SMP for Younger Patients?

I understand that younger patients may be denied hair transplants due to the fact they may lose more hair. If this patient gets scalp micro pigmentation as well and is happy with a shaved head if he loses too much hair, is there really a problem with running out of donor hair? I’ve actually seen results of men who get the procedure who still have somewhat of a hairline, and it looks much more realistic overall.

The desire to have Scalp MicroPigmentation (SMP) seems to be more common in younger men. The choice to do SMP reflects what may be a lifetime decision.

Let’s say, for example, that you have SMP done with your existing juvenile hairline at the age of 20 and then you progress to some hair loss pattern. You would then be stuck with your juvenile hairline even if you were to evolve into a Norwood class 6 or 7 pattern. You would not look normal, as you would have what appears to be a shaved frontal scalp and hair behind it… unless you shaved your entire head. Rarely can a class 7 patient be transplanted to cover the entire balding area (not enough donor hair), and in this scenario, if a 20 year old should let his hair grow out, the frontal leading edge (the SMP treated hairline) would not match the rest of the scalp unless he continued with a shaved look for his entire life.

So let’s say a young man decides to have SMP to address his frontal hair loss and is now stuck to shaving his entire head for the rest of his life. He then decides to do a hair transplant in the same area where the SMP was done, allowing him to then his hair grow out or shave it, and either way, he is covered (unless of course he loses more hair — let’s say in the class 4A pattern). Now the frontal area is covered with hair and pigment, and the back area may or may not be covered with pigment, but the problem now is that between the transplanted frontal area with SMP and the top/back of the head (in front of the leading edge of his natural hair in class 4A pattern), he would have developed a space which now almost certainly will be addressed with more hair transplants, or just SMP. With more hair transplants, he can let his hair grow out, but if he elects to fill the space with SMP alone, he is stuck once more needing to shave his entire scalp to remain looking normal.

There are clearly circumstances where one can receive SMP when hair is being lost in the front, but that does not reflect a stable situation because if this is a 20 year old, his balding will progress. It takes some degree of maturity and an objective mind to filter what I have just described here.

To be more specific, just as doctors would not recommend surgery to a 20 year old, the same reasoning would generally apply for SMP for a 20 year old withclass 3 pattern balding. But the rules here are not hard rules, as we try to educate our patients and understand where their thinking is going.