I was told by local FUE expert to not have vertex fixed as it could cause "halo receding affect. Recommendations? (Photo)

Question

I'm 27, have a receding hairline and bald spot. I was told my a local FUE surgeon that I should only have my front hairline fixed as getting the vertex FUE treatment could potentially create a "halo effect" with continual balding in the future. Please let me know what you think and any local or international suggestions for a fix. I would ideally like everything restored and full, but worst case I would like the vertex fixed. Thank you

Ken Anderson, MD, FISHRS · Answer

Dear charloliverrr,
Thank you for posting this question. It is absolutely not a good idea to have a crown/vertex transplanted at 27 years of age. The simple answer is that we don't know where you're going to "end up" with your hair loss. Since a hair restoration procedure of any type is merely a redistribution of whatever hair remains, it is entirely possible to run out of hair for transplantation during your lifetime. Since the results of a hair restoration procedure are permanent, and we don't know how far along the scale you're going to go in your lifetime, it may be a good idea to engage in some of the preventive therapies prior to surgery. 
There are a few ethical dilemmas in hair restoration, and the minimum age at which a man can should have a transplant to the crown is one of them. The issue is that when you look at hair loss patterns, as they progress in a male, the crown area can start small, but grow to a large size.  Consider the loss in your crown as more or less a circular pattern of loss.  Then remember that as the diameter of a circle increases, the area, which is what patients and physicians alike are concerned with, the area of the exposed scalp goes up exponentially.  The simple formula Area equals pi (e.g.: ) times the distance of the radius squared (area = r2 ) applies here. As you’re only 27 years old, and have decades of living to enjoy and hair loss to experience, nobody knows how large the crown loss get.  You can literally run out of hair to be transplanted if you start in the crown area this early.  Given the effectiveness of other forms of therapy which are non-surgical in nature, it would make more sense to try to grow some of the hair you have lost back with medical treatments, instead of surgical.  These treatments include: Low Level Laser Therapy (LLLT), platelet-rich plasma treatments (PRP), and finasteride.
One or all of these therapies have the potential to re-grow hair, but this effect is usually seen in men under 35.  You’re only 27 now, so it’d be a good idea to start some preventive therapy, such as those mentioned, for 6-12 months.  You may find that you are able to re-grow your hair without surgery, and hold off on a surgery until later in life when perhaps the medical therapies are not enough any longer.  However, it is possible to grow the hair back and have it remain there for 10-20 more years with continued medical treatments.  The general rule at my practice is to hold off on any method of hair transplant into the crown area before the age of 35.
I hope this information is helpful to you.
Kind Regards,
Ken Anderson, MD, FISHRS

Jae Pak, MD · Answer

If you know the extent of balding you will have, as you age, you can consider a well planned out surgery.  There is nothing wrong with having hair transplant surgery on the crown.  However, if you continue to lose hair, it may not look natural. If you are certain you will come back for more surgery and have enough donor hairs to address the continued hair loss, you can make an informed decision.

Sara Salas, MD · Answer

For me and in my opinion, you can get both fixed pretty much at once and if you are open minded to take finasteride, you probably will never have any more issues going forward. I think you’ll need a large case to cover all the needs. Somewhere around 3000 to 3500 And again Finasteride and possibly even minoxildil.

Parsa Mohebi, MD, FISHRS · Answer

Crown baldness is more challenging than restoration of the front. One reason is the extent of the area and the direction of hair that goes away from the center of the whorl area and leaving the crown more exposed. I personally like restoring the crown as long as we have a good master plan that reviews the stages of the hair restoration and can leave the patient enough hair to catch up any future hair loss. Today with the help of beard and body to scalp hair transplant we have more options to help with that process.

William Rassman, MD (retired) · Answer

If you continue to bald after the FUE was placed in the crown, you could develoop a halo effect which would require another hair transplant. If that should occur, it would be slow and gradual with enough time for you to address it

I was told by local FUE expert to not have vertex fixed as it could cause "halo receding affect. Recommendations? (Photo)

Answers (5)

Answer: Crown baldness

Answer: Crown baldness

Answer: Halo effect

Answer: Halo effect

Recommended reading

Everything you need to know about FUE Hair Transplant

Our mission is to create a world where every investment in modern beauty is Worth It.

I was told by local FUE expert to not have vertex fixed as it could cause "halo receding affect. Recommendations? (Photo)

Answers (5)

Answer: Crown baldness

Answer: Crown baldness

Answer: Halo effect

Answer: Halo effect

Browse related questions

Recommended reading

Everything you need to know about FUE Hair Transplant

Our mission is to create a world where every investment in modern beauty is Worth It.