My doctor said I shouldn’t transplant the crown

I am naturally a Norwood 3-temple recession and minor crown recession as well.

Had a 1200 graft hair transplant last year on my temples, and slightly slowered the hairline. The doc did not put enough grafts in, so I am getting a 2nd HT Nov 20 for an additional 300-500 grafts to fill it in, free of charge (there was sooo much drama surrounding this, see my post history for more info).

My crown was not operated on during my last HT, but since I am already going under the knife, I would really like my crown filled in as well. I’m not sure how to rate my crown loss-I guess a Norwood 2- in that my crown clearly has loss, but it is not unbearable. Sort of like how Norwood 2 on the hairline is noticeable, but a lot of people can still get away with it.

Both my doc and another doc in the office looked at my crown. They both advised against getting grafts on my crown. One of the docs said he never operates on the crown on people under 40 (I am 30) because of potential future loss. They also said I do have significant hair on the crown still (albeit miniaturized) and putting new grafts in could shock loss out these already fragile hairs. Essentially, they are saying that while I clearly have crown loss, it is not bad enough to merit a hair transplant for it.

I was very disappointed these docs advised against operating on the crown. My arguments for getting a crown are, if they do grafts on it and I do have future loss, I am prepared to get a 3rd HT. I am currently taking Dut and using Rogaine on this area, so not sure if I would even have more loss.

The docs recommended SMP as an option for the crown. I actually visited an SMP guy Thursday. It just seems like so much maintenance. The tattoo only lasts 4-6 years, have to put sunscreen on it everyday. Nervous it would look unnatural. So don’t want to do SMP.

Toppik works VERY WELL on the area, but again, it is still a lot of maintenance. And I would rather have the permanent option of a HT.  I’m kind of confused as well. I’m sure if I consulted other doctors, or went to Turkey, I could find a reasonable # of doctors who would work on the crown. Not sure why both these docs are advising against it.

My questions are:

-Should I insist my doc operate on my crown?

-Has anyone here had any experience with doctors advising not to get grafts on the crown?

-Would you side with the doctors or me in this situation?

-Any advice on how to deal with crown loss? Toppik works very well, but Id rather have the permanence of a HT.

Transplanting the crown is something that I have been doing for 29 years with no problems. Clearly the issue is skill of the doctor, experience, and proper indications for doing it (never too early if it responds to minoxidil for example). I have had my crown transplanted and it looks great!