Vertex (Crown) Hair Transplant in Bangalore, India

Hair transplantation is the most common cosmetic surgery performed in Bangalore and India. It is the technique of replacing lost hair with permanent safe hair from the back of the head or other parts of the body

When we think of hairloss, we think of a receding hairline, and frontal baldness. But there is another aspect of hairloss that is often overlooked. We are of course talking about the vertex or the crown

What is the vertex/ crown hair loss?

The vertex or crown is the area on the back of the head. It gets its name from the area that is covered by a crown

Hairloss can be of three types

1. Frontotemporal- which is the hairloss in the front, or the receding hairline
2. Vertex- which is the circular hairloss in the crown
3. Diffuse- which is generalized hairloss all over the head without any pattern

In most cases hairloss starts in the frontal area, and the vertex hairloss is seen later. However, in some cases, the crown can become bald before the frontal region.

Why is vertex important? Why is vertex hairloss frustrating?

Frontal hairloss is seen by the person themselves in the mirror, so they have an accurate idea of how it looks. Vertex hairloss is seen by others, who then comment. So the patient has to listen to these comments without being aware and be able to see the bald area themselves. This can lead to great disatisfaction. Hence patients have an unrealistic idea of their vertex, out of proportion to the degree of hairfall that is actually present.

Secondly, vertex is the highest point in the scalp- and hence is noticed from a distance by onlookers.

Lastly, vertex is circular and hence is large- it is reflected by light even in minor thinning and gets accentuated.

For all these reasons, vertex hairloss often gets distress out of proportion to its extent

How is vertex hairloss treated?

As with all hairloss treatment consists of two parts

1. Preserving your existing hair with medical management
2. Replacing lost hair with transplantation

Why is medical management important in the vertex?

Medical management is important in all hairloss, but it is perhaps even more important in the vertex for the following reasons

1. In the early stage, the hairs have reduced in size but not so much in number. At this stage, medication is the only treatment, as there isn’t enough space to place grafts
2. In the vertex, hairfall progresses in all directions as a circle. Hence if transplant is done without controlling hairloss, the central transplanted area can end up being surrounded by a ring of baldness. Hence the hairloss must be controlled with medication before planning transplant
3. If transplant is done without medication, and grafts are placed in between existing hair. Then once the existing hair fall without medication, you can end up looking similar to how you did before surgery. This can be very frustrating. Hence the best result is obtained by a combination of medication and surgery.
4. Lastly, if you try to pack amidst hairs, when the area is not ready for HT, you may end up damaging the existing hairs

What are the medical treatments for hairloss?

Drugs( Minoxidil, Finasteride, Dutasteride), Biological treatments( Platelet-rich plasma, fat stem cells), Physical energy-based devices( Laser) are the standard treatments

What are the challenges of hair transplant in the vertex?

1. The vertex is a large area and hence needs a large number of grafts
2. In the vertex, the hairs go in all directions like a circle. While in the front, when combed the hairs all go in the same direction and stack on top of each other. This stacking effect doesn’t happen in the vertex, and hence the same number of grafts in the vertex doesn’t look as good as the front. The number of grafts needed is higher
3. Planning the vertex and maintaining the natural whorl is tougher than the front
4. Implanting grafts in all different directions is tougher than the front

Hence for all these reasons, it is important to find someone experienced in vertex hairloss specifically, as it is more challenging than the front.

When can a vertex hair transplant be planned?

Generally, it is planned later than a front hair transplant- when the individual is about 30 years of age. By this stage, hair fall has achieved some stability.

How can I plan for a successful crown hair transplant?

1. Find a surgeon experienced in vertex hairloss
2. Control hairloss medically before planning surgery
3. Continue medication to maintain and improve your surgical result

How should I plan if I have both frontal and vertex hairloss?

In such cases a large number of grafts, usually around 4000-6000 may be needed. This would need a combination of FUT and FUE, or FUE from scalp and other donor areas like beard. This can be planned in two ways

1. Staged- with transplant to the front first, followed by the vertex. The advantage of this approach is lesser one-time expenditure, and you can improve the vertex medically before planning transplant. The front should always be given priority and done first, over the vertex. The best grafts should be done for the front. Remember, when people think of you, they imagine your face from the front.
2. One shot- by covering both areas together. The advantage of this approach is you have to recover from surgery only once.

Why choose Venkat Center Bangalore for your vertex transplant?

A vertex transplant is tougher than a frontal procedure. It requires an experienced surgeon to analyze and plan how best to treat it.

Dr. Venkat and Dr. Aniketh are experts in hair transplant, having authored a textbook on hair transplantation and operated thousands of cases. They have treated several vertex hair transplants.