The Definition of Lateral/Parietal Humps in Hair Restoration
From the hairline temple back, the lateral humps are the sections of the scalp that fall on the sides of the head, connecting the sides to the top of the head. When the hair in this area begins to detach from the mid scalp due to gradual hair loss, the lateral hump becomes essential.
The lateral humps stay intact in lower Norwood scale or even significant hair loss stages. The first indications of hair loss usually appear in the temporal area, which then moves backwards, generating a greater recession. In rare circumstances, lateral humps may appear to be intact, but the hair quality is poor and miniaturized; in this scenario, the region should be treated as if it had no hair.
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Evaluating Lateral Humps in Hair Transplantation
When treating severe hair loss with hair transplantation, it’s critical to check the lateral humps for hair quality and the possibility of their dropping further. If the lateral humps are not rebuilt, hair growth will seem artificial, and the hair line and mid-scalp will be rebuilt but separated from the hair on the sides and back of the head. The lateral humps must be considered while constructing the hair line, with a conservative approach to the design in general. This is due in part to the hair loss pattern and the fact that as the lateral humps disappear, the recipient surface area expands.
The bigger the surface area, the more grafts are distributed to create a balanced natural aesthetic look, rather than a front-loaded hair loss region that might be half the scalp. Understanding how the hair angles alter while rebuilding the region, from the top of the scalp angling down to meet the sides, is another critical feature. This necessitates dexterity as well as a thorough grasp of skull anatomy.
The portions of the scalp that fall on the sides of the head are known as lateral humps. They begin at the transition of the horizontal plane of the mid scalp as it transitions over to the vertical side plane of the head, as indicated in the second part of this series, and conclude just above the ears, where the hair stops. The anterior temple or temporal point is the anterior edge of the lateral hump and is located a few cm anteriorly. The transition from the crown hair on the back of the head to the posterior border is known as the posterior border.
Understanding the Lateral Hump in Hair Loss Progression
The lateral hump derives its name from how the hairs in the lateral hump begin to split from the central mid scalp and resemble a camel’s hump in someone with advancing baldness. In terms of form, it resembles an upside-down U. The lateral hump is unaffected by early baldness or even moderate degrees of baldness. The earliest symptoms of loss appear anteriorly in the anterior temple region and move posteriorly to the lateral hump, which then gradually falls away from the top to the bottom, revealing the inverted U shape that continues to descend downward.
It’s crucial to rebuild the lateral humps in advanced hair loss since a robust anterior hairline with a depressed, unreconstructed lateral hump appears unnatural and absurd. Indeed, the amount to which a hairline may be reconstructed is determined by the severity of the lateral hump. With severe lateral hump loss, just a little hairline can be reconstructed to match the lateral hump area and produce a natural-looking pattern.
Characteristics of the Lateral Humps and Parietal Humps in Hair Transplantation
Is there any reason the lateral hump has a name other than the upside down U shape? Yes, there are a few. For starters, the way the hairs are angled here is unusual. The top row targets immediately anteriorly, and as the rows advance, they tend to fall away vertically downwards in a gradually cascading pattern (Figure 2.65). It’s critical to duplicate this correctly, else the sides of the head would appear strange. In addition, the arrangement should be reasonably flat to the scalp, otherwise the hairs would stick sideways in an unnatural manner. Second, if the hairs are not generated in the aforementioned manner and are made to sweep inward to the midscalp, they will appear to be a combover, because hairs that fall on the outer area of the eye should fall outward rather than inward.
