I’m 26 with Thinning Temples — When Is It Safe for Me to Have a Hair Transplant?

Dr. Rassman,

I’ve heard many different opinions regarding the appropriate age to seek out a hair transplant. I’m roughly a Norwood 2 at age 26, and my father is a Norwood 6 (age 62). I came into your LA office last year and had a miniaturization test done. The test showed I had receded at the temples, but the rest of my hair was holding strong. I’ve been using a Propecia/Rogaine combination for 5 years, since the first signs of balding appeared.

I consulted with another doctor who said I was a good candidate for an immediate transplant. He mentioned I should front load the grafts, using 2400 to fill in the temples. I know he’s a reputable doctor, but isn’t it dangerous to use 2400 grafts to fill in the temples (~1.5 inch receded)? I know the miniaturization test showed the rest of my hair is holding strong, but who really knows what the future holds, especially given my genetics.

Is it prudent to wait a little longer to have surgery? Right now, when my hair is grown out long enough, I can spike my hair in front and the recession is barely noticeable. However, I hate the way my hair looks when I first wake up in the morning or after a workout– it clumps in the middle, clearly showing the recessed temples.

My questions is, even with a miniaturization test and a consistent cocktail of hair loss drugs, when can you safely have a transplant without the risk of looking foolish 10-15 years down the road due to the overzealous use of grafts in the early phases of MPB?

Let’s look at it this way — I advised you to take Propecia and said I’d retest you a year later with another miniaturization study. I gave you the consultation at no charge. Another doctor that you met wants to immediately perform 2400 grafts on you after just meeting you. Does that sound strange to you… like maybe that other doctor is more interested in your money and less interested in your long term Master Plan?

I could have certainly told you that you’d need 2400 grafts when I met you last year, but it would not have been fair to you, nor would it have been the honorable thing to do. I would have been taking advantage of you. As you point out, if you lose much more hair and already have 2400 grafts in the front, you do run the risk of possibly looking foolish down the road (maybe a bad Master Plan). You should return for another visit with me so that you can have another miniaturization test and a reassessment of your Master Plan based upon what has changed in you since your last visit. To answer your question, I can’t say with any certainty when a good time for a transplant is without seeing you again. This is one of those questions that simply can’t be answered without an exam.

I hate to see patients taken advantage of, and I’m glad you wrote to inquire about this. This could be a case of a doctor that is preying on your insecurities and wants to line his wallet, rather than look out for your best interests. I always suggest that potential patients do plenty of research so that you know what you’re getting into. Many doctors who ‘claim’ a great reputation, promote that reputation with good PR and lot of dollars in advertising. The only protection you have is to perform good research for yourself.