TLDR Treat the front and middle scalp before the vertex in hair transplants, aim for good density, use non-surgical options for young people, and customize treatment for natural results.
In the 2013 document "Management of the Crown," Jean Devroye, MD, addressed the challenges of treating vertex baldness in hair transplantation. The vertex, with its unique hair whorl pattern, presents difficulties in predicting the extent of balding until a patient is 40 to 50 years old, complicating treatment planning. The document advises prioritizing the frontal and midscalp areas before the vertex and suggests aiming for acceptable density rather than maximal coverage to conserve donor hair. It recommends non-surgical treatments like finasteride and minoxidil, particularly for younger patients, and views scalp reduction as an outdated technique. Follicular hair transplantation is endorsed as the standard for natural results. The document highlights the need for individualized treatment plans and the surgeon's skill in managing the vertex, emphasizing the principle of "first, do no harm."
29 citations,
March 2008 in “Dermatologic Surgery” The Cross-section Trichometer is a new tool that can measure hair quantity and detect hair loss and growth.
18 citations,
July 2003 in “Dermatologic Surgery” The conclusion is that creating natural-looking hair restoration requires replicating natural scalp whorl patterns and inserting grafts at specific angles.
581 citations,
October 1998 in “Journal of The American Academy of Dermatology” Finasteride safely and effectively treats male pattern hair loss, but may cause reversible sexual issues and harm male fetuses.
41 citations,
September 2014 in “JAMA Facial Plastic Surgery” Use finasteride, minoxidil, and follicular unit transplantation for hair loss treatment.
14 citations,
May 2014 in “Archives of plastic surgery” The position of the parietal whorl can predict safe donor areas for hair transplants in Korean men with male pattern baldness.
10 citations,
December 1997 in “Plastic and Reconstructive Surgery” Hair restoration surgery has improved with better techniques for natural looks and managing patient expectations, but it remains labor-intensive and requires careful consideration of potential complications.
January 2010 in “Elsevier eBooks” Hair transplantation is a treatment for hair loss mainly caused by genetics, with various techniques and potential complications, and results visible after 8-12 months.
9 citations,
April 2017 in “International Journal of Dermatology” Different areas of the scalp have varying hair thickness, useful for different types of hair transplant needs.
