Artistic and aesthetic difficulties arise when transplanting an area such as the crown. It is a technically challenging area in which to appropriately place and orient recipient follicles, as the crown is characterized by a swirling pattern of hairs.

Experienced hair doctors, who are artistically inclined, are best able to replicate a natural swirling pattern of the crown. One of the challenges associated with transplanting hair in the crown is related to supply and demand. Many times the size of the crown requires a good deal of donor hair, which is limited in even the best hair transplant candidates. Since this may be the case there are solutions to this problem:

One solution involves transplanting to achieve a less dense result since the crown is the least seen part of the head. The frontal region is seen as more important to achieving density since this area frames the face and is what others see when speaking to you. By using 2 or 3 natural groupings of follicular units in the crown, good coverage can be achieved without using excessive donor hairs.

Another solution for lack of donor hair can be solved with the Follicular Unit Extraction (FUE) technique. This allows for individual donor hairs to be extracted from the donor area–even after multiple hair transplant procedures in the past.

Hair Direction and Whorl Pattern
The crown hair usually exits the scalp in a whorl pattern. Some patients have more than one whorl.

The doctor will determine the slant of the incisions on the direction of the native hair, maintaining the natural angle of that area. For the crown area, when there is no existing hair to indicate the original pattern, the doctor will utilize experience and aesthetic talent in determining what looks natural.

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Choosing the density that appears natural and undetectable is determined during the consultation. The doctor will assist you in making a choice based on the extent of your hair loss, available donor, and personal preference. Notice the “whorl” in the image below, far right.


Diagram of Whorl

Simple diagram showing a typical “Whorl Pattern.”

Determining Hair Direction
The recipient sites are created to follow the direction and angulation of the native hair as it occurs naturally, by slanting the blade to mirror both the direction and exit angle of the hair. There is not a single pattern, exit angle or hair direction which is applicable to all patients. What is natural for one patient may be quite different for another.

There is no exact type of hair pattern; even so, there are some common trends. For example, in the central hairline, most patients’ hairs angle forward. This provides lift to the hair. However, on some occasions, patients have a cowlick, or other type of wave that persists in their remaining hair—in some cases the hair actually angles backward! In this instance, if transplanted hairs were angled forward, they would not blend properly. Consideration is given to the existing hair, since often we are adding to it and not just replacing it is an important factor.

To achieve a natural appearance, the hair surgeon has to have experience and artistic skill. These are important considerations in achieving excellent results.

Before and After photographs showing crown and mid-scalp hair transplant results with Dr. Friedman.


See Also:
Understanding Hair Transplants
Follicular Unit Hair Transplants
Follicular Unit Extraction
Typical Procedure in Eight Steps
Frontal Hair Transplants
Crown Hair Transplants
Facial Hair Transplants
Hair Transplants for Women
Eyebrow Hair Restoration
HT Questions & Answers
Patient Reviews
In-Depth Hair Transplant Info

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