Androgenetic alopecia affects different scalp regions with different timing and progression patterns. The frontal area (hairline and frontal forelock) typically shows earlier and more visually prominent thinning. The crown shows later onset but eventually deeper loss in many patients. The vertex transition zone connects these regions and frequently progresses unpredictably. For transplant planning, treating these zones as separate strategic problems produces better results than uniform approaches.
Frontal transplantation typically delivers higher patient satisfaction per graft used because the area is visible in mirrors, photographs, and direct gaze. Density requirements for natural appearance are higher in the frontal zone. The frontal hairline design is the single most important determinant of a transplant's perceived naturalness. Failed frontal transplants are visible to everyone; successful ones can completely transform appearance.
Crown transplantation is more complex strategically. The crown requires significantly more grafts to achieve visual coverage because the central whorl pattern means light reflects from many angles, exposing thinning that would be hidden in flat-coverage areas. Crown progression continues post-transplant in patients with ongoing androgenetic alopecia, potentially creating a 'donut' appearance of transplanted hair surrounded by progressing native loss. For these reasons, crown transplantation is typically deferred until medical therapy has stabilised progression, or addressed in combination with strategic patient education about realistic expectations.





Discussion (3)
AnonymousDad
11 months ago
This matches my own experience. Two years in and the picture is more nuanced than the early hype suggested.
Sophie L.
11 months ago
Really useful breakdown. The mechanism part was the bit I'd been struggling to understand.
Daniel R.
11 months ago
The cost/benefit case here is much weaker than the marketing implies. Useful that someone said it clearly.
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