Hair Transplants need to be researched, find the information here    

Research and find a great hair restoration physician.


  Dr Vogel on Corn Row correction > Page 2 > Page 3 > Page 4 > Page 5

Correcting The ‘Temporal Alley’ Caused by Progressive Hair Loss

Alopecia by definition is progressive. Hair loss may not be visually noticeable throughout one’s life but thinning of hair density is a natural aging feature of hair bearing scalp. A principle of hair restoration surgery to perform a procedure today that will stand the test of time is based on the premise that hair loss is progressive. (5) When progressive alopecia affects the appearance of previous transplant procedures the complaints are usually due to one or a combination of three problems. 1. Increased visualization of previously camouflaged plugs, 2. Increased appearance of alopecia because only the grafts remain, or 3. The development of alleys of alopecia in the temporal area. The approach to the first two problems would generally involve P R & R and additional hair grafting from occipital donor sites. When alopecia alleys need to be filled in, the forelock hair needs to be linked to the temporal fringe.

Case 5: (fig 8) 42-year-old male who had previously undergone plug transplants in his mid 20’s. Progressive alopecia has resulted in the increased prominence of his anterior hairline plug grafts and the development of bitemporal alopecia alleys. Although the appearance of an isolated forelock is a naturally occurring pattern of hair loss, the patient was not satisfied with the appearance of bald scalp in these areas. One option for correcting these alleys was to perform limited scalp reductions to raise the temporal fringe. After discussion with the patient it was felt that P R & R and additional grafting from the occipital donor site was the best choice for him. The patient underwent three sessions of plug reductions and grafting to correct his anterior hairline and link the forelock hair to the temporal fringe. A total of 35 plugs were reduced at the hairline and 1200 grafts containing 1-3 hairs per graft were placed at the anterior hairline and temporal alleys. Numerous 4-mm plugs in the crown vertex area were removed with 4.0-4.5 mm punch excisions and closed primarily without surrounding grafting. Results are seen 10 months following his 3-rd procedure.


Fig. 8. 42 year old male whose progressive hair loss resulted in the development of temporal alleys of alopecia. In addition, anterior and posterior plugs were unsightly. (a, b, d) results after 3 sessions ( c ) intra operative plan for linking the forelock to the temporal fringe, PR &R anteriorly and elimination of crown plugs.


Case 6: (fig 9) 47-year-old male whose previous plug hair transplant was performed 20 years earlier. Progressive alopecia has unveiled previously camouflaged plugs and resulted in the emergence of a temporal alley of alopecia on the right. The left temporal recession was inappropriately designed and grafted and the result is an unnatural blunted angle of recession. A total of three sessions of anterior plug reduction, recycling and grafting from occipital region were performed to link the frontal hair with the right temporal hair, soften the hairline and fill in the frontal forelock density. Plug excisions were also performed in the left temporal recession. A total of 1800 transplants with 1-3 hairs per graft were used in addition to approximately 50 plug reductions. Results are seen 1.2 years following the last procedure. The patient is currently having additional corrections performed to the crown vertex plugs


Fig 9. 47 year old male with corn row plugs, a right temporal alopecia alley, and a blunted left temporal recession. Results are seen following three sessions of PR &R, plug excisions in left temporal recession, linking of the forelock to the right temporal fringe and extensive grafting.




Hair Loss information on this site has been contributed by hair loss specialists and surgeons who have years of experience in the field of hair loss.

Library Articles

Non Surgical Treatments

Surgical Treatments

All Articles



Home  | Top of Page  | Contact Us