Hairline Design in Hair Replacement Surgery

Abstract

This article attempts to guide the reader through all of the considerations that must be made before settling on the best hairline for a given individual patient. Five essential components to the hairline's design and construction are considered in detail: the height of the hairline, the general contour of the hairline, the intersection of the hairline's lateral arms with the side fringe, creating macrocontouring and microcontouring, and, finally, the direction and angulation of the hairs along the hairline. The pros and cons for using either the hemioval or the flared hairline contours are outlined. The author's strong preference in most patients is the flared design. A step-by-step method for drawing the hairline is given along with several "checks" to be done after the final drawing to confirm its proper orientation to the other landmarks of the head and scalp. The various choices for direction of hairs in the hairline are presented and discussed, with the author's preference stated for curving the hairline direction through the front-central aspect of the hairline. Six pitfalls are mentioned that should be avoided in hairline design. The option of adding anterior temple transplantation along with that of the hairline is explored. This area's contribution to framing the face and supporting the frontal hair is emphasized. A few comments on creating a female hairline are then made, particularly concerning the need to create a shallower and gently curved recession on each side.

Classification of the Female Hairline and Refined Hairline Correction Techniques for Asian Women

“…Hair transplantation has recently been widely performed on women who seek to correct their hairline, 3 but studies of the female hairline and its correction method have rarely been conducted. Although numerous studies on the classification and correction method of the hairline of the male have been reported, it is difficult to apply them as they are to women 4,5 …”

“…Although numerous studies on the classification and correction method of the hairline of the male have been reported, it is difficult to apply them as they are to women. 4,5 Recently, a study focused on patterns of Caucasian female hairlines, 6 but Caucasian and Asian hair are different in many aspects, such as thickness, density, color, and degree of curliness. Hairline patterns may also be different between the two.…”

Aesthetics and Rejuvenation of the Temple

“…In females, the hairline sits lower than their male counterparts and takes a straighter path through the temporal region. 17 In patients who have undergone previous facelifts, iatrogenic alopecia may result from the upward migration of the hairless cheek into the area of the temporal tuft, or even higher in some cases. These patients are excellent candidates for hair transplantation or in some cases surgical adjacent tissue transfer may improve cosmesis.…”

Selecting the Best Eyelid Techniques

“…In females, the average height measures 5 to 6 cm from the trichion to the supra-eyebrow line but is typically higher in males, measuring 6.5 to 8 cm. 7,8…”