The crown region – sometimes referred to as the ‘bald spot’ – is located on the back portion of the scalp and is an area commonly affected by male pattern baldness. In fact, most men begin looking into hair transplants for the first time after noticing balding in this region. First time clients often tell us: “I hate the bald spot on the back of my head, it makes me look so much older than I am!”
So, what’s the matter? Aren’t all types of male pattern baldness equally treatable? Here at Modena Hair Institute we are experts in every type of hair transplant procedure, so is a hair transplant for the crown any different?
Simply put: yes. There are a number of things a patient with a balding crown must consider and talk to with their doctor, such as:
Prioritizing Frontal Hairlines First
While the crown features prominently on the scalp, it’s usually less cosmetically significant than more visible regions like the hairline and frontal scalp. Balding in the crown, because it’s at the back of the head, can be hidden more easily. Most men find it less discomforting than frontal hair loss, which is why we advise working from the front to the back when it comes to hair restoration.
If you’re experiencing hair thinning on the frontal area of the scalp, it’s highly advisable to tackle this area first, before attempting to restore the crown.
Even if you’re seeking to tackle both areas of thinning at once, it’s still usually better to start in the front and work back to the crown. That way if you do run out of grafts, the hairline, frontal scalp, and mid-scalp regions – which are more visible – are restored first. But why does this matter? Is running out of grafts an actual concern? Yes, you and your doctor will need to discuss:
Considering the Health and Strength of the Donor Area
The donor region – the area on the sides and back of the scalp where follicles are harvested for use in a hair transplantation – is limited. This means that a patient may not have enough life-time grafts available to cover the entire scalp if progressive hair loss occurs.
Both FUE and FUT/Strip methods of hair transplant surgery rely on a healthy and sufficient donor area to extract grafts for transplantation. If your donor area does not contain enough healthy, strong follicles to extract, it might result in a limited number of possible hair transplant operations.
When considering a hair transplant for the crown region, you must assess whether there is enough viable donor hairs to cover the frontal hairline in the future. If you fill out the crown area and begin to thin in the front, what will the result look like?
In most cases, the result would look unnatural. No man would like to have a full and thick crown, accompanied by a thin and empty frontal hairline. The opposite, however – men with fuller fronts and thinner crowns – is more natural and therefore more aesthetically desirable. So if you are faced with a limited donor supply, it is better to consider first what can be transplanted to the frontal hairline. An experienced hair transplant specialist should know how to approach splitting up the grafts, and will guide you through the process during the consultation phase.
Now, there are situations where men only thin in the crown and not the front. In this case, donor regions should be assessed differently and strategically. Certainty about how the hair loss will progress is impossible, but the closest approximation should be made. It is always wise to make sure there is adequate donor hair for the front first, as addressing the front first is almost always the safest and most strategic move.
So, should you have a hair transplant in the crown? Well, review your answers to the questions above and see how you feel. If you understand the need for a long-term approach and the idiosyncrasies of crown transplantation, you may be a good candidate. Consult with a clinic experienced with transplants in this region (make sure they can show you multiple examples of crown transplants) and make an informed decision with the above in mind.
Here is an example of a patient who met the criteria above and was able to restore his crown. Maybe you will be next!
Dr. Amir Yazdan, MD, is an internationally renowned hair transplant surgeon, expert guest on Dr. Phil and The Doctors, creator of the GroMD hair restoration product line, ISHRS member, accredited member of the IAHRS and a visceral advocate for patient care. Learn more about Dr. Yazdan or read rave reviews from his patients.