Here is a patient who was treated by another hair transplant surgeon who agreed to place 300 FUE grafts into each temporal peak. The temporal peaks are definitely a sign of a youthful hairline, but special care needs to be taken in these areas for many reasons. Firstly, the natural hair in this region is finer than the other scalp hair and it also does not grow long like the other scalp hair. For this reason you must explain to the patient that if you are going to transplant hair into this area, since the typical donor hair comes from the back and sides of the scalp, the new temporal transplanted hair will be coarser and will grow long. Also in a patient with curly hair it can look very unnatural. In addition, the hair lies extremely flat in these regions so it is imperative that the angles for the grafts are made as acute to the skin as possible so the hair does not grow outward. In a very young patient with significant hair loss I think it is a bad idea to address the temporal peaks because without knowing how severe the ultimate hair loss will be you can end up wasting grafts on an area that will ultimately be less important if you have to sacrifice density in more important areas, ie. the frontal and mid scalp.
Getting back to this patient, he was 26 years old with significant hair loss in the frontal scalp when he presented to this hair transplant surgeon who agreed to place 300 FUE grafts into each temporal peak, and not even address the thinning frontal scalp! Here are his results after 2 years which show less than 30 grafts growing on each side. The patient was so disappointed he ended up having scalp micro pigmentation in the area, but I personally do not believe this helps the situation at all. I think the scalp micro pigmentation looks very unnatural and I believe it can also harm adjacent hair follicles and create permanent scarring in the tissue. His photos are below.
Lesson to learn from this. BEWARE of physicians claiming to be FUE experts unless you have seen many before and after photos of their patients who they have specifically performed FUE on. In addition, be very careful before deciding to transplant into the temporal peaks, especially in the younger patient. Unfortunately many hair transplant surgeons in this field will do anything you are willing to pay them to do, but this is not always the right thing. Do you diligent research before having your hair transplant procedure.
All the best,
Marc Dauer, M.D.