Regions of the Head for Hair Transplant Part 3 of 4: The Lateral Humps
The lateral humps are the areas of the scalp that fall on the sides of the head. They start, as mentioned in the second part of this series, from the transition of the horizontal plane of the midscalp as it transitions over to the vertical side plane of the head and they end just above the ears where the hair stops. Anteriorly, the first few centimeters are known as the anterior temple or temporal point and is the anterior border of the lateral hump. The posterior border is the transition over to the crown hair on the back of the head.
The lateral hump gets its name for its appearance in someone with progressive baldness in which the hairs in the lateral hump begin to separate from the central midscalp and begins to resemble a camel’s hump. It looks like an upside U shape in configuration. With early baldness or even in moderate degrees of baldness, the lateral hump remains unaffected. The first signs of loss occur anteriorly in the anterior temple region that progressively continues posteriorly to the lateral hump which then begins to fall away from the top to the bottom, slowly to reveal the upside U shape that continues to fall downward.
Figure reprinted with permission from Hair Transplant 360, Volume 1 (Jaypee Brothers Medical Publishers, 2011), Samuel M. Lam MD
In advanced degrees of hair loss, it is important to rebuild the lateral humps because a strong anterior hairline with a descended, unreconstructed lateral hump looks unnatural and ridiculous. In fact, the extent to which a hairline can be rebuilt is contingent upon how bad the lateral hump is. At times with very advanced lateral hump loss, only a modest hairline can be rebuilt to match the lateral hump region to create a pattern that would be natural in its appearance.
Besides the upside down U shape is there another reason that the lateral hump has a distinct name? Yes, a couple. First, the way that the hairs are angled here are unique. The top first row aims directly anteriorly and with each progressive row they tend to fall away vertically downwards in a progressively cascading arrangement (See the Figure). This is very important to recreate correctly or the sides of the head will look unnatural. Further, the arrangement should be relatively flat to the scalp or the hairs will stick sideways unnaturally. Second, if the hairs are not created in the aforementioned manner and are made to sweep inward to the midscalp, they will look like a combover since hairs that fall on the outer portion of the eye should fall outward and not be combed inward.
I hope this introduction to the lateral hump, which again is only really important with someone who has very advanced hair loss, can be instructive in understanding its role when performing a hair transplant procedure in select patients. To learn more about the lateral hump please watch Dr Lam’s video Understanding the Lateral Hump.
Samuel M. Lam, MD, FACS is a board certified hair restoration surgeon specializing in hair transplant procedures for men and women. To learn more about Dr Lam’s hair restoration procedures please visit our website hairtx.com or call 1-888-866-3388 to schedule a consultation.