Wed 4 Dec 2013
What sort of end result is possible in terms of density for a patient whose hair loss is only affecting the crown?
You have to be careful. The crown (vertex) can be a dangerous place for hair transplants. If you are in your 20′s, I firmly believe that the crown should never be transplanted during that age range. If one is in his 30′s, then I think any coverage done there should be on the “light” side without maximal density. The reason is that often in a man with androgenic alopecia (male pattern baldness), the borders of the crown can expand, such that the square area of the crown zone increases logarithmically. If a younger man has this zone filled in densely, there is the danger that 10-20 years down the road there could be a 1-2 inch wide “halo” of bald skin around it, which is a very unnatural thing.
I have seen many of these from old hair transplants. Light coverage, on the other hand, fans out in the whorl direction typical of the crown’s hairs. If the crown enlarges, they simply fan out a little further to help cover that bald area and it isn’t that hard to find some donor hair to fill that space in to match the density of what is already there. But with a dense central part of the crown filled in, you then have to match that extreme density, which is usually impossible to do in the face of a shrinking donor area.