A 19-year-old boy with male pattern baldness type 3 was the youngest patient that I had operated till date. Extreme caution and a conservative approach are warranted since the endpoint of the male pattern baldness cant be determined at this age group. It must be assumed that the hair loss will be progressive. The density of the patient’s donor area also happens to be weak with very thin and fine hairs. Maternal side strong predisposition is there for Alopecia of advanced grades.
I recommend strengthening of existing hairs with medical management, PRP sessions, but leaving the hairline at a relatively high position to ensure sufficient donor hair for future procedures when needed. A mature hairline pattern is essential for long-term planning. The grafts will be concentrated only on the front and top. The decision to graft the crown should be deferred until he is older when his hair loss pattern can be more accurately assessed and the available amount of donor area determined. The patient must understand that because of his very young age, future sessions will be needed as hair loss progresses.