Hairline design in Hair Transplant

During hair transplant consultation, many of my patients bring old photographs from their prime years. Most often this is done with the good intention of giving me an 'idea' of the hair loss. Hidden inside that good intention is the expectation that their new hairline will look exactly like it used to be. As a plastic surgeon, this puts me in a tight spot. While old photos are valuable to me for assessment regarding design and pattern of hair loss, the extent of restoration depends solely upon the availability of hair in donor area and patient’s commitment for multiple sessions. My primary goal during reconstruction of a new hairline is natural appearance. A mature natural hairline looks far better than a low unnatural hairline any day. In fact low hairline is a hallmark of an inexperienced surgeon, who often becomes a ‘yes man’ and harms the patient in long run.

So, what makes an ideal hairline? You can find it yourself.

Discreetly, try to observe the hairlines of people around you. You will find that no two hairlines are same. This is because Mother Nature, the greatest artist of them all, never repeats her design. But, once you have seen many; you will also appreciate a pattern that keeps on repeating itself. While designing a hairline, one has to balance this fine art of creating a unique hairline while respecting the pattern. The uniqueness or artistry cannot be defined, but the pattern is here for you to understand.

1.       Location: The hairline basically separates forehead from scalp. Notice that forehead is surrounded on the top and sides by scalp hair and below by the eyebrows. Recession of any scalp hair will give appearance of baldness. So, under ideal circumstances, both top and sides should be restored. The height of forehead should be at least as much as the nose. Most transplant surgeons keep it in the range of 8 to 11 cm, but exceptionally it may be placed lower also.

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Note the unnatural location, shape, border and density of hairline.
This patient underwent hair transplant at a clinic in Gurgaon, a New Delhi suburb  .

2.       Shape: Hairline is slightly convex or wave shaped in adult males, while it is straight or downsloping in children and women. The former is called mature hairline and the latter, juvenile hairline. A straight hairline uses much more donor resources than a mature hairline. It is requested very frequently especially by young hair loss sufferers planning a hair transplant. However a wise hair transplant surgeon designs it rarely, for maintaining it in long term may need many more sessions in future.

3.       Softness: One of the most overlooked characteristic of natural hairline during hair transplant is its wispy, feathery appearance at the border with forehead. A good surgeon will try to replicate this using single, fine hair in the front of hairline.
Also notice that hairline is not linear. It is undulating and broken in places around an imaginary line. This also gives softness to hairline.

 A very natural looking hair transplant.  Note the soft, undulating, convex hairline. 

4.       Direction: The direction of hairs in the hairline is predominantly downward and forward. The exception to this rule is cowlick, where the hairs go upwards or to a side. The misdirected hairs in a transplant stand out against the grain of natural hair, especially in a short cut.

 A hairline is often termed the signature of a hair restoration surgeon. It is the most visible feature of a hair transplant and little mistakes in hairline can ruin the effect of an otherwise well executed surgery.  While choosing your surgeon, look at his creations and assess them for natural appearance. A striking unnatural change often becomes a point of conversation and has the potential of embarrassing you. Try to avoid it.

For further info on aesthetics of hair transplant contact Provelus hair Transplant Clinic, Delhi.