Crown Hair Transplant

hair transplant crown

A crown hair transplant uses the hair taken from the back and the sides of the head and transfers this hair to the crown area. Thinking about having a crown hair transplant? This blog will help you find out more about the procedure and what you need to consider.

What is the crown?

The crown of your hair is also called your “hair whorl”. This is a spiral of hair at the back of your head. You might sometimes see that you have 2 hair whorls in your crown- a so called “double crown”. This is also normal.

Hair thinning in the crown

As part of the process of male pattern baldness, you may notice your hair starting to become thin in your crown. This is because dihydrotestosterone (DHT) targets not only the hairs on the front and top of your head but also your crown.

This is depicted in the Norwood scale for male pattern baldness, (see below).

norwood scale for hair loss
Norwood scale of balding showing the different stages of hair loss

You will notice that the crown can be affected in male pattern baldness. In some men the crown can thin and bald quicker than the front of the head. In others it can thin and become bald over time in keeping with the natural progression of male pattern baldness. For example you may realise you have reached Norwood 3 Vertex in your mid 30s or 40s.

Some cases of male pattern baldness can be rapid, with crown and frontal hair thinning & loss by the age of 25-30. This is of course unfortunate for those who value having hair on their head!

Is crown hair loss different?

Losing hair on your crown can appear different to balding on the front. The underlying process that drives crown and frontal hair balding is the same. However, there are subtle differences that mean they look very different.

Because you look at your/ someone else’s crown from a steep angle- you look down onto the hair vertically. This means you can see more scalp- especially if you have dark hair and light skin. Have a look at the example below:

male hair loss crown

You can see that there are still lots of hairs in this gentleman’s crown but as they have thinned, more scalp is now visible. This has consequences for crown hair loss treatment.

Treating and Preventing Crown Hair Loss

The visible scalp in crown hair thinning means treatment can have be really beneficial. By using treatment like Finasteride, Minoxidil and in some cases PRP injections, you can increase the density of each hair and therefore hide any visible scalp. This means that by treating hair loss you have a secondary bonus of hiding signs of crown hair loss and balding.

Have a look at the case below. You will notice he has thinning and balding in his crown. By taking treatment to promote hair growth and thicken hair he has treated his hair loss and hidden more scalp in his crown. This has reversed his Norwood 3 Vertex/4 to a Norwood 2a/3a.

crown hair transplant before and after
Hair regrowth following 5 months of treatment

 

What about a crown hair transplant?

Unlike hair transplants to the front of the head, crown hair transplants generally require a lot more hair. This is because of the angle with which you look at the crown. Take the picture above for an example. We are looking directly down onto the gentleman’s crown. Each hair is pointed directly at us and therefore less of the hair shaft is covering the surface of the scalp from our viewpoint. This means more scalp is visible.

For this reason, when we perform hair transplants on the crown we require much greater numbers of hairs. This allows us to cover more area in the crown and make the signs of hair loss less obvious.

Because crown hair transplants require more hairs, your surgeon needs to carefully plan your operation. With higher numbers of grafts, you and your surgeon will need to take into account the following points:

  1. How much hair do you have on the back and the sides of your head
  2. Are your hairs thick or thin?
  3. The approximate number of grafts required to give you good dense coverage
  4. If you need a high number of grafts (e.g. >1500 follicles) then how will your surgeon plan the operation to make sure they all survive?
  5. If it is a lengthy procedure should you and your surgeon consider splitting the operation over 2 sessions?
crown hair transplant before and after
6 months of early growth following a crown hair transplant

Crown hair transplants can also be tricky to take care of once you have finished your operation. Because new grafts have been put into your crown, sleeping at night can be problematic. You might need to sleep at an angle to make sure you protect your grafts in the first 14 days.

As the grafts are at the back of your head you might find you forget that they are there! We have had a few patients bump their heads getting in and out of cars in the first few days after the operation. This is particularly problematic on the day of the operation. As you have had your head numbed, your ability to know where the top of your head is in relation to ceilings, roofs and doors can be impaired.

Going through this journey with your hair transplant surgeon is important. They need to make you aware of all the nuisances that you might encounter in the days following your operation.

Choosing to have a hair transplant

As we have mentioned before, choosing to undergo a hair transplant should be a well thought out decision, (click here to read blog). A crown hair transplant has some extra points you need to consider (as described above).

We encourage you to make sure your hair transplant surgeon is fully registered and licensed, including the clinic they work at. In the UK this includes both:

  • A GMC registration for the Surgeon
  • A CQC licence for the clinic

At The Treatment Rooms London we welcome new patients exploring treatment options for their hair loss. This includes having a crown hair transplant. Feel free to contact us today and book your free initial consultation, (click here).

Follicular Unit Excision (FUE)

hair transplant graft extraction

Follicular Unit Extraction has now been changed to Follicular Unit Excision. This reflects the importance and special surgical techniques required to make incisions and extractions in hair transplant surgery. In this blog we explain why this change has been made.

Follicular Unit Extraction now Follicular Unit Excision

Both Follicular Unit Extraction and Follicular Unit Excision refer to the same surgery. So what is the correct name we should be using?

What is FUE?

This is a type of hair transplant surgery where each hair follicle is taken out individually. FUE is carried out by using a small circular punch to cut around a hair follicle. Using specialised surgical tools these hair follicles are then removed and re-implanted into bald areas. Over time this will help recreate hair where it has been lost.

This technique differs from FUT (Follicular Unit Transplantation) where a strip of scalp is taken and hair follicles are isolated from this strip. Patients who have FUT have a visible scar line across the back of the head. In FUE this is avoided by having small dot scars at the back of the head. As these small dots are spread out they are not noticeable if someone grows their hair out.

Why the change from Follicular Unit Extraction to Follicular Unit Excision?

The change in name has been made to emphasise the highly skilled surgical nature of a hair transplant. The International Society of Hair Restoration Surgery (ISHRS)- the global leading authority on hair loss and prevention treatments implemented the change in 2018.

Dr Ricardo Mejia, ISHRS Board Member explained the main reasons:

When performed by qualified, properly trained hair restoration surgeons, hair transplantation is a safe and highly effective procedure to correct hair loss. However, it is a cosmetic surgical procedure and any attempt to downplay the significant surgical aspects of FUE to appear less invasive is misleading and potentially dangerous to patients

Dr Ricardo Mejia

Dr Meija explained that the term “extraction” in Follicular Unit Extraction, implied that the procedure only involves extracting or plucking out hairs without any need for surgery. And in some countries because the term “extraction” can have non-surgical implications, the surgery can be carried out by non-surgeons.

…over the past 15 years, the term “extraction” has been used to minimise the surgical nature of this surgery in order to imply a non-surgical procedure that only involves “extracting” hairs, as if they were being plucked out of the scalp without surgery. This misleading messaging has given rise to the worldwide expansion of follicular unit excision (FUE) surgery being performed by non-medical and unlicensed personnel- essentially spawning a black market for hair transplantation that has resulted in cases of serious cosmetic damage with scarring and hair loss, infections and even deaths

ISHRS website

Amending FUE terminology is one more way that we can inform patients about the true surgical nature of the procedure so they can make better decisions about their choice of physician and treatment

Dr Ricardo Mejia

Want to find out more about Follicular Unit Excision? Arrange an appointment with our Hair Loss Doctors and Surgeons. Simply click here to your book consultation!