| This is an example of one procedure to create a hairline that would not be appropriate for many men, especially younger men. This man is only 34 years old. I would be reluctant to graft this low a hairline in most men under age 40 and reluctant even then if their crown were more than minimally balding. This case, in my opinion, shows that “black and white” rules are fine for some and certainly make life easier for all involved (but leave some patients with the verdict of “not being a candidate” for whatever concerns their aesthetics had them visit the surgeon for in the first place). This gentleman is very smart and understands the consequences of future balding in the crown which, if extensive, could result in there not being enough donor hair to keep up a natural distribution of hair on his scalp. He states, however, that he has complete confidence that there is no crown balding on either side of his family. His crown (see photo) both with regular and 30X photography shows no evidence of male pattern balding. I agree with his assessment that the risks of insufficient donor hair are sufficiently small that surgery would be a reasonable option. He is not taking finasteride and would prefer not to. The absence of miniaturization or loss of density in the crown makes it reasonable not to use finasteride at this point. He can revisit this issue if miniaturization appears in the crown. A surgical plan should not be devised that requires a person to use ( with successful results) medicines for the rest of his life. |
