NY Hair Transplant : Crown Vertex

Additional Topics:

-	Limited role of scalp reductions
-	Use of Propecia/Rogaine
-	Transition from a hairpiece to hair transplants
-	Temple area transplantation
-	Trans-gender Transplantation
-	About Donor Scars

Links

60 Railroad Place Suite 102 Saratoga Springs, NY 12866
Phone: 518-581-1872 Toll Free: 1-800-281-9198
e-mail: saratogahair@spa.net

“The crown (or vertex) is that circular area of baldness in the far rear of the balding scalp which lies on a vertical plane. The hair within this area of the scalp, if present, is directed in a swirl or whorl direction, something like the spokes of a bicycle.

Our policy is not to transplant this area of the scalp unless a man is at least 38 years of age. By that time the hair surgeon can start to predict just how bald a given man will become, so that a terrible mistake is made at an early age. Many men with a small area of crown balding can progress to gigantic area of balding, which if transplanted early in life, later leaves the very deformed appearance of a thatch of hair surrounded by a large halo of bald skin.

We must emphasize that we deliberately try to “under-sell” what we can accomplish in this back area. We are very good at making it look natural, but we are not usually able to make it appear thick. The only time we can do that is if the man has a relatively small area and a thick, loose scalp – which allows us to perform a scalp reduction before transplanting in the remaining area. The patient below with the gray hair had this approach taken and had one of the rare thick crown transplants we have done.

The reasons why the crown can’t be made dense are as follows:
1) The hairs are angled in a “whorl” arrangement, by which they are all directed away from one another and not overlapping, as almost all the other hairs on our heads do.
2) The crown is on a vertical plane and very exposed to the public. Therefore, none of the grafts can be over 2-3 hairs each, or they run the risk of being slightly detectable
3) The crown is not the most important area of scalp. The frontal region and the midscalp are. Therefore, it is always wise and prudent to make sure that whatever donor hair is available is used primarily in these front and top sections first.


before	After 4 HT sessions

In selected men, we can use a “dense packing” approach to the crown and place up to 1000-1500 densely packed FU’s in this region. This can only be done if the other two areas have been taken care of or are fairly certain not to bald later on, as judged by the man’s age and maturity.
The photos in our “Crown Gallery”, which you can click on and view, show what we typically do in the crown area. In all of these patients, we were at the same time transplanting the frontal and midscalp areas and added in the extra FU’s that were placed in the crown, usually around 300-350 per session.


Before	After 1 scalp reduction and 3 HT sessions