it’s ok cause by then I’m not out there chasing young sexy women. Not that life is all about chasing sexy women. But hair surely helps me enjoy being young.

There are two options that can help you. You can shave your head and get Scalp MicroPigmentation done so you always look full headed (see here: https://scalpmicropigmentation.com/bold-shaved-look/ ).

Or you might consider a hair transplant when you are a bit older.  I recommend that you wait until you are 26 years-old for the hair transplant option.

In the previous post, I showed a patient with necrosis of the scalp created by a surgeon who placed too many hair grafts too close into the scalp.  Here is a similar patient with a scar, that I found on the internet, which shows the best treatment for this and the final results after the balloon expansion was completed.  This is not an inexpensive process. The patients I had wore a hat to cover the abnormal appearance and went undetected.