Is getting the crown done not really an option

[consideringmyoptions]

I have been losing my hair for 10 years and most of the loss has been in the crown. I just recently started losing a bit of my hairline, getting tiny widows peaks. I have longer hair and use concealers but dislike the stress of hiding my hairloss. If surgery on the crown isn't a good idea, I'm not sure I would even bother. I'm in my mid 30's btw. So is coverage of the crown just not done?

[Dr. Michael Beehner]

The answer to your question about what to do about the crown does not have one answer for all men in their mid-30's. There are some men with only moderate donor stores and an already fairly wide crown/vertex, which you know is going to enlarge more during the next 20 years, in whom it is probably a better idea to stay out of that area and concentrate on filling in the top, which there is enough donor hair to do a good job with. Such an approach frames the face and from most angles looks to people like a "full head of hair."

Then there are some other men who have very ample donor hair height and the back of the vertex is way up high, almost at the transition between the horizontal and the vertical, in which you look at a man of 35 and the whole thing is a "slam dunk." 35 is a whole lot better for making this decision than 25. I would never do that in a 25 year old, namely, commit to going down the back hill with grafts.

So, the answer is to see a hair surgeon you trust and get his honest opinion of what's best. Sometimes this can be accomplished with four views sent over the internet (front, top, rear, and one side), but nothing beats having the doctor put his hands on the scalp and feel the laxity and thickness of the scalp, and put the 30 power magnifier on the scalp to see how the FU's shape up. Each patient is different.

Mike Beehner, M.D.

[Hal]

The crown is considered a "black hole" by surgeons and patients alike because of its ability to suck up available grafts in an attempt to provide decent coverage.

 

You only have so many donor grafts available and the conventional wisdom is to use these wisely-- that is, to place them where they will have the best cosmetic value.

 

That of course is in the front-- the hairline and the core. You want to frame the face.

 

Naturally, everyone's hair situation is different. But the general consensus is that you do the crown last (if at all).

 

You're a good case in point-- you're worried about the crown but you state you are now losing the hairline.

 

I'd think long and hard before doing anything with the crown and depleting my donor supply until I knew how the hairline and frontal core were going to resolve.

 

Hal

[Spanker]

I think the above is correct. Everyone is different. You may consider crown coverage at a low density just for some coverage but understanding it wont be thick.

 

Best thing to do is to see a doc in person. a good doc.

[consideringmyoptions]

Thanks everybody. I'm going to make an appointment and see what the doctor says. I wasn't planning on making a move for at least a year.

[RCWest]

The receeding hairline is the first thing people notice about hairloss. Concentrating on a good hairline and front half with transplants is key. The crown can be covered to some extent then hair transplants from the top can be brushed over the crown to hide thinning.

[skepticalguy]

Put that rogaine on that shit, and save your donor for the front! Thats all the rogaine does anyway, It sure as hell dont grow your hair back in the front.. Much to my dismay!

[mattj]

Are you using any treatments?

[ziggy00]

It's good you're keeping your options open and thinking about it. Best not to make a rash decision. Like you said, you're noticing loss up front, so in a year you might want that done more than the crown.

[consideringmyoptions]

I have been using rogaine(5 years), nizarol(1 year) shampoo and a laser comb(6 months).

[mattj]

Do you think the laser comb is helping? I think the general consensus is that they are a bit of a scam. You may want to consider adding Propecia to the fight.