Receding Hairline at 22 – Am I a Candidate For a Hair Transplant?

This is an excellent question. Whether to perform a hair transplant on a young man is a very controversial area among hair transplant specialists. My approach to this situation is based on the following considerations:

1. Hair loss when you are young (e.g. early 20′s) can be especially difficult because this is the time of life when you are typically entering the job world and actively dating. Hair loss can have a significant effect on self confidence and self esteem.

2. Hair loss due to male pattern baldness is a life long progressive condition. Any treatment plan has to be based on this fact. Having a strong family history of extensive baldness in one or both sides of the family makes it more likely you will experience the same fate. This makes a hair transplant more risky.

3. The treatment plan is partly determined by your motivation and the degree to which your hair loss bothers you. If the hair loss has only a minor effect on you or you on the fence about doing something about your hair loss, then you are not a candidate for surgery. Beginning a medical program would be the place to start. You must be highly motivated to do something (ie correct a receded hair line) to be a good candidate. On the other hand, excessive preoccupation of your hair loss as causing all of your problems can be a sign of psychological issues and may indicate you will not be satisfied with a hair transplant.

4. Medical treatment with finasteride to prevent/reduce future hair loss is the foundation of any treatment plan, whether or not surgery is indicated. Topical minoxidil can be a useful addition for those who are good about using a topical product daily. Understanding the pros and cons of medical treatment are very important.

5. A hair transplant uses the limited number of hair follicles in the donor area to create a desired result. The grafts are permanent but the hair around them is not, and may be lost to the hair loss process. For this reason, putting grafts in the crown in a young man is a bad idea. A young man without significant thinning in the mid scalp and crown, and with only a receded hairline, is the only situation where I will consider a hair transplant for young men.

6. The hair transplant creates a linear scar in the back and/or sides of the scalp. This scar is usually inconspicuous but the healing process can be variable from person to person. The patient will not be able to shave their head or wear a very short “high and tight” hair style. If a shaved head style is considered, it is advisable to try this before doing a transplant. If you like this look, you do not need a transplant. Follicular unit extraction does create small round scars that may be less noticeable with short hair but will be visible with a shaved head.

7. Assuming that surgery is otherwise indicated, the location of the hair line has to be carefully chosen to accomplish two goals: 1) look good in the near future and 2) look good as you age. If the hairline is too high it will not accomplish goal #1. If it is too low, it will not accomplish goal #2. Some compromise is necessary and you must feel comfortable with the plan before proceeding.

In summary, if you are unsure whether this is the right decision, then stay on medical treatment and give it more consideration. If you have carefully weighed the pros and cons, and you are highly motivated to restore a hairline that will look good now and in the future, then you might be a good candidate. You should seek a surgeon who is not only experienced in the most advanced techniques, but also understands all the nuances of performing surgery in young men. Do not proceed with a surgeon that does not discuss these factors, seems in a hurry to do surgery, or worse yet, you are not able to meet until the day of surgery. As I discuss with my potential patients, this could be one of the best decisions you ever make or one of the worst.