Hairline Design

[Cant decide]

This may be a potentially dumb question but here goes... When looking at patients post op pics, it looks like most docs design the hairline to be a perfect oval which I guess is how a hairline unaffected by hair loss would look. However, I would think that it would make more sense to design the hairline so as not to be a perfect oval as this may tend to look "too perfect"; especially to those who have known you pre HT. Thoughts??

 

Thanks

[Cant decide]

This may be a potentially dumb question but here goes... When looking at patients post op pics, it looks like most docs design the hairline to be a perfect oval which I guess is how a hairline unaffected by hair loss would look. However, I would think that it would make more sense to design the hairline so as not to be a perfect oval as this may tend to look "too perfect"; especially to those who have known you pre HT. Thoughts??

 

Thanks

[Leeson]

That actually is a good question and has been discussed many times here on hairline irregularities, asymetry, jagged hairlines, "u" and "V" designs, etc. Use the find feature and you will find a wealth of info on this topic.

[used2beshaggy]

This is by no means an expert opinion, but what in nature is perfectly symmetrical? Whether it be arms, legs, or boobs, nothing is perfect, so I would imagine a hairline wouldn't be perfect. Acouple of small irregularities would add to the naturalness of it. I just got my hairline done, and it isn't perfect, but grown out I hope it will look natural!

[mmhce]

Can't decide,

 

This is a good topic.

 

Some of the answers to your question can be found in the responses to my questions here:

 

Hairline Reconstruction/Re-shaping

 

http://hair-restoration-info.c...1079204&f=3466060861

 

 

Suffice it to say, in nature, things APPROXIMATE to perfect symmetry.

 

Hairlines are re-constructed to be imperfect, by the surgeon, in order to mimic nature.

[GTDL]

That's actually interesting, as I have often wondered why so many doctors do a 'zig-zag' jagged hairline on patients. But it actually makes a lot of sense when you think about it. It does (as mmhce said) mimic nature.

[Dr. Scott Alexander MD]

This is a very important question. The hairline is the most important part of the hair transplant and something that you are going to have to live with for the rest of your life. A good one makes the transplant undetectable or a bad one will cause you to want to wear a hat for the rest of your life. It is really amazing to me to think that hair transplant doctors in the past and continuing today use the semi-circle arc for a hairline. Just remember nothing in nature is a straight line and hairlines are never symmetrical. If you want a good test to see why I use a jagged line take your hand and pull back the hair on someone's hairline and look at the pattern that it makes. It always goes in and out. I base my hairlines on where it looks like the patient's hairline would have been if he hadn't of receded or gone bald. The most important thing is to tie it into existing hair; making it look like he hadn't lost anything. There are usually enough hairs on the head, although sometimes very few, to be able to tell where that hairline should be. Most of the doctors out there were taught through many geometric designs and measurements where to put the hairline. These always end up looking mechanical and unnatural. Every time they draw a straight line on the head, they have a tendency to follow that line. In fact, in our current journal, "Hair Transplant Forum International" on page 55, there is a contraption someone is trying to sell that uses a laser light to give you a straight lined semi-circle. If anyone knows of a doctor using this, please run the other direction! I attached a picture of it to this post.

I cannot believe in this day and age that doctors are still wanting to draw lines like this.

[Cant decide]

Thanks Dr.Alexander and everyone else for your feedback.

 

Dr. Alexander: You stated that the proposed hairline should never be a semicircle. The pics of your patient "osidekid" who posted his results here show his proposed hairline (after surgery) as a semicircle. Can you explain why this is different from the semicircles you are writing about in your earlier post? By the way, his results look fantastic.

 

Thanks

[Acrobaz]

I thought about this a lot before my HT. I thought about designs and even brought along to the consultation photos on my laptop of what I used to look like. But, despite all this preparation, what I simply wanted to avoid - like everyone, I guess - was a hairline that did not look natural.

 

My surgeon told me that he did not need to see the old photos. He understood what I wanted was a more mature hairline that did not make me look 25 again (I am nearly 40 now). In the end, I smiled and said, "I trust you". He smiled back and said "Right answer".

 

And it was. He drew a hairline and then spent about 15 mins making what, to my eyes, looked like minute adjustments to it. All part of the artistry!

 

Incidentally, I've looked at osidekid's weblog. I have to say it looks more like an asymmetrical oval than a semi-circle to me! I think we also have to factor in the tendency of the brain to impose symmetry and regularity of shape where it actually may not exist ... I agree that it is an excellent job!

 

Regards.

[mmhce]

Thanks for the information Dr. Alexander.

[Dr. Timothy Carman]

Can't decide-

That is an EXCELLENT question.

It is my personal opinion that there is no greater decision made in the course of the hair restoration procedure than initial the surgical plan, which includes the design of the hairline (when there is need). IMHO it is a relatively easy task to make most men look good a year from their transplant. The challenge, to me, which speaks to the art of the procedure, is to create a surgical design that looks good ten or fifteen years from today. Therefore, I believe it is critical to design on the conservative side, to allow for a patient to "grow into" a "mature hairline". Doing so also further assists in helping me achieve a most important overriding concern I have for all my patients: maintaining the lifetime "supply-demand" balance in their favor- on the "supply" side, by judicious use of their finite donor supply. A more conservative hairline will utilize less grafts, not only from the design (contour) differences between that and the "semi-circle" you describe, but also due to the fact that, in nature, when recession does occur, those areas have a naturally decreased density relative to the density present in the midline. As for the symmetry issue- perfect symmetry in the organic shape is an anomaly of nature, so one should be more concerned with the appropriateness of the design in relation to the patients overall facial features, more than adhering to mathematical calculations and measurements.

Good question.

[Dr. Mohammad Humayun Mohma]

Hair line design as all have mentioned is a single most important factor second by the direction of hair growth and then distribution of the grafts.

 

In order to make a hair line the following factors are inportant.

 

1) Facial profile

Height of Calvarium

Forehead Inclination

Height of Forehead

Outer canthal (eye socket) width

Height of chin

Excisting ftontal forelock

Nasal Root depth

Facial shapes

2) DOnor area availability

3) Liking and disliking of the patient

 

It is all these things that will determine if the hair line should be oval, round or flat.

 

The five imporatnt factors to make it look natural are

 

1) Irregular hair line

2) Angle of exit

3) Density

4) Transition zone

5) Angle of curvature of hair shaft.

 

So afte all making a hair line that should suit an individual for rest of his life and deciding it at age of 28 or so is not so easy thing.

 

Its science with art.