Planning for maximum coverage in surgical hair restoration

BACKGROUND. Previous articles in this publication have suggested that an isolated frontal forelock is probably the best objective for a majority of patients undergoing hair transplantation. OBJECTIVE. This communication disputes the advisability of all isolated frontal forelock for a majority of hair transplant patients. METHODS. Previous studies and publications indicate a relatively low incidence of extensive male pattern baldness. Newer harvesting techniques require relatively small donor areas to yield large numbers of grafts. Alopecia reduction can significantly improve the donor/recipient area ratio, and minigrafting can produce very natural looking results with less donor graft utilization. All of the preceding are presented to support the position of the author. RESULTS. Limiting oneself to an isolated frontal forelock is an overly conservative objective for a sizable majority of patients. CONCLUSION. The isolated frontal forelock is a wise goal for a minority of patients who should be chosen on the basis of their limited objectives as well as their family history and a careful physical examination at the time of presentation. For most patients, more extensive coverage remains a reasonable option.