I would like to solicit some comments from doctors, if possible, on hairline design issues especially in younger patients.

I have noticed that there are several younger patients in the forum, who are in the earlier stages of hair loss, who are interested in hair transplants. I know it is hard to overgeneralize as each patient is different, but I was hoping that some doctors might contribute their thoughts on proper placement, planning, design issues, etc etc.

I have tried to explain some of the different issues to the best of my ability. However I am apparently considered "anti-transplant" according to one poster, which I guess is a reason for very enthusiastic guys to dismiss my opinion. Since a HT doctor would not be considered "anti-transplant" maybe a doctor can explain rational strategies for hairline placement and planning in a younger patient.

The more doctors who can reply, the better...

Thank you.

This is a good timely question. First of all, I would avoid transplantation below age 25. This is a perfect time to use medications, as our most dramatic responses occur in the young. If the only effect is perservation, then these meds are also very effective as it is better to save hair while there is more to save.

If a transplant is done on a very young person, I would recommend 2 things: 1) stay in a frontal forelock pattern 2) don't transplant the temples or lock in the fronto-temporal angle. Young people losing their hair are likely to be the ones with severe hair loss later. Locking into a forward fronto-temporal angle could be a major problem later. Some might do well with it but some will pay a dear price. Bottom line- it isn't worth it. Better yet, don't do a transplant at all until nature shows a little of its hand first.

Dr Parsley:
Thanks for that post. That is EXACTLY what I wanted to convey so often, but with my non-medical background, I stumbled to find the right terms and words.
What you wrote is really the warning I (and Joto, arfy, etc) would like to put out to men in their young 20s who are balding and considering an HT.
The point is not necessarily "absolutely don't do it", but rather, "know your options and the risks involved".

vocor1
Knowledge is Power
If the worst question is the one never asked, then the worst answer is the one never shared.

I agree w/Arfy and Dr Parsley as well. (and joto-vocor)

Definately Err on the side of conservative. Even just putting healthy hair in the top-scalp area will show a dramatic improvement, and save your grafts for later, most of these young guys will need them, I didnt even receed till 35, imaging a guy losing it at 24 ?.

I think slight recession in the temple area looks more natural anyways.

NW

it is not a definite don't for all cases. Like vocor said - 'know your options and the risks invovled'.

"Any sufficiently advanced technology is indistinguishable from magic''. Arthur C. Clarke

My point is actually: It is your life and your decision. If you can live with your decision AFTER getting educated on the HT process and the risks involved, then best of luck to you.
I can't add anything to that argument. If you go into an HT fully confident and educated, then I feel I've done my part, so to speak.

vocor1
Knowledge is Power
If the worst question is the one never asked, then the worst answer is the one never shared.

I especially liked the line:

'I say this based on over a decade of experience that indicates that individuals with minimal loss at age 23 will have minimal hair loss in their mid-30s.'

I believe I am one of those guys - especially when combined with my family history. Waiting to have a procedure performed accomplishes nothing in my case, other than extending the time I'm miserable because of crappy hairline.

"Any sufficiently advanced technology is indistinguishable from magic''. Arthur C. Clarke

When you are planning your hairline, pick something that is not going to stand out to other people, even when you are older. Most guys eventually have some amount of recession, so even though a hairline with "no recession" is possible, getting one via surgery is going to draw unwanted attention to your hair transplant.

quote:

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An unfamiliar pattern will (then) generate the query "What's wrong with this picture?" to the consciousness. Therefore the challenge is to create a painfully ordinary hairline by common shape and location that will be ignored by others. The eye is easily bored- keep it that way. The goal is to have the hair become a nonissue. However if a hairline that is unique in some way is created, the eye will be engaged and the "What's wrong with this picture?" question will be triggered, thus failing the patient.

---

(from "The Consultation" by Patrick Quinlan)

In other words, if you pick a permanent hairline that very few people have, you will have a lot of people scrutinizing your hair.

PRGuy:
You bring up valid points, but hair DOES recede in U and V shapes.
Let me tell you, I receded in a V on the top. I know this is atypical, and hopefully I'll find some picts to substantiate my case. My military ID at age 21 showed a V. At 24, the V was pretty much gone. When I had my HT, the V was a distant memory. But it did exist.
My point is, the V was the shape of my hairline AS I BEGAN TO BALD. Yeah, it deteriorated into something much worse, but I turned back the clock.
That was all a factor when Dr Rose and I chose the hairline to construct. He asked me how my hair once looked, how it recessed, and whether or not I had a widow's peak (I did not).
How else do you create a "natural hairline" but to ask how nature caused your hair to recess?
Like I said, you bring up very valid points. But with some people, the U and the V are in fact natural hairloss patterns.
Look on TV at sports broadcasters, you'll see a ton of natural Us. There are fewer natural Vs, but I know I count as one.
Just my two cents.

vocor1
Knowledge is Power
If the worst question is the one never asked, then the worst answer is the one never shared.

quote:

---

I think that quote in particular is not addressing the issue of the (v), (u) or jagged hair line but rather the placement and pattern of the grafts.

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Umm, I think hairline design IS the pattern and placement of the grafts.

If you "spotted" some bad U or V shaped hairlines, that doesn't mean that U or V shapes were wrong, just that they were not pulled off effectively. You can't dismiss them because you saw bad work. As Vocor said, the U or V hairline just means that some amount of recession was replicated (or an attempt at replicating recession). In my opinion that is the way to go for the vast majority of guys who get transplants: build a little recession into your hairline, and if you think there's a chance you are going to progress to a Norwood 5-7 someday (or are already there), then you might want to build even MORE recession in to your permanent hairline.

• Most guys do have AT LEAST "some" recession over time. Very few guys go through life like Ronald Reagan.
• If a guy has a permanent transplanted hairline that doesn't look like 98% of the rest of his peers, he may be drawing a lot of extra attention to his hair.
• If that's the case, your hair transplant will probably get a lot more scrutiny, especially by the time you are in your 40s, 50s, 60s, and so on. You'll have a strong hairline, but you will also look "different". That might not be such a good thing for every guy.

Or worse...a girl losing at 24!!

quote:

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Originally posted by NW:
I agree w/Arfy and Dr Parsley as well. (and joto-vocor)

Definately Err on the side of conservative. Even just putting healthy hair in the top-scalp area will show a dramatic improvement, and save your grafts for later, most of these young guys will need them, I didnt even receed till 35, imaging a guy losing it at 24 ?.

I think slight recession in the temple area looks more natural anyways.

NW

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Jenn,

I wish you luck sweetie, Dont let it get ya down, in fact I have seen some nice improvements on Female's.

Spencer Kohbren used to have a Doc that addressed only Female hair issues on his "The Bald truth" website...But lately I have not been able to log in ??

Perhaps they were working on it, or he has went strickly radio ?.

NW

Believe me I dont think I can get much more "down" than this!!!But, I have learned a few valuable life lessons from this experience.

1) Enjoy your life, and be grateful for everything given to you!!

2.)Love yourself for who you are (Even if you cant stand looking at your thinnning hair in the mirror!!)

3) Most people are not what the appear to be.
(My jerk off boyfriend left me 2 days ago after 1 year, because he said he cant deal with what is happening to me...HELLO LOSER...I am the one dealing with it!!

4)Reach out to people.

As for the Dr. that has done great jobs on women...please if you find out his name, let me know!!

Was it Dr. Shapiro by any chance? I heard his name mentioned a few times..

Thanks NW
Jenn

Female hairloss,

Dr Geoffry Redmond,

BTW, I also do have the utmost respect for the physicians at the Shapiro Clinic as well.

NW

Hey NW

That is o sfunny you mentioned him. I am actually making a pilgrimage to NYC to see Dr. Redmond. Its gonna cost me a pretty penny, but I figure I might as well go right to the top!!

I am seeing him on May 13th!! I hope he can give me some direction!!

Do you know if Shapiro does work on Women?

Jenn

jenn,
FYI, i don't know if any of the other guys have told you this, (or you already know this) but don't order propecia or proscar for your hair loss. Women aren't even supposed to handle the stuff. Just in case you were thinking of ordering it since we all talk about it so much.

The funny thing is, I have talked to women who are actually taking Propecia, prescribed by their Doctor. But I know that it can major problems with the female reproductive system.

I am going to see Dr. Geffrey Redmond in NYC, he is a specialist in female hair loss and female hormones.

hopefully he can put me on proper meds...

Thanks for the tip
Jenn

HT is a pricey proposition.
But money is replacable and time isn't. A credit debt can be paid off, but years of worry ain't worth a few some saved dollars.
Sorry about you BF. People are like that sometimes. The ones that stick with you through the hard times are the keepers.

vocor1
Knowledge is Power
If the worst question is the one never asked, then the worst answer is the one never shared.

Jenn,

I would be guessing on Shapiro working on women, you may give them a ring, I hear constant praise for them - Dr Redmond is really the guy I know is specialized in womans issues, I hope actually you can perhaps get some drug/hormone therapy and maybe not have to do HT, but admitedly I have seen photo's of womens success's.

Hairloss can suck, but the field has seen some advancements..and inside you are the same great person youve always been ?. I would be optimistic - but careful too !! I like the appt. you have with Dr Redmond...it would be my 1st step.

There are some woman posters on here now and then too....one is named "too funny man"...you may want to look up her past posts ?..maybe her situation is similiar..I believe she had HT.. and do not know if it was a success or not ?

NW

I would like to see this thread return to the topic of hairline design.

Here's another thing that bothers me about the approach of just filling in the temples... many doctors advocate that every surgery should be a "stand-alone" improvement. Meaning that if the patient never gets another surgery, and continues to lose hair, he will not be left with a bizarre appearance. A surgery shouldn't require any later surgeries to "fix" it to a level of "looking normal again". Each surgery should stand alone, even if the patient became fully bald later.

I definitely see the merit in that approach, because there is no guarantee that patients will maintain all of their current hair with medication. And you might have plenty of money available for surgery right now, but 5 years from now, if you really happened to need it, and couldn't afford it, it would be a disaster. There is nothing worse than being "stuck" with incomplete work, and no resources to complete it. It's hell on earth.

This "stand-alone" approach is one reason that patients are advised to wait until they have a reasonable amount of hair loss, and not use transplants as a mere touch-up. (Other reasons are the risk of shock loss if you have a lot of existing hair, the alleged benefits of getting a large "first-pass" session, etc).

More grist for the mill...