Hi all, I apologize for the long post, I promise this will be the one and only long post from me, ever (though I do look forward to contributing several much shorter messages in the future!). Somehow I sat down with my laptop and all of this just came out! Here goes . . .
Falling under the rubric of unsolicited advice, please allow me to put together a few words to the younger guys on this forum and others considering a hair transplant procedure.
I am 36 years old, and I underwent two, small (â€œtinyâ€ by today's standards) hair transplants with the Bosley Medical Group in San Francisco in 1993, when I was just 22 years old (243 â€œminigraftsâ€ total). This one decision has impacted my life very deeply, and not at all in a positive way. I hope that some useful information can be gleaned from my experience, and hence I want to offer this post, my first, though I have lurked here for some time.
I cannot tell you how much pain the decision to get 243 â€œminigraftsâ€ (as they were called back then) put into the front of my head has caused me, personally and professionally. I have been beating myself up for 13+ years about this, with much guilt, in particular profound sadness for having spent most of my adult life under a baseball cap, and avoiding many social situations altogether, including many of the â€œhappyâ€ and â€œfunâ€ ones. This is not the way to live, and while I feel I have already achieved a lot of what I want to do in life, in particular in relation to my wife and family, I would be lying if I didn't say that there has always been an underlying current of sadness over how I screwed up my head, much of my sociability, and related to this that I have to live under a hat if I want to try to hide this fact from the world.
In this post, please allow me to briefly discuss my take on three topics, topics I believe are relevant to the younger guys on this forum considering a hair transplant: (1) the sleaziness of much of this â€œindustryâ€; (2) the nature of the important life lessons one learns as a young man in his 20s, and how this sometimes gets intermeshed with the impetuousness of youth in such a way that leads to less than optimal decisions; and (3) my general advice for anyone under the age of, oh, say, 30 considering a hair transplant.
There are many voices, more senior and far more knowledgeable on these topics than mine on these forums, but what I can offer, at a minimum, is personal discussion from the vantage point of a (still) relatively young man who made the unfortunate mistake of falling for slick advertising, lies, and perhaps most problematic, confusing one's â€œlooksâ€, in this case hair, with one's â€œidentityâ€ as a person.
â€œPure Sleeze, or the Dangers of Signing a (Lifetime) Contract with the Devilâ€
I grew up in the 1980s, playing sports, lifting weights, and reading those â€œJoe Weider Muscle and Fitnessâ€ magazines. I worked out nearly everyday, ate tons of good food, did not drink or smoke like some of my friends, and enjoyed the athletic body I was able to build. I also read the advertisements in Joe Weider's Muscle and Fitness, and more crucially, the â€œarticlesâ€ (though in retrospect, they were also advertisements) on Dr. Bosley and his â€œpracticeâ€ in those magazines, which talked about how wonderful Dr. Bosley's practice was and how he was the industry standard reproducing completely natural looking hairlines on balding men. Of course, I had a great head of hair at that stage of my life, but I still read all the articles and looked at the (now known to be fake) photographs of supposed transplanted hairlines. Please remember that the 1980s (and in some ways, early 1990s) were a completely different time in terms of available information. It wasn't that long ago, but in terms of availability of information, it was a world away.
I'm not going to go into full detail on Bosley's deceit, as this has been documented elsewhere, including using airbrushed photos of supposed hairlines he built, actual â€œfakeâ€ photos of heads that had never undergone hair transplants but were represented as typical Bosley Medical Group transplantation work, the downplaying of pain, suffering, and scarring, understating the financial commitment continued hair transplants represent, etc. If I did go into detail, however, it would be in the form of a hundred-page thesis of sleeze and salesmanship, and from what I read and hear from some people, some of this still exists in the industry today.
If I were to tell such a story, I would detail and document the lies â€“ how Bosley's sales people, dressed in medical uniforms at a local (non-surgical) sales office assured me that there would be no scars on the front of my head, and if so, how they would be negligible and of no more consequence than when I â€œcut my face shaving in the morningâ€; how a linear scar in the donor region is typically difficult to find on patients â€œjust a few months after the procedureâ€; how Rogaine/minoxidil is a sham; and how the grafts would not compromise the integrity of the recipient area, in that there would be no bumps or pitting. Fast forward to the surgery (which was scheduled before I even spoke to the doctor!), I would further elaborate on how when I showed up in San Francisco for the surgery, another â€œSenior Medical Assistantâ€, again, dressed something like a doctor, re-iterated his and the physician's opinion that minoxidil was in fact a sham, and how I shouldn't worry too much about future hair loss, as my father had â€œgood hairâ€. I would also tell the story of the late-20s man visiting the San Francisco Bosley office the same day I did, with severe balding, who was encouraged to â€œget 100 minigrafts and see what you think!â€ I can only hope that this young man made it out with his scalp intact.
On meeting the doctor, I would fully detail how it was only then revealed that the best strategy was not to place the hairs along the hairline I wished to beef back up to where it was when I was 18 (how was I not set straight right then and there in terms of expectations?), but rather that the best strategy would be to pluck areas of hair behind the existing hairline and stick the grafts in there, and that this is the standard procedure that Bosley has successfully followed for many years. After all, this â€œnew hairâ€ once in place, would be undetectable and â€œbetterâ€ than the old hair anyway, as it would be permanent, and as the existing hair would probably fall out soon anyway. In relation to the physician, I would also discuss how I was told by the Senior Medical Assistant that all Bosley doctors are trained for a minimum of one year by working under Dr. Bosley himself in a kind of mentorship, though it has since been discovered that at least one Bosley doctor, from the Beverly Hills office, started cutting away on unsuspecting heads after merely viewing half a dozen procedures. Finally, I would tell of the excuses for the linear scar being visible months after the procedure (recall I was told it is â€œdifficult to findâ€ the linear scar(s) merely â€œa few monthsâ€ after the procedure), as the excuse was classic â€“ I was told that I was â€œtoo whiteâ€, and that if my skin were darker, as it is for many patients, that the scar would not be so visible.
Now, I don't want to go into the details of my life shortly after undergoing the second small hair transplant, but suffice to say that I was not in a position to fight Bosley, as at that point I was personally going through a very difficult time, on top of the botched Bosley outcome.
Today, nearly a decade and a half later, I have, of course, lost a lot more hair, and the plugs â€“ some with several, thick hairs in them right along the front of my head â€“ are out there for everybody to see. Many of these plugs are raised; rather than the smooth scalp I was promised, and was told was Bosley's trademark, the skin up front looks, and I imagine feels, something like the surface of the moon. The linear scars, of course, are also just as prominent.
Retrospectively examining my reaction over the years to the bad outcome, I suppose I could have just shrugged it all off, damned Bosley, not apologized to anybody, and walked around confidently displaying to the public the ongoing science experiment that was my scalp for the remainder of my 20s and into my 30s. But, I didn't, and I haven't. Perhaps other men would have, and more power to them. Thus, in practice, I went straight from being a naÃ¯ve teenager to an immediate post-teenager at an insecure and transitional time in my life, to being a scarred young man, literally and figuratively, in my 20s and 30s. I have missed out on full participation at countless social activities, parties with old friends, and family gatherings, most regrettably, with people now passed on, due to an insecurity not over hairloss, but rather over the scarlet letter I attempt to hide on my head, in the form of ugly, raised, off-color, pluggy tufts of odd-looking hair, or as Bosley called them, â€œminigraftsâ€, as well as the linear scars that also comprise the damaged surface of my head.
Equally as painful, however, is finding that my â€œbaseball capâ€ trick wore off years ago, as it increasingly comes out just how many people, from my personal and professional life, know exactly why I am married to that damn hat. Some people are understanding and supportive, others are not. Some people have found kind ways to tell me â€œit's okâ€, and I have appreciated that. Others, I have discovered, have running jokes about it, and have particularly painful nicknames for me. I am not looking for sympathy here; my purpose in posting is in the hope that it might offer food for thought for any young man, or men, thinking of embarking on a potentially life-long contract with hair transplantation.
â€œThe Impetuousness of Youth, and the Importance of one's 20s in Becoming a Manâ€
Legally in the US, one becomes an adult at age 18. One can vote in Presidential and other elections, helping to chart the course of political leadership of the country. You can't (legally) drink at 18, and renting a car can sometimes pose problems until you reach 24. Beyond these important milestones, however (and who would doubt the rush one gets renting a car for the first time, ha), it is in one's 20s, and well into the 20s, I would add, that I feel that one begins the process of fully exploring and truly getting to know oneself, who you are quickly becoming, and who you would like to be. These life lessons that only come through getting one's hands (at least) metaphorically dirty with the experiences of life, can sometimes conflict with the impetuousness of youth, and a kind of dualism sometimes develops that pits the emerging man against the fading youth, and I mean â€œfading youthâ€ not at all in terms of appearance.
Thus, what I am arguing is that there are an incredible number of challenges and changes that one naturally undergoes in their 20s (and 30s perhaps, too); education comes not only through â€œschoolâ€ of whatever form if applicable, but more crucially, through life experiences more generally. And, most crucially, these emerging changes can quickly alter perceptions and priorities, and as such it is quite possible to find oneself having made perhaps too quick of a decision to embark on something like hair transplantation. On the financial side, family emergencies and obligations, student loans, broken pipes and leaks in the roof of the house you struggled to buy, and, eventually, kids' braces, broken arms from skateboarding accidents, and the desire to start college savings and retirement funds can all alter one's financial priorities, away from maintaining a (perhaps unsustainable) youthful hairline and toward other things that you now have â€“ and want â€“ to do.
Even if you have or make a ton of money quickly in your career, say you are a multi-millionaire by the time you are 25, I would still submit that it is worthwhile to consider holding off on hair transplantation until at least a bit later, first, for aesthetic reasons, as you do not truly know how much more hair you are going to lose in the, say, 60 more years you are going to be alive. Second, and equally as important and alluded to above, I think it is worthwhile â€œgetting to know yourselfâ€ as you experience your 20s, going through those changes and seeing where they lead you, before even thinking about a procedure as permanent and life-altering as a hair transplant.
In closing on this point, I want to re-iterate that I know and understand how hard it can be to experience early hair loss â€“ believe me, if anything, I would argue it was much harder in my day, as I grew up as a teenager in the 1980s, when very few bald guys would be considered â€œcoolâ€. Today is baldy heaven compared to those days. But please, remember my point, and don't make the same mistake I did, in misunderstanding and allowing a conflation of one's appearance, in this case, hair, or lack of it, and one's sense of self. This might sound trivial, but in practice I think it can be more difficult than we would always care to admit.
â€œUnsolicited Advice, or What I would tell my (hypothetical) son if he wanted a Hair Transplant?â€
Ok, gloves off. I don't want to get preachy, but assuming that some of the words I have offered above have made at least a degree of sense, let me offer some unsolicited advice.
First, my advice to my (hypothetical) son would be to get out there in life a bit before even considering a hair transplant â€“ progress through some jobs, perhaps further one's education, travel to other countries and get to know communities and people in your own area with whom you have never interacted. Do some volunteer work, develop your hobbies, make new friends. Find what really inspires you to do your very best. In other words, I would try to explain to my son that priorities can change rapidly in one's 20s, and yet embarking on a relationship with hair transplantation can â€œlock one inâ€, literally, for life. You might find yourself having to service a vanity, an understandable one to be sure, that simply might not be as high a priority as one gets even just a few years older. Buy a house, get a tattoo, get married â€“ you know, all of those things that are potentially LESS permanent than a hair transplant, before thinking about getting a transplant yourself (ha). I am, of course, being facetious here to some degree, but I hope the point is clear â€“ the decision to get a hair transplant can be with you for the rest of your life. Perhaps there are no absolutes, but my suggestion to my son, assuming my genes carried good donor characteristics and a family history of strong heads of hair late in life (not the case), I would suggest that he wait at least until he's 30 years old.
Second, if a hair transplant was even remotely being considered, I would secondly strongly recommend that my son immediately look into the scientifically proven, non-surgical treatments for hair loss â€“ namely, oral finasteride, topical minoxidil, and ketoconozole shampoo. These are all now available in generic form and are quite affordable. I would furthermore suggest that he stay on all or some combination of these (plus perhaps other proven treatments) for two full years before undergoing a hair transplant, if that option remains a desired one. Getting on the scientifically-proven medication serves three purposes: (a) it significantly slows down hair loss and might even regrow some hair for several years; (b) it buys time in terms of a â€œcool downâ€ period to really RESEARCH hair transplant physicians and options (to separate the scumbags from the honest-to-goodness superstars/top doctors out there, and yes, there are in fact â€œtrue scumbagsâ€ and â€œtrue superstarsâ€ operating at this very moment; and (c) perhaps most importantly, it also offers a â€œcool downâ€ period in terms of the wider context of pondering whether one really wants to embark on hair transplantation at all, given the rapidly changing environment and structure of priorities of a young man's life.
My third bit of advice, and I fear I might be quite dogmatic on this one despite a desire to allow my son to lead his own life, would be to avoid any and all hair mills like the plague. Let's say, hypothetically, that in the future one of the hair mills improves to the level of offering results as good, and as consistently as good, as the top doctors in the field (which I doubt will ever happen, as this is simply not their business model, it would be like asking for a gourmet meal to be routinely provided by McDonalds) â€“ I feel it would still be advisable to avoid such a hair mill, as these are the very people who knowingly misled, lied to, and scarred and disfigured the heads and lives of thousands of unsuspecting individuals over years and even decades, all to make a buck. Remember, RESEARCH! Take advantage of all the informational resources that were not so readily available back in my day. Do your homework, and if you decide to get a transplant, by all means be willing to travel wherever you need to go to sit in the chair of one of the best, and in your well-researched opinion, the VERY BEST doctor on the planet for your particular procedure. Interestingly enough, it can be noted that the top doctors out there are really not that much more expensive than the butchers of the hair mills.
Finally, if my hypothetical 30+ year old son, well-researched, with good hair genes and strong donor characteristics, and having been on finasteride, minoxidil, and ketoconozole shampoo (in addition to perhaps other non-surgical treatments) for at least two years still indicated to me that he wanted a hair transplant, I would advise that he do so, particularly initially, in a conservative fashion, and that he look into an FUE/FIT type procedure rather than a strip. While as of yet I would consider myself to be under-educated on FUE/FIT, I would nevertheless recommend that my son (or any younger man) look into the least invasive type of transplant, which at least for me, turns the scales toward a skilled FUE/FIT physician. People can disagree on this point, as again, this is just my opinion.
When I look in the mirror each morning, I not only see the person I am at 36, someone who for the most part enjoys his work and his family and does his best to live in a respectful way toward all people, but I also see elements of that insecure 22-year old, rushing into the local Bosley sales office looking to hold onto some semblance of a teenage hairline. More accurately, when I catch a closer glimpse of my face, my eyes, and in some sense, of the person who resides â€œbehind those eyesâ€, I realize that for the most part, that insecure 22-year old â€œsimply doesn't live here anymoreâ€. But at the same time, because of my physical scarring and rag doll head, I also realize that that same insecure 22-year old is still, at a minimum, having some of his junk mail delivered to this address. And my greatest fear, and on some days, uncomfortable realization, is that in very tangible ways that the 22-year old, though gone, has significantly scarred the 36-year old, and because of this and the assorted neuroses that have accompanied it, that the 36-year old is perhaps performing well below his potential in several areas of his life. And there's nothing that can do more damage to one's life than shattered confidence.
Of course, I am happy to report, these are things I am now taking active steps to overcome, better late than never!
Again, I apologize for this post running so long, that was not my intention. But hopefully something I have said will resonate with somebody, and be of use in their decision-making processes in dealing with their hair loss. Besides the factual material expressed above, the rest is opinion, and remember, reasonable people can reasonably disagree. At the same time, however, I think a strong case can be made for the key points I express above.
Thank you for your interest!