Temple Hair Transplants
Middle-aged men often have a V-shaped hairline, called a widow’s peak. This is due to balding of the temples accompanied by recession of the hairline. Hair loss at the temples is common, especially in men, and is often the first sign of male-pattern baldness.
It can affect women as well where the cause can be female-pattern baldness, alopecia areata, or cicatricial alopecia, among other conditions. Treatment options include medications, platelet-rich plasma, and hair transplants.
There is more than one method to get a temple hair transplant and, in this article, we will cover whether a temple hair transplant is the right procedure for your hair loss and which method is the best. We will also discuss what to expect in terms of cost, the surgery procedure, and recovery.
What is a temple hair transplant?
In terms of technique, recovery, and expected outcomes, temple hair transplant is comparable to other types of hair transplants like full-head or hairline hair transplant. What makes it different is the careful deliberation required on part of the patient and surgeon regarding the timing of the transplant.
This is because temple hair loss is often the beginning of pattern-hair loss in men and an early transplant, for example for a Norwood 2 classification, can result in an unnatural look as the hairline recession continues after transplant. The optimal timing for a temple hair transplant is the one when the hairline is sufficiently stabilized and the surgeon and patient agree on the expected outcome. Once the feasibility is established, there are several hair transplant procedures to choose from, including FUE (follicle unit extraction), FUT (follicle unit transplant), and DHI (direct hair implantation). All the procedures are currently in practice, but FUE is the one more commonly used nowadays.
The specifics of the procedure will be detailed in the coming sections but at the basic level, temple hair transplant involves harvesting hair follicles from a donor site and implanting them into the temple area – the area of skull defined by the junction of the four skull bones, on either side of the head. Like other hair transplant procedures, temple hair transplant gained popularity in the 1990s, with the introduction of the modern techniques of FUT and later on FUE.
Performing a temple hair transplant with good results require specialized surgical skills usually performed by plastic surgeons and dermatologists experienced with FUT and FUE. A good surgeon will have the understanding of mapping out a proper frontal hairline and not just the temples. Careful consideration of the direction and texture of the implanted hair is required so that there is a natural blending of the temple hairline with the rest of the scalp.
Characteristics of Temple hair loss
Temple hair loss is often the first indication of pattern-baldness. Signs that might alert you to possible temple hair loss include visible thinning of hair around the temples, losing a relatively large volume of hair while brushing and washing, and a considerable decrease of overall hair volume. In men, the most common cause is androgenetic alopecia. In women, female-pattern baldness usually presents with generalized thinning of the hair and widening of the part, rather than temple hair loss. In some women, however, the temples may be preferentially affected. Other causes which more commonly lead to temple baldness in women include traction alopecia, scarring alopecia, pregnancy, and stress. Some women experience postpartum hair loss which is usually diffuse but may affect the temples disproportionally.
Alopecia area and scarring alopecia can affect both sexes. Scarring alopecia, which is known as primary cicatricial alopecia in medical terms, is an inflammatory condition in which there is loss of hair follicles and fibrosing of the scalp. Alopecia areata is an immune-mediated disorder, which can affect any hair-bearing of the body including the scalp, beard, and eye-brows, leading to the appearance of discrete bald spots. Telogen effluvium is a relatively uncommon condition where the shedding of a large number of hairs occurs over a short period and may involve the temples.
The Norwood scale is a commonly used clinical tool to assess the degree of baldness in men with androgenetic alopecia. According to this scale, hair loss in male-pattern baldness typically starts with thinning of the temples and progresses forward to involve the frontal hairline and backward to involve the vertex. Isolated temple hair loss represents the early stage of male-pattern baldness on the Norwood scale, in which there are seven grades (Type I to VII), starting with minimal frontal hair-loss to complete baldness. In women, the Ludwig and Sinclair scales are used to grade hair loss.
There are several medical and surgical options to remedy temple hair loss.
Medical options include medications like Minoxidil and Finasteride which prevent further hair loss and promote hair restoration. They are useful in patients with early hair loss and can stabilize the hairline. The effects, however, are often short-lived and temple hair recession recurs once the medications are stopped.
FUE, FUT, and DHI are the surgical procedures currently in use for various types of hair loss including temple hair loss. FUE is usually preferred over FUT as it avoids scarring of the donor area among other advantages. DHI (direct hair implantation) is a modified version of FUE. In FUE, individual follicles are harvested from the donor area, placed in a solution to avoid desiccation, and then implanted onto the recipient area. In DHI, harvesting and implantation are done simultaneously, obviating the need to store harvested follicles. DHI is a new procedure with good results, but relatively complex and time-consuming.
Platelet-rich plasma (PRP) and micro-pigmentation are alternatives to temple hair transplant. PRP can be used for temple hair restoration when the hair loss is not severe. It can also be used as an adjunct to hair transplant to expedite the recovery process and promote healing. Micropigmentation is a non-surgical hair loss solution that involves tattooing dots in the scalp to create an illusion of fuller hair. Hair texture and texture, donor area, the contrast between skin and hair color, and the underlying cause of hair loss are some of the determinants of a successful outcome. Patients with androgenetic alopecia typically do well compared to those whose hair loss is due to an inflammatory condition. Curly or frizzy hair is somewhat difficult to work with during transplant but the results according to some surgeons are better than with straight hair.
Like other cosmetic procedures, temple hair transplant is not available on the NHS.
The back of the head or occipital region, as it is called in medical terms, is usually the first-choice donor area for temple hair transplant. This area is preferred because the hair there is usually permanent and resistant to the effects of DHT, the hormone responsible for male pattern baldness.
The donor area must be healthy and have a good follicle density. If that is not the case with the primary donor area, or the number of follicles required is large, body hair can be used as an additional or alternative source. The beard, chest, back, and legs are body areas from which hair follicles can be harvested. Since the texture and color of body hair may be different, extra care and expertise are required on part of the surgeon to ensure that the hair blends well.
The cost of a hair transplant depends on the number of grafts required as most clinics charge per graft unit. As a crude estimate, for temple hair loss which classifies as Norwood scale II, 1500 grafts would be required on average while a Norwood III temple hair loss would require 2500 or more grafts.
The expected cost for 2000 hair grafts in the UK would be between £ 5000 and £7000 for FUE. FUT tends to cost less than FUE.
In comparison, a similar transplant would cost on average £1800 to £3000 in Turkey. The average cost per graft is £ 2,5-5 in the UK and half as much in Turkey.
Surgery in the UK vs Turkey
Hair transplants for the temples is not covered by the NHS and most private insurance firms. The cost can thus be significant for the individual if a large number of grafts is required.
One way to cut costs is to consider doing the surgery outside the UK. Turkey is one of the countries popular among European health tourists. The cost of a hair restoration procedure in private clinics in the UK can be significantly higher than those offered in Turkey. The benefits of doing a temple hair transplant in Turkey include:
- Low cost – When the combined costs of travel, hotel stay, and transplant procedure are considered, you can still save up to 70% on your hair restoration treatment in Turkey, compared to the UK. (1)
- Quality healthcare – In terms of healthcare standards, Turkey is comparable to most European countries. Modern procedures like FUE and DHI are available in many clinics around Turkey.
Certain things need to be considered while opting for hair transplant surgery abroad, like:
- The logistics and costs of staying in a foreign country
- Visa and flight considerations.
- There will be more days off work compared to surgery in the UK and given the cosmetic nature of the procedure, some employers may not count the leave as sick leave.
- If repeat sessions are needed there will be a lengthy stay abroad or repeat visits.
Risks and considerations
- Doing transplant for early temple hair loss may result in an unnatural look if the temple hair recession continues and hair thins out towards the vertex.
- Temples are a prominent part of the frontal hairline and before graft harvesting and implantation, the hairline should be mapped out in accordance with the patient’s facial structure, ethnicity, and preference.
- Infection: Every surgical procedure has its attendant risk of infection. Following a temple hair transplant, both the donor and recipient areas can get infected. Adequate surgical hygiene and post-operative care are important to reduce infectious complications. Antibiotics are commonly used in the first few days to minimize the risk further.
Temple transplant timeline
To find out a qualified surgeon in your area you can check his qualification and whether he is registered with a national or international association of hair restoration surgeons, like BAHRS, IAHRS, etc. (3) Once an appointment is booked, the first visit will involve an assessment of your hair for suitability for transplant and a discussion regarding the expected outcomes and hairline design.
Surgery: If the number of grafts is small, the procedure may be completed in a single session, lasting 3-4 hours. More sessions will be required for extensive hair loss. It is done under local anesthesia.
1-2 postoperative days: Swelling, tightness, and slight pain are common and would settle with pain medications.
First few weeks: Many patients experience itching, scalp dryness, and scabs during the first week. Don’t be alarmed, it is normal. Don’t pick the scabs and avoid scratching. The scabs will fall off spontaneously by the second week.
Recovery: It takes, on average, 9 to 12 months for the implanted to grow significantly.
Results and aftercare
First Month: In the first couple of weeks, you will need to be careful while sleeping and washing your hair. After a temple hair transplant, it may be advisable to avoid sleeping on your front, so as not to damage the newly implanted follicle. The implanted hair usually falls off by 3-4 weeks. It is normal and not a cause for concern. You can wash your hair but avoid direct application of water from a hose or shower. Massage gently using baby shampoo and avoiding excessive rinsing.
2-3 months: The implanted hair would have likely shed off by now and your head might look similar to what it was before transplant.
8-9 months: By now sufficient growth is achieved that the new hair can be styled and combed as usual.
1 year: Hair recovery is mostly complete by the end of 1 year. Good results are expected after FUE with up to 80% of the transplanted hair showing growth.