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Temporal triangular alopecia usually starts in early childhood and treatment with Minoxidil has limited effectiveness.

Scalp reduction gives the most natural result for significant crown baldness, despite potential complications, and a systematic approach to surgical hair restoration results in few complications and high graft survival.

The hairline lowering surgery with bone tunneling suture fixation is safe and effective, with high patient satisfaction.

Recognizing congenital triangular alopecia is crucial to avoid unnecessary treatments.

Scalp flaps are used for reconstruction, considering factors like inelasticity, hair growth, and blood supply, with techniques adapting to age-related changes in vascularity.