Aesthetic Importance of the Parietal Eminence Area (Posterior Parietal Triangle), an Essential Island of Scalp Requiring Hair Restoration

Abstract

Introduction: Hair loss is a progressive disorder that if not treated in the early stages may lead to baldness, requiring a hair transplantation. Hair restoration of the frontal area of the scalp, followed by mid-scalp and vertex, is the usual order of priority for hair transplantation. Because of the progressive nature of hair loss, patients who undergo hair transplantation in the frontal and mid-scalp may later show prominent bald scalp in the parietal eminence area (posterior parietal triangle). This thinning in the parietal eminence is noticeable in frontal lateral profile views, which can be concerning to the patient. The parietal eminence, or posterior parietal triangle, is part of the vertex/crown, and the vertex is the last priority of scalp hair restoration. However, to maintain the patient’s aesthetic appearance, we feel the parietal eminence area should be covered when implanting the mid-scalp.

Method: We examined our patients who underwent hair transplant in the frontal and mid-scalp areas. Some showed thinning and/or baldness in the parietal eminence area, which was readily visible in the patients’ lateral profile and frontal view. We concluded that the parietal eminence area is an essential aesthetic area of the scalp and therefore should be treated as an extension of the mid-scalp area. Based on this, we modified how we transplanted the mid-scalp. The mid-scalp area was extended to both sides to include the parietal eminence (posterior triangle) area. The transplanted hair in the parietal eminence area shadows the central vertex area.

Results: The patients who underwent hair transplant procedures to cover the frontal and mid-scalp along with the parietal eminence area showed good hair coverage and were happy on follow-up.

Conclusion: Hair transplant of the parietal eminence is an underappreciated means to maintain balance in the frontal and lateral profiles and restore the head’s contours. In limited donor availability, when the vertex is not transplanted, preferential attention to parietal eminence can provide indirect cosmetic benefit to the vertex.