I am an Asian male, 49 yrs old and I want to have a hair transplant to restore my crown but there is a dilemma. I have two cowlicks I dislike having but the hair restoration physicians that I have consulted with thinks it would be best to recreate the whorl pattern.
My question is, why not do away with the cowlicks and just have the hairs arranged so the hairs will lie without a swirl pattern? I’m not bald yet, just have thinning hair on the vertex. What do you think is the best plan of attack to fix this? Doctors can recreate hairlines without a cowlick. Why not vertexes?
Cowlicks or swirls in the vertex of the scalp are actually quite necessary. I understand you didn’t “want” them growing up, but they are really just a natural pattern that has to be reproduced in a hair transplant. The best way to understand why I am saying this is to look at a young boy’s head and really study the cowlick. If you look carefully, it is really just a slowly changing direction of the hair. Hair in the front of the head is forward facing and hair on the back and sides is downwards facing. Those directions cannot be changed. The only way for the hairs in the front to transition into hairs facing downwards on the sides and back is to have this swirl. The swirl allows the hair to change direction.
Don’t get me wrong. If it were possible to reconstruct a vertex without a swirl, all hair surgeons would do it. Swirls, even when transplanted, still give a thinner look. If there was a way to lay the hair down flat in the vertex like in the frontal area (and still look natural), the density would appear higher. If you look at that same young boy, you may even see scalp at the center of the swirl. He is not balding there; it is natural. The hairs point straight up and out in the swirl and do not give a maximum density.
With regards to your double swirl issue, there may be some options. Sometimes, if one swirl is stronger than the other in my patients, I will try to just recreate the stronger one and forget about the other. With the growth of the new transplant and the slow loss of native hair, the secondary swirl will no longer be important. I am not sure if this is possible with you but it might be worth asking your hair transplant surgeon.
Dr. David Josephitis
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