Parietals (temple points): when to rebuild them and when not to

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The parietal area (in English temple points) is one of those areas that most interest patients who often want to reconstruct them to frame the face better, reduce the size of the forehead, or have a more aggressive hairline. In our opinion, however, it is not always recommended to treat this area, so let’s indicate in which cases it is preferable to avoid reconstruction and in which cases the procedure is recommended instead. We thank Dr.Bloxham and Dr.Feller for sharing parts of this text.

 

Patients for whom parietal reconstruction is recommended in most cases:

  • Patients with significant hair loss in general in the temple area

This does not mean that any patient who had slightly more defined parietals and is now experiencing mild thinning or less density in that area should be treated. Surgery is suggested for people who have evident miniaturization in the parietal area. It should be noted that there is a scale for those who suffer from miniaturization in the temple/parietal area:

As can be seen this patients have a recession in the upper temporal region and to intervene on other areas of the scalp with transplantation without treating the parietal area could lead to a less natural appearance, what many times is called a “hairpiece effect.” In these patients treating the temple/parietal area jointly or otherwise with other areas of the scalp is important to achieve a completely natural result.

  • Patients with minimal hair loss and who do not need a large number of follicular units in other scalp areas.
  • Patients who have fine-gauge hair and minimal contrast between skin and hair color. These two factors greatly affect the naturalness of the reconstruction of the parietal area.
  • Patients who are no longer very young for whom the situation is almost stable and the possible future evolution rather predictable.

 

Patients for whom reconstruction of the parietal area is NOT advisable:

  • Patients young with an unstable situation and who may need a transplant with a large number of follicular units in the future to treat other areas of the scalp.
  • Patients who are not suited for an aggressive hairline due to their facial proportions
  • Patients with deep receding hairline (deep recession of the fronto-temporal angles). Indeed, if the patient has deep receding hairline, reconstruction of the parietals may accentuate this problem by making the loss of the temples appear deeper because of the advancement of the parietal.
  • Patients withthick hair (above average caliber), dark hair, and who have a high contrast between hair color and complexion: hair in the parietal area is usually very fine. Even using an adequate number of single follicular units if the hair is black and coarse, the parietal triangle will always have a somewhat artificial appearance.

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