9 months after 2nd HT..Is the crown a never ending battle?

[Gettinold]

I lost ALL the hair in my crown throughout my 20's, so naturally, this is where I wanted to start my HT journey. From my own personal experience and a lot of the photos that I 've seen, it seems the crown just turns into a never ending battle for desired coverage while the rest of the head takes off running (see my photo album, the small patch in my hairline was almost immediate [well, 4 months] gratification). I'm 9 months into my second transplant and I'm still not to the point where I can go out without a hat or lot of concealer in my crown. There's obviously a lot of growth, no question about that, but I'm not willing to keep pumping grafts (and several thousand more dollars...already $11k into this) into the crown when I may need them in the future...opinions, comments?

 

Please don't take this is as a crack on my doctor, I had a highly recommended surgeon who did a great job...this is more on the nature of crown transplants themselves..

 

Photo 1: Pre HT crown

Photo 2: 1700 graft HT at 14 months

Photo 3: Second HT-1500 grafts at 9 months (current)

[FUE2014]

I looked at you album and you have definitely come a long way, front is looking really good! I agree the crown is a stubborn area to fill and is not known as the black hole of transplants for nothing. However, I think if you were to put another 1500 grafts in there you would be very close to getting the coverage you are after. Also bear in mind that your long hair probably makes your crown seem worse than it is.

 

On a related point, I do wonder if a lot of surgeons lack the skill to perform surgery on the crown in comparison to the hairline? You see some great coverage from Lorenzo on the crown, but not many other doctors spring to mind.

 

Everyone is obsessed with what doctors perform the best hairlines, but often little attention is paid to the doctors which perform the best crown work.....I'm sure it must be an art in itself, no?

[TommyLucchese]

No crown expert here (or expert on anything, for that matter) but the common line is that second transplants take longer to grow in and that crown jobs themselves take longer too. So at 9 months I think you have more time for improvement

[Gettinold]

Thanks for the replies:

 

Well aware of the fact that the 2nd transplant takes longer to come to fruition than the first, but I'm not going to kid myself into thinking that in the next 6 months I will have a 20 year old's crown with no skin showing at all...I've definitely come a long way, no doubt, and even if progress stopped here I know that the hair transplants were a success, just not exactly what I had really hoped for...it was mainly a general question of "how much is too much" and "what should the expectation be" for crown transplants.

[Gettinold]

I looked at you album and you have definitely come a long way, front is looking really good! I agree the crown is a stubborn area to fill and is not known as the black hole of transplants for nothing. However, I think if you were to put another 1500 grafts in there you would be very close to getting the coverage you are after. Also bear in mind that your long hair probably makes your crown seem worse than it is.

 

On a related point, I do wonder if a lot of surgeons lack the skill to perform surgery on the crown in comparison to the hairline? You see some great coverage from Lorenzo on the crown, but not many other doctors spring to mind.

 

Everyone is obsessed with what doctors perform the best hairlines, but often little attention is paid to the doctors which perform the best crown work.....I'm sure it must be an art in itself, no?

 

Agreed-it's definitely a different technique, and I'd say that Dr. Charles has it down..if you look at the immediate post op photos, you can see the natural "spin" and angle a crown has. That seems like something that would take a lot of practice to achieve...but on the flip side, that same pattern makes the crown much more difficult to "fill in".

[Gettinold]

Well, 11 months in here....no progress and last night my girlfriend of 9 months brought up my thinning crown and suggested a buzz in the future. It was a huge kick in the nuts after 2 transplants and 11 grand was spent to avoid that...can't tell her I can't because of the scar in the back of my head. Pretty frustrated at this point, I still have a sizeable bald spot and not expecting any miracles in the next few months. There's definitely more hair there than there was originally, but I'd really hoped for better coverage from 3200 grafts, especially since it would be unwise to put any more in the crown..

[Cant decide]

3200 should have made a huge difference. Maybe try a different style? Maybe the grafts were not angled optimally for coverage? I have never been a fan of Dr. Charles work. Nice enough guy but does not impress me at all with the work he posts.

[Cant decide]

Just took another look at you pics. I think your issue is your styling. Try to get a style that allows some shingling at the crown. The way you have it now is far from optimal for illusion of density in the crown.

[hsrp10]

SMP can do wonders for the crown without surgery

I would at least look into it

[aaron602]

sorry to hear your stuggling with you crown

i think fue with bisigna and Lorenzo would b optimal in getting a result your looking for

Lorenzo is amazing

[Gettinold]

3200 should have made a huge difference. Maybe try a different style? Maybe the grafts were not angled optimally for coverage? I have never been a fan of Dr. Charles work. Nice enough guy but does not impress me at all with the work he posts.

 

I've tried a few different ones, different stylists trying to "add" coverage, over the past 2 years...no matter what, my crown is thin and frustrating...definitely not what I was expecting from my investment. I've seen several good results from Dr. Charles, just not sure what happened here, it's almost like the second transplant didn't yield..

[Gettinold]

sorry to hear your stuggling with you crown

i think fue with bisigna and Lorenzo would b optimal in getting a result your looking for

Lorenzo is amazing

 

I already have over 3000 grafts in my crown, don't think it would be wise to put any more in when I will probably need them down the road...

[FUE2014]

The crown can respond really well to minoxidil, presumably however this is something you have considered and decided against?

[Gettinold]

Thought about that, was told my follicles were dead though....Not a fan of drugs or being on them for the rest of my life, may have to. If I don't have enough grafts, a BHT may be an option...my bank account would disagree though.

[Shampoo]

You have some nice improvement, but if I were you I would have another 2000 transplanted into the crown and start taking propecia....or you will most likely continue to lose hair in the crown. I would think doctors should think twice about performing crown transplants on patients that refuse to take propecia.

 

ps: what is your age?

Edited April 14, 2014 by Shampoo

[Gettinold]

You have some nice improvement, but if I were you I would have another 2000 transplanted into the crown and start taking propecia....or you will most likely continue to lose hair in the crown. I would think doctors should think twice about performing crown transplants on patients that refuse to take propecia.

 

ps: what is your age?

 

I'm 34, had my first HT at 32..I understand your view, but the thing is, when I had my first HT, my crown was not thin or thinning, it was BALD. Dead, shiny, smooth BALD. The crown was done and starting to move forward, other than some shed a few months after my 2nd HT, I haven't lost ant more hair. Propecia would have made no difference at all. The problem with another 2000 grafts in my crown (other than the extra $6-7k) would be that I'd have over 5000 grafts in my crown alone..doesn't leave much for the rest of my head, should I need it down the road.

[Spanker]

To be pretty much 100 percent bald in a large area of the crown, its not that bad. I would say that you are at about 80 percent of what I would expected. Not great, but not awful.

[sl]

Crown design and the spiral really can eat up the grafts also and it is called rightly so the "black hole" and most surgeons will not place at high density there due to the amount of grafts it could need and the danger of "rear loading" them, so often the plan is to give covering but not going too dense and especially if loss is possible in other areas.

 

This area is notoriously slow to come in and as said second surgeries also can be slower also.

 

Hair calibre and groups also make a difference and you have fine hair also with possibly lower groupings. Your doctor will probably be able to confirm the calibre and groups you had also as it does make a part of the overall equation.

 

All the best for your ongoing development there.

[Paulygon]

Gettinold,

I have a similar issue and we've discussed it in the following thread:

how to tackle my crown (no more FLAPPY combover!) - Forum By and for Hair Loss Patients

 

Cantdecide brings up a good point, regarding styling.. my hairdresser create a flap that seems to provide decent coverage for now.. though I am still interested in getting grafts in that crown region.

[FUE2014]

Would love to see an update on this from gettinold, agree the crown is the hardest place to get that illusion of density. For me give me frontal hair loss over crown hair loss any day of the week. With a decent surgeon, the front is fixable. The crown, however, is a battle that few will ever win.

[AB2000]

Try growing your hair out long. You can comb it back into a pony tail and cover the low hair density bald spot.

[husqvarnawrk]

As someone interested in a transplant for mainly the crown area, I would like more info on the subject too.

 

To the OP, you do have some good progress from the shiny bald patch on the first photo to the latest ones.

 

I, personally, will ask to use beard hair and normal hair for my crown. I'm aware it will be difficult to achieve 100% coverage, but even a partial one will work.

 

In my opinion a bald crown is hideous to look at. I can't stand mine so I buzz everything down to no-guard.

 

Edited: I typed "bear hair" instead of "beard hair". Some freudian slip! Laughing at myself now.