With all due respect, because it might help to avoid a potentially stretched and problematic scar on the back of the head. There are too many scar repair cases to count on forums like these that are still coming in daily. The fact that even the best doctor cant predict whether a scar will stretch, and considering a HT is cosmetic surgery, if the front looks good at the cost of the back looking bad, it would make sense to elect a surgery that does not inherently come with that risk. ((depending on the personal goal/characteristics/NW pattern/future loss/ etc. of the patient)) Just my opinion. That being said I respect Dr. Fellers work very much, but this one point kind of struck me.