Hairline Reconstruction/Re-shaping

[mmhce]

How is the reconstruction/shape of a hairline determined by a surgeon?

 

There a rule of thirds that exists in artistry where the face can be divided into thirds;

the distance of the chin to the tip nose being one third, the distance of the tip of the nose to the brow being second third, and the distance from the brow to the edge of the hairline being the final third.

 

Is this rule used as a basis for the reconstruction/re-shaping of the hairline?

 

And how is the reconstructed/re-shaped hairline done in relation to the shape of the face of the patient?

 

I.e. a patient with a round face, or one with a long face etc.?

 

Isn't it true that the natural hairline is imperfect/slightly asymetrical and re-construction must mimic this imperfection?

 

I.e. reconstructing a too perfect hairline seems un-natural?

 

Thanks

[Dr. Timothy Carman]

mmhce-

In my opinion and experience, as I think would be the case for most hair restoration surgeons, recreating the human hairline, ultimately, is an artistic process. Certainly, the rule of thirds, which was derived from the work of Leonardo Da Vinci, would enter into the mix, as this set of observations was derived from observations of normal human anatomy. In addition, there are a number of "triangulation" formulas present in the industry to aid in hairline recreation. after all is said and done however, the execution of the process of creating a natural appearing hairline is an artistic one. All those features you address are relevant; the shape of a person's face, their age, colour and consistency of their native hair- and- this one to me is the most relevant (and the most elusive to describe)- the "character" of their face. In observing these features, one certainly also has to observe the factors that make for a natural result. One concept you touch on, the imperfect/assymetrical concept I feel is very relevant, as per this discussion:

http://www.hairrestorationnetwork.com/eve/showthread.php?t=144257

And yes: too perfect is an immediate "tipoff" that something unnatural is present.

Good questions.

Sincerely,

[Eman]

mmhce- what Dr. Carman said is spot on. The hairline is artistry!!

[Smoothy]

Very well explained Dr Carmen-- Great

 

SMOOTHY

Dr. Shapiro

Propecia/Rogaine xtra

MSM/Zinc/B6/Saw Palmetto

3 oz Zrii daily

[Dr. Michael Beehner]

Just a couple of comments relative to your question about the hairline:

First of all, DaVinci's "rule of thirds" for most males places the hairline too low. It is fine for females, although many female hairlines would actually start a bit lower than the DaVinci upper mark.

There are a few key things that factor in to where to place the hairline. The most important are:

a) What does the patient want? (assuming it's reasonable)

b) Where is the temple hair? If it is far back near the ears, then the hairline should be a little higher, unless the patient has unlimited donor hair and wants a major temple area restoration along with the work on top. If the temples are far forward, then a lower hairline will be "held up" nicely by this temple hair and is more acceptable.

c) How old is the patient and what is the potential for a "worst case scenario" later on? For a man in his early 20's, I would be a little conservative in the hairline height, and, even more importantly, on where the lateral arms of the front hairline intersect the side fringes.

Some doctors want an easy, fool-proof method for determining every patient's hairline height. In the early days of hair transplantation, some used "two fingers above the top forehead crease" or "four fingers above the eyebrow." If I was forced to recommend some simplistic method, it would be this: imagine a horizontal line going across the top of the head and projecting out and also imagine a vertical line coming upward along the front surface of the face. This would form a right angle. Intersect that right angle with a line directed 45 degrees downward onto the upper forehead and this would be the point. It would be the perfect median between horizontal and vertical for that particular patient. As I mentioned above, I think the decision should be more nuanced and individualized than that.

I agree with the above comments that the hair surgeon's artistry and use of micro and macro contouring is key to a natural look. A smooth-edged, dense hairline should never be created.

Mike Beehner, M.D.