Author Bio: Dr. Sanusi Umar MD is the author of this article.
Temple hair is the front vertical wall that frames the top thirds of the face, traveling from the temple recesses on either side of the face, down to the temple points behind either eyebrow. The temple area consists of two critical details, the temple points and the temple recesses. Here, the hairs are naturally finer and less dense than the hair at the back of the head. Temple hair also follows a different geometric pattern than the rest of the scalp hair. It subtly shifts in growth direction, angle, density, shape, and follicular thickness as the hair progresses from the very edges towards the sides of the scalp. Dr. U is of the opinion that temple hair restoration is pivotal to an overall flattering look in a hair transplant. This delicate, face-framing area of the hairline can very well determine the difference between a natural-looking outcome and an obvious surgery. Without proper temple hair placement and growth, even the most expensive procedure will yield toupee-esque results. The sides of the hairline are like the walls of a house–the roof will look very odd without a frame to hold it up.
Dr. Umar uses his groundbreaking Dr.UGraft ™ FUE technology to solve this problem, safely extracting viable hairs from outside the traditional SDA zone (the rear center of the scalp). This finer graft hair selection enables the creation of soft, completely natural-looking hairline and temples.
The patient below presented an extreme case of temple hair loss. Previous surgeries at other clinics had left him with a depleted head donor area as well as multiple scars. His past surgeries included outdated practices such as flap surgery and scalp reduction. Multiple scalp reductions had displaced his temples and half of the sides.
This patient sought a temple hair restoration after experiencing severe temple hair loss, so he consulted with Dr. U about his options.
Causes of Temple Hair Loss
Temple hair is lost in both men and women because of two reasons:
- Androgenic alopecia in men (male pattern baldness)
- Traction alopecia (most common in women)
Androgenic alopecia is the most common type of hair loss, and does not affect women at the temples; women lose hair in an entirely different pattern from men, and thus the hairline is not affected in the same way. Ninety-five percent of baldness in men is caused by androgenic alopecia, which displays very specific patterns illustrated asType I to Type VII on the Norwood scale. From Type I, the earliest stage of a receding hairline, to Type VII, the most extreme hairline recession and crown hair loss, the common factor is a loss of hair at the edges of the face. This includes the temple hair.
Traction alopecia is a far less common condition comparatively, however, it has a large impact on the African American community. Traction alopecia is caused by a tight pulling on the hair that leads to scalp scarring and hair loss over time. Abrasive hairstyles, accessories, and attachments that tug constantly at the hair often result in thinning along the front and rear hairlines.
How to Know if You Need Temple Hair Restoration
For those with only slight hair loss or thinning, reconstructing the temples is necessary to complete the look of a youthful hairline. This detail is necessary for framing the face in the most flattering and natural way possible. Also, without the temples the hairline would appear to project too far forward. Temples are necessary to create a balanced looking, aesthetically pleasing outcome.
For those with advanced hair loss, temple hair restoration is highly advised in combination with restoration of both the hairline and crown. Without the temples, restoring the hairline and crown areas only would yield a very incomplete looking result, similar to a toupee.
Photos of Crown and Temple Point Hair Transplant Using BHT
The patient below had several unsuccessful surgeries at other clinics, using both the strip method and FUE, prior to finding Dr. Umar. The result was a sparse pluggy look and strip scars at the rear scalp, with baldness still prominent. Using a combination body hair transplant (BHT) comprised of beard, body, and scalp hair, Dr. Umar harvested 9,000 donor grafts to repair the prior damage, fill the crown, and build a natural-looking hairline.
The patient is now able to cut his hair to a #1 guard without the embarrassment of strip scars, is pleased with his thick head of hair covering the crown, and has a youthful temple point design.
Video: Temple Hair Transplant Using BHT
Watch the video below to see the patient’s hair transplant journey and hear him discuss with Dr. Umar the changes he noticed in himself. “I’m very, very happy,” says the patient of his overall results.
Why is Temple Hair Replacement Such a Difficult Procedure?
It is difficult for most hair replacement surgeons to achieve successful temple point hair transplant due to a few reasons:
- Limitation on the quantity of donor hair.
- Limitation on the right quality of donor hair, matching the right thinness of hair that grows along the edges of the face.
- Surgeon skill and artistic ability to create the correct growth direction, angle, density, and shape that would naturally occur for a particular patient
Some surgeons do not offer temple point hair transplant procedures based on any of the above reasons. Mistakes in the temples would show and be quite obvious. Therefore, clinics who lack the ability to restore natural-looking temple points and recesses may claim that it simply cannot be done. In worse cases, some doctors will attempt the surgery with subpar results.
Click below for a completely risk-free consultation with Dr. Umar to learn more about temple hair replacement, and whether it is right for you.
How Dr.UGraft Technology Masters Temple Point Hair Transplant
Dr. Umar has spent years of his practice researching and improving upon the Follicular Unit Extraction hair transplant method. He has even developed technology that could expand the traditional donor area beyond the SDA (safe donor area) on the back of the head. His innovations aimed for revolutionary advancements like the use of hair from the nape of the neck, as well as body hair transplant using beard, chest, arm, and leg donor hairs. Dr. U eventually arrived at his Dr.UPunch Rotor™. This small and intuitive handheld device is the foundation of his extraordinary Dr.UGraft™ technology. It’s specially designed features enable the safe extraction of donor grafts from both the head and all areas of the body.
The cylindrical design of conventionally used hair transplant punches is only suitable for removing head hair which grows close to ninety degrees. When it comes to more sharply angled hair, they are more likely to severely damage the follicle.
With the ability to harvest hair beyond the established donor zone on the head, Dr. Umar can expand both the donor quantity and the range of different types of hair that can be used (e.g. finer hairs from the nape, chest, arms, and legs)
The Dr.UPunch Rotor™ allowed Dr. U to treat the extreme temple hair loss shown in the patient below. Previous surgeries had depleted his traditional donor area on the back of his head, and the patient also exhibited baldness from overharvesting in the past, in addition to scars from strip and double flap surgeries. A prior scalp reduction had also created an island of abnormally angled hair.
Not only did this patient require a global restoration of hair throughout his scalp, but also an appropriate hairline to frame his face. A hairline alone would only serve to provide an upper border of hair above the forehead. Therefore, well-constructed temple points are necessary to complete the framework as a necessary detail to give this patient a more normal looking appearance.
Dr. U essentially reconstituted the patient’s entire head hair using non-head hair. In order to produce the most natural results, Dr. U mapped out and followed the patient’s natural head hair pattern and positioned the grafts accordingly.
Shown 2 years after his surgery, the head hair replacement using body hair has provided coverage for the patient’s hair loss, severe frontal pitting, and strip and flap surgery scars. Dr. U also created temple points to suit the patient’s facial features.
Overcoming General Contraindications for Temple Hair Replacement
Occasionally, there are contraindications for temple hair restoration. These typically include, but are not limited to:
- Hair curliness
- Donor hair thinness
Average hair clinics require patients to be at least 35 years of age. This is due to the permanence of hair restoration surgery and the gradual progression of hair loss over time. Here is the rationale. If a 25-year-old were to undergo temple hair transplant as a Norwood Type III, but will mature to a Type VI ten years later, several surgeries would be needed to fill in the natural hair loss that would occur in the meantime. Continually filling in the thinning that occurs behind the newly created frontal hairline would be costly. And if the patient is developing severe, Norwood 7 hair loss, they may run out of donor hair available on their scalp with no resources left to fill in the baldness that occurs.
However, a more experienced high-level surgeon may be able to look beyond the generic age guidelines and be able to create more individualized strategies.
With the right approach, it is quite possible to overcome conventional age restrictions. Even young patients can pursue temple hair replacement to complete the results of their hairline restoration, helping them look their absolute best. At Dr.U Clinic, Dr. Umar has acquired substantial skill and wisdom to make allowances for patients who are suffering severe emotional turmoil over their baldness.
The below 23-year-old patient had advanced hair loss for his age. With a balding crown, a minimal scalp donor count, no body hair, and his young age, he was a particularly challenging case. Dr. U designed a plan which would entail a soft, diffuse coverage using 2,000 grafts, and require the patient to keep his hair in a short buzz cut, lending to the illusion of a fuller scalp. The final result was a subtle yet marked improvement and a great success.
Conventional FUE hair transplant surgery has long been contraindicated for patients with extremely curly hair. Therefore, the surgery excludes certain ethnic groups, unfortunately. This is because non-straight hair is difficult to extract without damaging the follicle. Curly hair also has the tendency to grow back into the skin, and causing extensive scarring. These issues applies of course, applies to the temple area. Within the conventional paradigm of using straight cylindrical FUE punches, curly hair can be a challenge for performing temple point transplant, among other areas of hair restoration on the scalp.
Again, a more experienced temple hair restoration surgeon might have the means and knowledge to overcome this limitation. Dr. Umar has operated successfully on African American male patients through the advent of his Dr.UPunch Curl™. This device enables him to restore the temple points and other hair loss areas of many patients with curly hair.
The below African American patient had superficial micropigmentation performed to disguise his receding hairline. But as the tattoo faded, he desired a more permanent solution. Using only 750 FUE grafts, Dr. U restored his temple recesses, which covered the tattoo and gave him a completely natural-looking hairline.
Donor Hair Thinness
Most hair transplant clinics only have the means to harvest regular head hair. However, this is not natural choice for the outer edges of the temples which tend to be very soft and fine hair. Many clinics don’t have the ability to extract thinner hair grafts. Nor are they able to predict whether thinner nape hair can last long term. These are typical reasons why clinics may not offer temple hair restoration to patients.
Dr. Umar not only possesses the right technology to safely remove nape hair, but he has also come up with an effective reliable diagnostic test to know which patients qualify as candidates for this type of graft. He performed his Shave Test on 128 patients from 2006 to 2011, Dr. Umar found that not all patients have permanently viable nape hair. By shaving the heads of would-be patients, he found that he could distinguish those who had a clear line of demarcation between the SDA and the nape, and those who had a gradual and uniform spread of density from the SDA to the nape. The latter were excellent candidates. Those who did not pass the FUE Shave Test still underwent successful surgeries using donor hair from the chest–and still saw beautiful, highly satisfying results.
Dr.UGraft™ FUE Surgeries Break New Ground for Natural Looking Temple Points
In order to achieve the most attractive hairline and temple hair restoration, patients are advised to provide a photograph of themselves, pre-hair loss. This enables Dr. Umar to see your hairline in its truly natural state. As the doctor designs your new hairline, these are the main considerations for optimal outcome:
Softness of the Temple Donor Hair
A natural hairline typically does not emerge from the edges of the face as a sudden, dense wall, but rather soft and gradual, even if very subtle. As such, the donor hair used here must be a softer, finer texture such as that from the nape. Many clinics avoid the use of nape hair altogether because of the difficulty in safe extraction, which can adversely affect the follicles’ longevity. To overcome this limitation, in addition to the FUE Shave Test mentioned above (which helps determine whose nape hair is most viable for harvest), Dr. Umar created his Dr.UPunch Rotor™. This revolutionary device allows for the safe and reliable extraction of all types of hair follicles from the nape, head, and body regardless of their angulation. Patients can, therefore, expect to see their expected growth when healthy, robust and undamaged grafts are transplanted.
Temple Graft Placement and Density
This includes the angle and direction of hair when it grows out, as well as how tightly Dr. Umar packs the transplant area. Temple hair grows downwards and slightly backwards, but does not shift this direction suddenly–it is a gradual shift in direction from the top center of the hairline. Dr. U is able to re-create this slow shift, graft by graft, with an overall artistic vision for the final result. He knows exactly how each graft comes into play before it is placed into the scalp.
Shape of Temple Points and Temple Recesses
Is the patient young or old? Is the hair loss severe or mild? Is the patient’s face round or oval? How large is the forehead, how thick are the eyebrows, how wide are the eyes? All these variances and more come into consideration when designing the shape of the temple recesses and points. Ultimately, the hairline should complement the facial-skeletal contours and appear age appropriate. For instance, younger men tend to have a sharply pointed temple point, whereas mature men will have this detail appear more rounded.
Receding Hairline Before and After BHT Photos
Similar to the above case, this patient presented to Dr. Umar having had subpar work done previously at another clinic. The surgery had left him with a pluggy look that failed to fill his crown, did not adequately reconstruct the temple area, and yielded an abrasive hairline overall. In addition, his traditional donor area was riddled with strip scars, leaving him with no head donors left.
His only option for 14 years was wearing a hair piece to cover it all up. Then he found Dr. Umar.
Dr. U’s signature Dr.UGraft ™ technology enabled the harvest of 9,000 grafts from the patient’s beard and chest. With no visible scarring to these donor areas post-surgery, this patient gained a full head of hair and hairline, while Dr. Umar also filled in the humiliating strip scars.
Video: Temple Hair Restoration Results
In the video below, both the patient and Dr. Umar discuss additional details of the overall temple hair transplant experience. The patient was extremely relieved to regain a normal head of hair and noted, “I feel free. Born again!”
Click the button below if you have questions or concerns about your hairline and whether a temple hair transplant is right for you.
Frequently Asked Questions – Temple Hair Restoration
Is Minoxidil a good solution for temple hair recession?
Minoxidil, commercially known as Rogaine, has only been clinically proven to regrow hair on the top of the head. However, many people have had success regrowing temple hair by using Minoxidil at a very early stage of hair loss; this means the hair being ravaged by the hormone DHT is only thinning out, and not completely dead yet. Once DHT kills the follicles at the temples, Minoxidil will be ineffective at regrowing hair in this area of the scalp.
Is FUE or strip surgery better for a temple point hair transplant?
FUE is certainly the more desired type of hair transplant surgery for successfully recreating the temple area. This is due to the fact that strip surgery extracts a strip of hair from the SDA only–a traditional donor area at the rear center of the scalp. The SDA is an area where hair grows thickest, densest, and longest; it is not the ideal caliber of hair for designing a soft, gradual, and natural-looking hairline. Temple point work using strip surgery will typically yield harsh and unnatural-looking results. Contrarily, FUE using highly specialized technology like Dr.UPunch Rotor ™ enables the harvesting of donor hair from outside the SDA, such as nape or peri-auricular hair, which is finer and shorter.
Do I need to tell my doctor how I want my temple hair area to be designed?
If you’ve chosen the right surgeon–someone with vast experience, technical skill, and artistic vision–he or she should be able to create temple points that compliment your face and appear completely natural. Providing a picture of yourself from before you began balding is always helpful to the surgeon in designing the ideal shape.
Why do many hair transplant doctors refuse to perform temple hair transplant surgery?
Many hair transplant surgeons refuse to perform temple hair restoration because of the requirements necessary for a good outcome. Crafting a temple that captures the variously changing hair angulation and the use of the type of hair needed to impact the necessary softness required for a natural looking temple and temple point calls for an advanced skill set and artistry that a novice provider would find challenging. Often the surgeon would require the ability to harness hair from outside the traditional donor zone. Furthermore, if a surgeon does not feel comfortable with his or her skill or creative ability in crafting a hairline that suits the unique facial-skeletal structure of each patient, this may not be a procedure they feel comfortable offering.
Temple restoration is our specialty. To ask Dr. U any questions about FUE hair transplant not answered in this article, click the button below:
Further Reading – Temple Hair Restoration
Learn more about general hair loss here.