Ideal number of grafts for crown

[RG11]

Hi everyone, I am looking into getting a hair transplant at the start of next year and have been browsing this forum for a good while now. 

From what I have read from surgeons they tend to prioritise volume at the front of the head.

For me, I want volume in the crown as this is the worst part for me and the part I hate the most. 

I have also seen so many hair transplant where it looks great at the front but still thin on the crown and for me that is just a complete waste of time and money.

Is anyone in a similar position where their crown is their worst area and has had a successful transplant where they no longer look thin in this area?

I am looking to find out if there is a number of grafts that typically do the job to cover this area sufficiently, so that I can ask for this with my surgeon. 

Thank you in advance for anyone able to help.

 

[BaldDude]

Depends how bald your crown is. Post photos 

[shadowcast]

2 hours ago, RG11 said:

Hi everyone, I am looking into getting a hair transplant at the start of next year and have been browsing this forum for a good while now. 

From what I have read from surgeons they tend to prioritise volume at the front of the head.

For me, I want volume in the crown as this is the worst part for me and the part I hate the most. 

I have also seen so many hair transplant where it looks great at the front but still thin on the crown and for me that is just a complete waste of time and money.

Is anyone in a similar position where their crown is their worst area and has had a successful transplant where they no longer look thin in this area?

I am looking to find out if there is a number of grafts that typically do the job to cover this area sufficiently, so that I can ask for this with my surgeon. 

Thank you in advance for anyone able to help.

 

I don't think a reputable surgeon will prioritize any area. The surgery is for you, not for the surgeon. I think patients tend to prioritize the front, since this is what others see when they're having a conversation. I actually had my crown done first, like you it's the part that bothered me the most.

There's no point in asking about number of grafts here, you should send photos to surgeons of your choice. They should be able to give you a good estimate. That being said, as long as you have a decent donor, then your crown can likely be fixed. I had a very large slick bald crown. It's not "thick" now by any means, especially when the hair is very short, but if my hair has a decent amount of length to it, then nobody would ever know that I was bald.

Edited July 23, 2022 by shadowcast

[RG11]

15 minutes ago, shadowcast said:

I don't think a reputable surgeon will prioritize any area. The surgery is for you, not for the surgeon. I think patients tend to prioritize the front, since this is what others see when they're having a conversation. I actually had my crown done first, like you it's the part that bothered me the most.

There's no point in asking about number of grafts here, you should send photos to surgeons of your choice. They should be able to give you a good estimate. That being said, as long as you have a decent donor, then your crown can likely be fixed. I had a very large slick bald crown. It's not "thick" now by any means, especially when the hair is very short, but if my hair has a decent amount of length to it, then nobody would ever know that I was bald.

Thanks, how many grafts did you have done in the crown?

[Z--]

If you're losing in the crown, you'll very likely lose in the front someday. You don't want to be in a situation where you have hair in the crown but none in the front, it'll look weird. Even with a bald crown and some hair in the front, doctors usually prioritise the front as it'll frame your face. 

What Norwood are you? Are you on meds? Btw, you'll likely never get full density with transplants, only the illusion of density, so if you can't live with a thin crown, might not be worth it, imo. It's really tough to get fully coverage.

[shadowcast]

Just now, RG11 said:

Thanks, how many grafts did you have done in the crown?

3,600. Again, you have no idea how my balding area compares to yours. You haven't seen my photos, and I haven't seen yours. Start contacting surgeons.

1 minute ago, Z-- said:

If you're losing in the crown, you'll very likely lose in the front someday. You don't want to be in a situation where you have hair in the crown but none in the front, it'll look weird. Even with a bald crown and some hair in the front, doctors usually prioritise the front as it'll frame your face. 

What Norwood are you? Are you on meds? Btw, you'll likely never get full density with transplants, only the illusion of density, so if you can't live with a thin crown, might not be worth it, imo. It's really tough to get fully coverage.

I spent a bunch of time after my first surgery with only the crown fixed, and I looked fine. Having thinning only in the front is a common natural pattern.

And believe me, going from friar tuck to "maybe thinning a bit" under very bright lighting is so completely worth it.

[RG11]

I have photos saved from when my head was shaved but they're on my laptop which I don't have access to right now. The picture attached is what my head looks like shaved. 

[THE TRUTH]

Hi there, 

The crown is generally refered to as being "the black hole" for grafts because it always looks seethrough (the hairs do not overlap each other on the crown as they do on the midscalp and hairline so you lose the benefit from the layering effect). The head is a sphere on the crown area and also hairs change direction of growth....

That's why it always require 2 times more grafts for the same surface than the mid or the hairline. 

VERY FEW surgeons in the world have the required skillset for working on crowns. Forget about Turkey...

If you want to get Redemption from the BALD SPOT curse than I would look into Konior, Zarev, Sever Muresanu, Pradeep Sethi, Felipe Pitella, Wong and Bruno Pinto. These guys arr expensive but they know who how to create the illusion of density on the crown. 

And remember you will probably require at least 2 if not 3 passes on the crown. The crown is hardly ever a one and done thing... 

Now as other members told you, most doctors prefer to focus on the front instead of trying to fill in the black hole at the back because it consumes a lot of grafts. 

It's trade-off.

You'd either have to accept a slightly receded front and go all in for the crown OR accept a better-looking (but still thin crown) and focus more on the front.

You front isn't that bad to be honest. I think you do need some work on forelock and maybe lower the hairline 1cm.

On your picture, it is unclear how far your crown drops at the back ?...

But judging by these pictures, you need  4000 grafts perfectly placed with +90% survival rare  to make it look FULL.

But before rushing into surgery, I think you should get on a strong pharmaceutical stack. I can see that your crown is not slick bald so there are still miniaturized hairs that can be boosted by medication. 

Try some oral Dura + oral minox + topical AA + microneedling. Give it 6-8 months. 

The truth is for most people medication doesn't do crap. However there are some good responders and 100% worth giving a try. It may reduce the number of grafts required. 

All the best

Edited July 24, 2022 by Shill from the mill

[RG11]

3 hours ago, Shill from the mill said:

Hi there, 

The crown is generally refered to as being "the black hole" for grafts because it always looks seethrough (the hairs do not overlap each other on the crown as they do on the midscalp and hairline so you lose the benefit from the layering effect). The head is a sphere on the crown area and also hairs change direction of growth....

That's why it always require 2 times more grafts for the same surface than the mid or the hairline. 

VERY FEW surgeons in the world have the required skillset for working on crowns. Forget about Turkey...

If you want to get Redemption from the BALD SPOT curse than I would look into Konior, Zarev, Sever Muresanu, Pradeep Sethi, Felipe Pitella, Wong and Bruno Pinto. These guys arr expensive but they know who how to create the illusion of density on the crown. 

And remember you will probably require at least 2 if not 3 passes on the crown. The crown is hardly ever a one and done thing... 

Now as other members told you, most doctors prefer to focus on the front instead of trying to fill in the black hole at the back because it consumes a lot of grafts. 

It's trade-off.

You'd either have to accept a slightly receded front and go all in for the crown OR accept a better-looking (but still thin crown) and focus more on the front.

You front isn't that bad to be honest. I think you do need some work on forelock and maybe lower the hairline 1cm.

On your picture, it is unclear how far your crown drops at the back ?...

But judging by these pictures, you need  4000 grafts perfectly placed with +90% survival rare  to make it look FULL.

But before rushing into surgery, I think you should get on a strong pharmaceutical stack. I can see that your crown is not slick bald so there are still miniaturized hairs that can be boosted by medication. 

Try some oral Dura + oral minox + topical AA + microneedling. Give it 6-8 months. 

The truth is for most people medication doesn't do crap. However there are some good responders and 100% worth giving a try. It may reduce the number of grafts required. 

All the best

Thank you very much for the info and also for the recommendations. That is very helpful and I will definitely take a look at them.

I have been on finasteride for over 2 years now and I think it has helped me to lose a lot less hair than I probably would have done. I have also been using minoxidil for maybe 3.5 years and did micro needle as well for a period of time but stopped this as I wasn't noticing any benefit.

The way my hair is you can't really notice it from the back that I'm bald in top as it doesn't go down far and I have longish hair at the back of my head that I currently sweep over it to cover it. My fringe also grows quite long at the front so as long as I have my temples filled in it should look good.  I did originally want to lower thr hairline but as I've grown my hair longer on top, I've relealised if I just fill in the sides and keep it the same and keep it a bit longer on top, it looks like a better hairline.

I was originally looking at Dr Bicer in Turkey as I know she is highly recommended on here and has a lot of experience. 

[THE TRUTH]

Just now, RG11 said:

Thank you very much for the info and also for the recommendations. That is very helpful and I will definitely take a look at them.

I have been on finasteride for over 2 years now and I think it has helped me to lose a lot less hair than I probably would have done. I have also been using minoxidil for maybe 3.5 years and did micro needle as well for a period of time but stopped this as I wasn't noticing any benefit.

The way my hair is you can't really notice it from the back that I'm bald in top as it doesn't go down far and I have longish hair at the back of my head that I currently sweep over it to cover it. My fringe also grows quite long at the front so as long as I have my temples filled in it should look good.  I did originally want to lower thr hairline but as I've grown my hair longer on top, I've relealised if I just fill in the sides and keep it the same and keep it a bit longer on top, it looks like a better hairline.

I was originally looking at Dr Bicer in Turkey as I know she is highly recommended on here and has a lot of experience. 

Try oral minoxidil OR topical compounded with tretinoin since this enhances the sulfotransferase enzyme.

Bicer is good yeah. I talked about her many times. 

She is not the best when it comes to crown but she is definitely a safe bet ! 

She won't botch or overharvest. 

[RG11]

4 minutes ago, Shill from the mill said:

Try oral minoxidil OR topical compounded with tretinoin since this enhances the sulfotransferase enzyme.

Bicer is good yeah. I talked about her many times. 

She is not the best when it comes to crown but she is definitely a safe bet ! 

She won't botch or overharvest. 

OK I was also look into this and that's good to know about Bicer. Cheers!

[Rahal Hair Transplant]

Rg11,

it would really be helpful if you post photos so we can see exactly how much loss you’ve experienced in your crown. Also, have you stabilized your hair loss with medication? What I’m concerned about is that you seem to think that any signs of thinning showing in the crown, even if the frontal area is nice and dense and natural looking is a waste of time.  Honestly, if that’s your point of view, then hair transplant surgery may not be for you.

The truth is, the crown is very difficult to achieve both full coverage and high density to the point where it doesn’t at least appear a little thin looking.  This is true for several reasons but for the most part, it’s a matter of supply versus demand. Not only that but the direction and angulation of the hair in the crown is far different than the rest of the scalp. The hair in the crown follows a whorl pattern and in order to provide both coverage and identity in the crown, it takes an awful lot of grafts.

The truth is, hair transplant surgery can produce very natural and dense looking results but if you’re looking for true density with absolutely no signs of thinning, especially in the crown then your expectations are unrealistic and as a result,  you will not be satisfied with any result.

Best wishes,

Rahal Hair Transplant 

[THE TRUTH]

2 minutes ago, capitalhaircenter said:

Hi @RG11, 

First, we need to learn your age. After that, we need to see your donor area. If your donor area is rich, you can undergo hair transplantation. Moreover, what is the situation of your crown area? Can you send all of your photos to us? We will kindly give a free consultation to you. 

Hello capitalhaircenter, 

May I ask if you offer free shilling courses ? 

Thanks you very much, 

Best regards