21 and want a hair transplant

Hello Dr Rassman, I was wondering if I could geta HT at 21, I’m on finasteride and minoxidil since 2 years (both oral) I have pretty much stabilised my hair loss and have gotten the maximum regrowth possible from these pharmaceutical treatments, I wonder can a HT be done so that I do not sacrifice my prime years and youth worrying about hairs? I’m okay to be on pharmaceuticals for life, currently I’m NW 2.5-3.

Hair loss comes from apoptosis, which is hair-cell genetic death. We are born with a finite number of hair cycles. Let’s say some of your hairs at the hairline level, had a 7-year cycle that is genetically programmed, others might cycle 9 times while others might cycle 10 times genetically. Assuming that your hair cycle is 3 years (average for young men), the hair would fall out at the end of each cycle, only to regrow again after it goes through a sleep phase (Telogen). But if you have genetic balding that limits the frontal hairs to 7 cycles and the cycles last 7 years, that means you might lose your frontal hairline hair at the age of 21 (7 cycles programmed to last 3 years each). Do the calculations yourself. That is the reason I don’t do hair transplants on men under 25, because many have apoptosis genetically ingrained in some hair follicles that fall out when they are 23, 24, 25, 26, 27 etc… Do you get it?  

For me, it is important to build a personalized Master Plan for each patient, projecting what I think is going to be his hair loss pattern so I can balance the donor supply against the loss.  Too many young men go to Turkey, get 4000 grafts in the frontal 1 1/2 inches in thair hairline, and end up using up more than 50% of the donor supply in the process, so when they turn 27 or 30, their hair loss may go back to the crown, and when they want a hair transplant again, they may not have enough hair to do it.