What happens when the lateral hump area drops?

[bullitnut]

Great topic, my family history of hairloss is very advanced and most members have lost their latural humps.....this was one reason I started meds and is the main reason I am very reluctant to stop taking my Finasteride.

 

[Bigmac]

In a few years time I can see many guys with weird looking hair due to them not researching at all and just going for it as some would say.

 

[Techno1]

Hi Topcat,

I still see this going on which is why it is an important topic I have seen patients have surgery in the last few years with other clinics and these patients have been given totally inappropriate low hairlines on a Norwood 6 for 1500 to 2000 grafts not taking medication they have then lost all native hair and the lateral humps have dropped so there is a gap. In some cases there is just not enough donor hair to address all that they need to get them to a natural balding pattern again.

In these cases they would be best to fue out the low hairline and plant the grafts further back. Some patients are very educated and others are not in some cases I have had patients demanding these low straight hairlines with extensive loss and we will walk away.

So what do you do when you get a Norwood 7 patient in that has lost the lateral humps? You have to rebuild them or you just cannot tie the hairline to the sides or you would end up with a hairline like the line I drew in black on the patient below which is way too low. Here is an example of a NW7 patient when the lateral humps are rebuilt, he gets a natural mature look to frame his face and gets a significant cosmetic improvement.

Before front

After Front

Design Pre op

If you were to tie the hairline to the sides without rebuilding this is what the hairline could end up looking like.

This guy could potentially have 1000`s more grafts with Fue to add more cover and density. The other day I was standing behind a guy that had an Fut surgery, his scar was visible with his shorter hair but my eye was drawn to the ring of bare skin around his head where he must have continued losing hair. His crown had a low dip that extended into the donor zone. His donor looked as though it would support another 1500 grafts which I would utilize with beard hair to fill in the bare ring.

 

[Bigmac]

There is potential for this patient to have more grafts from his donor and beard just like David (Garageland) did.
The guy you saw would most likely benefit from another procedure to connect the sides/lateral humps to the transplanted hair on top. It is important for everyone to know the risk of progressive hair loss, which is why meds are important but if you don’t wish to use them, then know this hair loss progression is far greater.