Every hair transplant is different because every patient has different needs and requirements. Patients who suffer from thinning may wish to arrange a transplant in order to thicken their head of hair. Others may suffer from patchiness or bald spots which they wish to be filled, whilst some patients may book a hair transplant in order to bring a receding hairline forwards.
Nevertheless, one of the most common requests from patients seeking a hair transplant is to have the crown region treated by the surgery. The crown is located at the very top of your skull: it is the highest point of your head. It is sometimes referred to as the ‘bald spot’ or the ‘vertex’, and it is one of the areas of the scalp that is most affected by male pattern baldness (or androgenic alopecia, as it is medically known). Patients with a family history of hair loss are most susceptible to balding in the crown region.
This type of hair loss can age a person prematurely and reduce their self-confidence. If this is the case for you, it might be worth considering whether you are a suitable candidate for a crown hair transplant. In this article, we will cover everything that you need to know about this form of surgery, from the types of transplants that are available to the cost of the procedure.
Why does Thinning or Balding Occur at the Crown?
If you suffer from male pattern baldness, it is likely that you will experience some thinning or hair loss at the crown of your head. This genetic condition is caused by the presence of a hormone called dihydrotestosterone (or DHT) in the body. As you age, DHT causes your hair follicles to shrink and weaken, which can make the hair that grows from them become thin or fall out altogether.
The hair follicles in the crown region are some of the most sensitive to DHT. Meanwhile, the hair follicles at the sides and lower back of your head are more resistant to the hormone, which is why the hair in these areas tends to remain in place whilst a bald spot forms at the crown.
How Can I Spot Thinning or Hair Loss at the Crown?
The symptoms of male pattern baldness can take hold gradually, and it is often the case that patients do not realize that their hair is being affected by the condition until balding has already begun.
A receding hairline can be an indication that your hair will begin to thin at the crown. However, it is important to note that it is perfectly normal for men to experience some recession in their hairline as they age. Generally speaking, the hairline should retreat by approximately 2 to 3 cm after a man becomes eighteen-years-old. This happens when the juvenile hairline converts into a mature hairline, and it is perfectly natural and ought to be expected.
However, if your hairline recedes beyond 3 cm from that which it was at the age of eighteen, it is possible that your hairline is receding. If this occurs, check to see if there is any thinning at the crown. A receding hairline is often an early sign of male pattern baldness, and patients who suffer from this condition often find that the hairline connects with the crown, uncovering the entirety of the top of the head.
By contrast, some patients experience thinning at the crown before their hairline begins to recede. If you think that you might be experiencing hair loss or thinning, the Norwood Scale can help you discover whether you suffer from male pattern baldness and identify the stage of balding that matches your hair.
Can You Have a Hair Transplant on Your Crown?
Yes, it is perfectly possible to have a hair transplant on the crown of your head. In fact, it is one of the most commonly treated areas.
However, treating the crown does come with some complications, and it can be a slight tricker area of the scalp to fill. One reason for this is that the hair that grows naturally in the develops grows in a circular pattern known as a hair ‘whorl, or swirl. When performing a crown hair transplant, surgeons must mimic this shape when they transfer hair to the crown in order to produce natural-looking results.
Additionally, the crown is a relatively large area of the scalp. This means that, during the surgery, a large number of hair follicles must be transferred from the donor site in order to cover the crown sufficiently.
Nevertheless, the surgery is possible, and there are two different techniques or types of hair transplant which can be used to treat hair loss in the crown region:
Follicular Unit Transplantation (FUT) Hair Transplants:
During a FUT hair transplant, your surgeon will remove a strip of skin from a region of your head that is growing healthy, natural hair (called the ‘donor site’). As we mentioned earlier, the lower back and the sides of the head are not usually affected by male pattern baldness, and so it is typically from one of these areas that the strip of tissue is extracted.
Once the strip has been removed, the area of the head from which it was taken will be stitched closed. The stitches will be removed after approximately 10 to 14 days have passed. This will leave a very thin, linear scar, which can be hidden using the surrounding hair.
Then, your surgeon will remove hair follicles from the extracted strip of skin during a process known as stereo-microscopic dissection. The extracted hair follicles are then grafted onto the crown of the head.
It will take some time for the transplanted hair follicles to take root in their new location. Additionally, patients will have to wait for the re-located follicles to produce new hair. Nevertheless, patients can expect to see the final results of the treatment after approximately 12 to 18 months have passed since it was administered.
Follicular Unit Extraction (FUE) Hair Transplants:
Whilst FUT works by removing a strip of skin from the donor regions of the scalp, FUE hair transplants work by transplanting individual hairs from the donor site to the treated area.
During an FUE hair transplant, the donor region is shaved. Then, your surgeon will extract hair follicles from this area using an instrument called a micro-punch. A local anesthetic will be used during this process to minimize discomfort as much as possible.
Upon extracting an individual hair follicle, your surgeon will immediately re-insert the follicle into the crown. Your surgeon will then extract another hair follicle from the donor site and transplant that into the crown. The surgery will continue in this way (transferring hair follicles one by one) until the crown has been filled.
FUE transplants take longer to complete than FUT transplants because each hair follicle must be removed and re-inserted individually. Usually, it takes approximately one day to administer an FUE hair transplant. However, crown hair transplants often take longer to complete because the crown is a large area of the scalp, and so a larger number of hair follicles must be transferred in order to cover it. As a result, it can take up to 2 days to complete an FUE transplant on the crown.
Akin to an FUE hair transplant, patients can expect to see results from an FUE hair transplant after approximately 12 to 18 months have passed since the surgery was conducted.
Which Type of Hair Transplant is Better for Treating the Crown, and Why?
As we mentioned, the crown is a relatively large area of the scalp, and a significant number of hair grafts are required in order to cover it.
For this reason, FUT is usually the better technique for treating hair loss in the crown. This is because a lot more hair follicles can be transplanted using the FUT technique than the FUE technique. However, you may be a suitable candidate for an FUE hair transplant if the balding area around the crown is relatively small, as fewer hairs will be required to fill it.
How Much Does a Crown Hair Transplant Cost?
The cost of a hair transplant always depends on an individual patient’s needs. For example, the number of hair grafts that need to be transferred during the surgery affects the cost of the treatment, because it takes more time to transplant many hairs than a few hairs. Consequently, the size of the balding area around the crown will affect the cost of the treatment, because a larger bald spot requires more hairs to fill it. You can estimate the number of grafts that would be required during your transplant using our handy Graft Calculator.
Generally speaking, FUE hair transplants are more expensive than FUT hair transplants, because each hair follicle must be harvested and re-inserted one by one. As a result, FUE hair transplants take longer to complete.
Crown Hair Transplant Timeline:
This timeline describes what patients should expect in the weeks and months following a crown hair transplant:
1 Week After Your Hair Transplant:
In the first week after your transplant, your scalp will be healing from the surgery. The transplanted hair follicles are taking root in their new location, and you must be careful not to move them out of place by brushing or washing your head. Both the crown and the donor site will undergo some swelling, scabbing, and itchiness. Your scalp may also ache a little as it heals, and you should use painkillers such as paracetamol or ibuprofen to treat this.
2 Weeks After Your Hair Transplant:
After two weeks have passed since your transplant, swelling should decrease. There may still be some itchiness or redness, and you will probably notice scabs being shed as your body begins to heal naturally. You may also notice hair being shed from the crown. This is to be expected: as the new hair follicles take root in the crown, they will shed old hair and prepare to grow new hair.
1 Month After Your Hair Transplant:
You will continue to notice some hair shedding from the crown one month after the hair transplant procedure. Different hairs in the crown region will be in different phases of their growth cycle, which means that some new hairs will have started to grow, whilst others will be falling out. This may create some patchiness in the crown for now, but try not to worry – it will even out over time. Meanwhile, the hair in the donor regions should have grown back completely.
If you notice any signs of persistent inflammation (such as redness, or if the scalp is hot to the touch), then you should contact your clinic immediately.
3 to 6 Months After Your Hair Transplant:
Once three months have passed since your transplant, the hair in the crown area will be a little more uniform and even. However, it is likely that the new hairs will be very thin. This is simply because they are new, and they will become thicker with time.
12 to 18 Months After Your Hair Transplant:
After approximately twelve to eighteen months, you should notice the final results of your hair transplant. The hair in the crown will be covering the balding areas completely, and the hair will be thick and strong in appearance.
No one should have their self-esteem affected by hair loss. If you are considering whether a crown hair transplant might be right for you, arrange a consultation and one of our friendly specialists will advise you on possible options.
About the Author
Dr Suhail Alam
Dr Alam is devoted to providing high quality, holistic, patient centred care designed to make patients look and feel their best. He has a specialist interest in Hair Restoration Surgery and Regenerative Medicine.