Almost daily, I see patients with thinning in both the "back" and "front" of the scalp. And while many of these patients tell me the back bothers them the most and they would prefer to do "everything" in one shot or focus on restoring the back first, I almost universally advise them to focus on the front "half" of the scalp first.
This is for a few reasons:
1) Because it is a more visible and cosmetically significant region.
2) A full front with a thinning back is a pattern found in nature and, therefore, looks natural regardless of whether the patient has a second procedure to address the "back."
3) Because the back frequently appears fuller and the overall appearance of the ENTIRE scalp looks fuller when the front is done.
And reason 3 is where today's patient comes into play:
The patient is a male in his 30's with NW VI patterned hair loss. The front is more pronounced than the back, and he's consistent with daily minoxidil usage in the "back" region.
I had the above conversation with him and despite reservations about not addressing the back during the first surgery, he understood "point 3" and trusted that everything would look thicker.
Here is how he looked 6 months after a 3,000 graft transplant. Now, these are not the best "apples to apples" comparison pictures here. Obviously his hair is combed back in the befores and down in the afters. But this is the point of the presentation: he was unable to comb his hair how he wanted before (down) because there was a lack of hair in the front and the thinner hair in the back looked like a "comb over" when he tried to swoop everything down. Now with 3,000 grafts in the front, he's able to "bring it all together" and create a thicker, fuller look in the entire scalp despite having no transplants in the back whatsoever.
Hair Restoration Forum
Norwood class 3
The earliest stage of male hair loss. It is characterized by a deepening temporal recession.