Hair Transplant | Propecia Has Slowed My Hair Loss - I Am 41 And Interested in a Crown Hair Transplant

Propecia Has Slowed My Hair Loss - I Am 41 And Interested in a Crown Hair Transplant

I’m 41 years old and have been losing my hair since around the age of 24. I’ve been on propecia since it came on the market which has really slowed my hair loss down. I’m around a Norwood class 4 but I have a lot of hair in the hair line. Do you think it’s ok to have a hair transplant performed to fill in my crown now that I am above the age of 40 and have maintained a lot of hair for all of these years?
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Without seeing your scalp, I will have to speak in generalities. I am very pleased you have been on Propecia. As I am sure you are probably aware, Propecia is able to stabilize male pattern balding in up to 90% of men as long as they continue to use it. Before talking about transplanting your crown, I would like to focus on the last part of that statement. Propecia controls hair loss, but it does not cure it. If you were to stop taking Propecia, your balding would resume. However, worse than that, it is possible that your balding could actually catch back up to where it would have been at age 40 had you not been using Propecia at all. If you have been using Propecia since age 24, that suggests that you could lose a tremendous amount of hair over a year or two period if you stopped taking Propecia. So before considering whether you want to have your crown transplanted, you need to be certain that you are willing to continue taking Propecia indefinitely. Even if you are committed to long-term use of Propecia, please keep in mind that it is possible that you could develop side effects down the road that would necessitate its discontinuance. That would be quite unusual after having used it for such a long period, but we very rarely see men who develop enlarging breasts (gynecomastia) after many years of taking Propecia.

Assuming you understand the implications of discontinuing Propecia, I do think it would be reasonable for you to have your crown transplanted. I am fairly conservative regarding the crown, however, and I would suggest that you have it transplanted at partial density rather than attempting to achieve full thickness. I say that for two reasons. If your balding should resume after having transplanted the vertex, you could be left with an ever expanding halo of balding skin surrounding an island of transplanted hair. If that island of transplanted hair was low to medium density rather than high density, it will make it much easier for you to have that halo of balding skin transplanted at a similar density. Also, you must remember that if your balding has resumed, the hair on the front and top of your scalp will also be eroding away. That means you will want to have saved enough donor hair that you can fill in those areas too. Unfortunately, if you had dense packed your crown previously, there is a greaterchance that you would exhaust your donor supply before you were able to lightly fill in these new balding areas.

I hope that helps.

Sincerely,
Blaine Lehr M.D.
Member, International Alliance of Hair Restoration Surgeons
Member, American Hair Loss Association