uneven receding of temples

[cricketlover]

guys, just wanted to know if one temple recedes faster than the other. does the slower temple catch up at a later point of time? this is because one side of my temple has receded probably an inche more than the other.

 

wanted to know others experiences on this. do both the temples recede at the same rate or do they recede unevenly & then catch up. also, does this hold any significance?

[cricketlover]

guys, just wanted to know if one temple recedes faster than the other. does the slower temple catch up at a later point of time? this is because one side of my temple has receded probably an inche more than the other.

 

wanted to know others experiences on this. do both the temples recede at the same rate or do they recede unevenly & then catch up. also, does this hold any significance?

[notgoing2gobald]

temples always freak me out...I wonder where they are going to stop, because the temples are so low on the frame of your face that when I look in the mirror and imagine *THAT* being the bottom line of my balding pattern then assuredly I would be a NW7+...This can NOT be the case.

 

Regarding will both temples final fate be an even recession: I think there is no absolute answer for this...

 

don't know if you have seen this or not, but I was checking this out last night:

 

http://www.hairlosshelp.com/websites/galleryview.cfm?id=Bobman|gallery41.cfm

 

Bobman just went in for temple reconstruction recently I believe. That doesn't appear to have taken up too many grafts and will really frame his face well. Scroll around and look at the other pics where his hair is grown out post ht#2 PRIOR to temple reconstruction. His hair still looked pretty damn good without temples...

 

I think I would view temples as a bonus/luxury after I was happy with the density on top of my head. I think it is something ONLY us hair geeks notice after obsessing over our hair and the multitude of photos on the net...

 

I mean SERIOUSLY think back to before you lost any hair. Do you ever recall thinking about how great your temples look? Or being envious of some dudes temples?...Don't get me wrong, I too look at my temples in complete astonishment and mystery as I wonder where exactly they will end up. Just trying to put an objective level-headed thought on this one...

[hoose]

ng2gb summed it up; temple points do add a finishing touch and definitely play a role in framing the face and need to be considered in the hairline construction; what i mean by need to be considered is if the patients temple points are reeceded and due to donor limitations does not have them addressed or addressed minimally then the hairline height needs to compensate for this; it is natural for someone with reeceded temple points to have a higher, more mature hairline; however, it is unatural for someone with reeceded temple points to have a lower, more aggressive hairline; so in summary, temple point construction isn't necessary but adds a finishing touch and further frames the face; and the doctor needs to make sure the hairline and temple points complement one another;

[Dr. Michael Beehner]

cricket lover,

You might be reassured to know that the majority of men have asymmetrical patterns and depths of recession, when comparing the two sides. In the past 18 years of evaluating these on patients, this has become clear. Obviously, in most men there is a minor variation, but in some it is quite striking and creates a challenge when drawing in the hairline that will be used.

In our own practice, in men over the age of 35 we transplant the anterior temple area and points in around 40% of all such patients. It helps greatly in framing the face and "holding up" the new frontal hairline hair. Many men in their 40's and 50's also have pronounced graying in this area, and the simple transferring of some of the darker donor hairs from the back into this temple area helps darken them up a bit and make them look more youthful. I will try to add a few photos of a couple of patients in whom we did this to give you an idea of how they can help in fully creating the new hairline on a male patient with male pattern hair loss. The patient with the darker hair is 49 year old and had three transplant sessions to create what you see here. The second one, with a lot of gray hair present, had two sessions and you can see that the temple areas look darker in the "after" photo.

Mike Beehner, M.D.

Mike B

[Dr. Michael Beehner]

Will try and add the other temple photos here, as only one went through on the first try.

M. Beehner

[Dr. Michael Beehner]

Another temple photo.

MLB

[Dr. Michael Beehner]

Final photo attached. Will use Photo Album of Patients section next time, as I'm only able to enter one photo at a time.

Mike Beehner, M.D.

[notgoing2gobald]

Dr. B,

 

is it a requirement in your practice that the patient be at least 35 to transplant into the anterior temple points or is this just a stat you mentioned?

[Dr. Michael Beehner]

The reason I don't fill in the temples in men younger than 35 is similar to why I don't fill in the crown/vertex in men under the same age: It is too difficult to predict in a younger male how bald they will someday become. In most men the anterior border of the temples migrates rear-ward over the years, and in a certain percentage of men with male pattern baldness, the side fringes drop way down to a Norwood VII level of hair loss. If the surgeon committed a bunch of valuable donor hair to filling in those temple areas when they were young and they do in fact go on to progress to marked degree of baldness, then valuable donor hair was used which could have been used on top, and, more importantly, that hair can appear very strange and abnormal looking if everything it is connected to moves away and leaves it almost looking somewhat isolated. I think a surgeon has to have some sort of a "line in the sand" for some of these issues as to where to put hair, and that's where I have set my limits. I think for the younger male the overriding great thing a hair transplant does for them is frame the face and erase the high bald forehead that has nothing at the top of it defining it. The temples and crown are sort of "extra's" that are nice to have, but only at an age when they can be safely done without doing any harm to that patient's future appearance.

Mike Beehner, M.D.

[notgoing2gobald]

Dr.B,

 

thank you that was a great response and (somewhat) adressess one of my biggest concerns. I say somewhat because I don't understand how docs treat these young men who become NW7's if the top has been filled in at a younger age and the sides come down substantially...

 

Now then, in a case such as this there would also appear to be an "island" of isolated hair on top with the sides balding down further in the later years. How do the docs know if there will be enough donor hair to fill the sides up to match the top?

 

This has always been one of my concerns as Im 28...

 

would really appreciate an explanation from you on this one as they are always very informative...

[Dr. Michael Beehner]

Notgoing2gobald,

It sounds like you are asking about what a surgeon does once the damage is done and a presumably now middle-aged or older man who was transplanted when he was younger, now presents with an island of hair on top with a "halo" of bald skin around it and not much donor hair left to correct the problem. Hopefully this unfortunate predictament will become rarer as physicians get smarter about matching their translant patterns with the natural history of male pattern baldness. However, the combined pressure of patients presenting with unrealistic expectations and the physician's eagerness to please or to fill a booking in his/her schedule for financial reasons can lead to young men being filled in densely in a way that can not be sustained in later years and will most likely look detectable as abnormal, particularly when the patient's total available "safe" donor hair was used to do the early work.

Looking at the problem from the early point, that is, when the patient is before the physician and a plan is being laid out - each patient is different and unique. You have to look at their family history, but not rely on it too much. A very important factor, especially in the 29-31 year old, where you start to get tempted to more aggressive, is to look under magnification for miniaturized hairs in the nearby fringe areas to see if it is indeed strong hair with very little miniaturization present. If there IS miniaturization, even just 5-10%, then a conservative, "frontal forelock" type of pattern is a wise course of action and will frame the face nicely. In this mode of planning, the surgeon creates a front-central forelock of density that extends back into the middle portion of the midscalp, and then decreases the density in a gradient toward the sides and toward to back. The idea is to create a pattern that actually exists on some men's heads as they naturally bald - at least 20-30% of men have this pattern as they lose their hair. And if you accomplish this, then twenty years down the road that transplant will not draw attention because it mimics a pattern that exists on many men's heads naturally.

If a man does reach 38 or so and these dire fears don't come true, then everyone can become more aggressive and use the remaining donor hair in a more aggressive manner, simply because it's easier to see the future of a man's hair loss pattern at that later age.

Mike Beehner, M.D.

[Dr. Michael Beehner]

Sorry, I forgot to complete my answer and say what could in fact be done for the patient who ends up in mid-life with an area of dense transplanted hair surrounded by a halo. By the way, these people often become social recluses and won't be seen outside the home without a hat on. I have met many of them in my career. It is a very sad situation.

The good news is that it is almost always possible to make things better. It usually is necessary to "soften" the density of the areas on the lateral and rear edges of the transplanted hair. This will require some new FU grafts, which can usually be salvaged from what remains of the usual donor areas - often using FUE in the high and low areas where a scar can't be used - and also by simply removing some of the rear and side stronger grafts and using them in a more spread out, sparser pattern around the stronger central hair. The goal is to create a GRADIENT at the two lateral sides and rear, trying to visually bridge the bald ally that separates the mass of hair on top from the side fringes. Oftentimes, this all goes down a lot better if the patient adopts a hairstyle of sweeping it back to one of the rear corners. It also often takes around two sessions to pull this off, as the amount of invasive work you can do at one sitting is limited by blood-supply considerations.

Mike Beehner, M.D.

[prit54m]

As the nape hairs are thin in nature and so somewhat similar to temporal area hair, can it be used for temporal area re-construction. I am 54 and has lot of nape hair.