Crown Design

A natural whorl (or cowlick) is created in the crown by transplanting hair to match the patient's original hair direction. This is based on the patient's pattern of hair loss, donor availability, and hair density. Some transplant surgeons will not treat the crown area, arguing that the limited donor supply is best focused on the front.

Patient G.R. before & after one hair transplant of approximately 500 grafts artistically placed to rebuild the crown area.*

However, this is a necessity only for patients with an exceptionally limited donor supply. Most patients with Class 5-6 baldness do have sufficient supply to treat some or all of the crown, provided the whorl is reconstructed. While some patients may choose partial restoration focused on the front and top only, those who want full head coverage may achieve their goal in the hands of a transplant surgeon skilled in crown restoration. Often, Propecia R and Rogaine R are recommended to slow the progression of hair loss in the crown. It is with this combined approach that Elliott & True physicians are able to successfully treat this cosmetically important part of the restoration.

Hair Density

Individuals vary considerably in the density of the hair in the donor area. Hair density is determined by the closeness of follicles to one another, not by the texture or caliber of the hair. It is common for a patient with very fine hair texture to exhibit exceptional density and to produce an abundance of grafts. Because the density of hair may vary considerably throughout the donor scalp, it is necessary to evaluate several zones of the permanent hair. The information provided by examination is used to determine the number of grafts, the type of grafts, and the resulting density of the transplanted hair.

Grafts are harvested from the donor area located on the back and sides of the scalp. A double suture technique is used to close this area of scalp. Donor areas sutured with this technique under low tension result in a virtually undetectable fine line scar. Staples are never used with this technique.

Graft Size

The grafts are small pieces of skin, which contain follicular units of hairs. They are trimmed down to nearly the size of the follicular unit. Follicular units are the natural groupings in which hair grows. Most persons average 2 hairs per follicular unit. The majority are 1-2 hairs. Three hair units are less common and four hair units are unusual. We make these into grafts that may be single-hair grafts for the front of the hairline, two hair grafts for about one-finger width immediately behind the front edge of the hairline, and grafts of one or two follicular units containing three to four-hairs to use as filler grafts for the rest of the head. These three to four hair grafts cover the top, back and, if needed, sides of the head.