Male pattern hair loss is typically classified according to the Norwood Classification Chart below. Generally mature patients (approximately age 40 or older) of Class 5 and above on the Norwood Chart can have the appearance of a full head of hair through hair transplantation procedures. Their supply is sufficient and their pattern of loss is such that a restoration program can leave them with complete coverage. This will usually involve at least two procedures. Men with loss like those of a Class 6 or 7 may need to be content with more of a thinning look. They will have hair so as not to be bald, but may lack the density of the hair on the sides and back.
Hair transplant procedures work well for all who have an ample supply of permanent hair. Men of all ages and all ethnicities are potentially good candidates for the procedure. Hair transplant procedures involve redistributing hair from an area of relative excess to an area of need. No new hair is created with the procedure. The more hair a person loses, the more hair he needs to recreate his natural look. The task of the transplant surgeon is to give a patient a natural look that will look good after the procedure, and for the rest of the patient's life. This involves treating the loss today and planning for the possibility of future loss.
Young patients, those in the 20s and early 30s, can have significantly more loss as they age and this possibility must be accounted for in any restoration plan. Once a person reaches his mid-forties, his pattern is well established and the transplant doctor can accurately assess how much donor hair is available for transplantation. A good rule of thumb is that whatever hair loss pattern a person has at age 45, is what will remain. The pattern should not change substantially over the remainder of the patient's lifetime. This makes it much easier to inform the patient about his restoration plan. For the man in his early 20s with significant hair loss, it is very difficult to know how severe the loss will become. Since the transplants are permanent, the doctor must plan for the possibility of severe loss and be conservative. He must preserve donor grafts in the event that the patient needs further transplants as he ages. Young patients pose a significantly greater challenge.
Another problem with young patients is their expectations. The 24 year-old patient can easily remember what his hair was like at 20. He may want the hair transplant surgeon to recreate that look. This is a classic mistake. Hairlines naturally mature as we age and a 20 year-old's hairline would look unnatural on a 40, 50, or 60 year-old. Further, the young patient may not have enough donor hair to maintain that look as future loss occurs.
