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Expert warns against hair transplants for men in their 20s

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Before his corrective procedures, Jeff's hair was patchy and thinning beyond his transplant line, as seen here. (Image courtesy of Armani Medical)

For balding men, the promise of regaining their hairline with the help of a hair transplant can seem all too good to pass up.

But one doctor is now warning that for men in their 20s, undergoing a hair transplant could be something they will go on to seriously regret.

“About 20 to 30 percent of my hair transplant surgeries are on people for corrective purposes or people having secondary or tertiary procedures,” Dr. Abraham Armani, a hair transplant surgeon and founder of Armani Medical in Dallas, Texas, told FoxNews.com. “They have had procedures by other doctors and they come to us to improve or completely correct it.”

According to Armani, problems often arise when a hair transplant is done before a man has fully finished losing all of his hair – making it a risky procedure for younger men who may continue to lose hair for many years.

During a hair transplant, a surgeon typically removes a strip of hair from the very back of a man’s head, relocating it to the front of the head where balding occurs.  

“Those follicles in those areas [in the back of the head] are permanent, there’re never going to shed off permanently so we take advantage of that,” Armani said. “We can remove them and transplant them anywhere else on the scalp or on the body and it will be permanent.”

However, if a man has not yet finished losing his hair at the time they receive the transplant, problems will arise.

“Let’s say a 19-year-old comes to see me and I do a hair transplantation and lower his hairline by one inch, that hair will always be there,” Armani said. “Let’s say five years later, he has rapidly lost the rest of the hair in the front and now he has this strip of hair that I transplanted that’s forever going to be there and behind that – that is empty space. That’s not a natural look or a good look.”

Jeff, a 40-year-old man living in the Dallas area, had two hair transplants while he was in his 20s and has experienced firsthand the risks of getting this corrective procedure at a young age.

“I started losing my hair, I noticed at 18 or 19 years old, and it was really a self-esteem issue and a confidence issue on my part,” Jeff, who chose to withhold his last name for privacy reasons, said.

By age 20, Jeff started looking into hair transplant procedures and eventually connected with a doctor who promised he could restore his receding hairline. Even though he hadn’t done much research, Jeff agreed to the procedure. But immediately after removing his bandages post-transplant, Jeff realized he had made a huge mistake.

“The analogy that I’ll use is that I looked like, if you can imagine…the hairline that was on a doll, where it looks pluggy, or like a cornfield— that was my experience 20 years ago,” Jeff said. “I was devastated.”

At age 24, Jeff underwent a second hair transplant in an attempt to regain a more natural hairline. But again, he was left with unsatisfying results. Finally, last year, Jeff visited Armani in a last-ditch attempt to finally correct his patchy hairline.

“By the time he came to see me last year, he looked really unnatural, and was very self-conscious,” Armani said. “…When you say about the pluggy appearance, that only gets worse as you are losing more in the surrounding area, so all you are left with [are] islands of hair surrounded by bald areas, and that’s what we are trying to fix with Jeff.”  

Armani said a lot has changed in the field of hair transplantation since Jeff had his first surgery 20 years ago – especially as medications that can slow or halt balding, like Propecia and Rogaine, have become more popular.

“We need to stabilize [a patient’s] hair loss first using medication and once his hair loss is stable and we know the pattern of balding, what we are looking at in the future, then 3 or 4 years later he can look at hair transplantation,” Armani said.

To begin correcting Jeff’s hairline, Armani prescribed Propecia in an attempt to halt further balding and thicken Jeff’s remaining hair. Then, to correct the existing patchiness, Armani performed a hair transplant utilizing a technique called follicular unit extraction (FUE).

Because of Jeff’s two previous transplants, the skin on his scalp was too tight for a traditional transplant. But by using FUE, Armani was able to transplant individual hair follicles, selectively filling in the bald spots between Jeff’s previous transplant lines.

“We went in and all the areas where he had thinned out, with areas of bare skin surrounding eyelets of hair or patches of hair, we gave him a more natural look,” Armani said. “Though I told Jeff there was only so much we could do in one procedure. So we did one last year and I think he’s happy, but the goal is to have one last procedure to make him look better.”

Even though Jeff still plans to have one more procedure, he’s happy with his improved look.

“From a year and a half ago to today, it looks thicker,” Jeff said. “You can’t see that I had transplants; before you can see right through my hair because it was thinning.”

Jeff hopes his story will serve as a warning to other young men considering a hair transplant.

“If you’re thinking about doing this at an early age, take it from someone who did it at 20 for all the reasons that could be tucked under the umbrella of low self-esteem, confidence issues and vanity – it will decrease your confidence even further,” he said.

Armani recommends that men considering hair transplants meet with an experienced physician specializing in hair loss issues – and avoid chains that use salespeople instead of physicians to tout their procedures.

“Hair loss is not just male pattern baldness, there are medications that can cause hair loss, medical problems like hormones that cause hair loss – and a salesperson is not going to be able to diagnose these problems,” Armani said. “First, patients have to search for someone who specializes in hair loss and transplantation, who sits down, analyzes scalp, takes a medical history and then they can have informed options of what they need to do – whether medicine or waiting or hair transplantation.”