The Psychology of Hair Restoration Patients
By Robert M. Bernstein, MD & William Rassman, MD

Men under the age of 25 with hair loss are having hair restoration procedures more frequently today. These young men are confronted by both their entry into manhood and the perception that their balding is aging them at an accelerated rate. These patients often feel deprived of an essential element of their youth. This feeling is created and affirmed, seemingly by everything our western culture promotes.

Hair is indicative of a healthy, youthful appearance. Images on television and in the movies reinforce the association between a youthful appearance and a full head of hair. It is difficult for a young man who is balding to sort out his identity when surrounded by a world of hairy, virile, healthy, "normal" appearing young men. For these young hair transplant candidates, objectivity does not always prevail. Panic sometimes generates the decision to get their hair back. The premature loss of hair becomes equated, in their minds, with the premature loss of their youth; therefore, medical education, ethics, and honest rules of engagement (informed consent) must be high on the physician's priorities when discussing the hair restoration procedure with this youthful subset of the balding population.

Men in their 30's and early 40's are more deliberate about the decision to undergo hair transplant surgery. Many have considered the procedure for some time, but faced with the difficulty of getting accurate information and finding a doctor they trust, they may wisely delay the decision. Some outside factor may finally push them to become serious in pursuing hair restoration surgery. This factor may be a business decision, (a younger looking person may have more earning potential), a divorce, or the availability of financial resources. Alternatively, it may reflect the self-indulgence of a confident, successful person doing something for himself.

Having hair restoration surgery is moderately expensive. The cost depends upon several factors: the amount of work that must be done based upon the level of hair loss, the expectations of the patient, the proposed method, and who will perform the work. It may cost more than a mid-size car, a cruise, or a safari, so it deserves serious consideration. A vacation or a safari lasts but a few weeks; a mid-sized car will last a few years; but a hair restoration will last a lot longer. The cost of the restoration is a factor, but should not be the overwhelming determinant.

Going to an expensive surgeon does not guarantee good results. If the cost of the work exceeds the patient's ability to pay for what he actually needs, the patient may not be able to finish the work he started. A poorly planned procedure, or failure to complete what was started, can produce a medical oddity. A properly staged procedure over long periods is as good a choice as a Fast Track¨ approach. The key to a successful hair restoration is the creation of a customized plan that reflects the goals of each patient. An attempt to cut costs can lead to a lifetime of regret every time you look in the mirror. One should ask: "How much hair will I actually get for the dollars I am planning to spend?" As men grow older, they become more discriminating. They have life experience, and know what they want because they have the maturity to make balanced, non-emotional judgments. They are thoughtful about the decision process and they usually take the time to research their choices reasonably well. For those who can afford it, there is no substitute for the best money can buy. Men under 30 may be more motivated by the emotional aspect of looking older too soon. They are vulnerable to high-pressure sales tactics by unscrupulous salesmen. Men over 30 often feel they have worked hard, achieved a great deal and therefore decide to reward themselves. More often, they may want to look as young as they feel, and having hair is important to their sense of well being.