Dispelling the Myth of the Required High Hairline in Follicular Unit Hair Transplantation

Abstract

When using follicular transplantation, it may be appropriate at times to divide the face into thirds at the time of hairline development.

A Method for Evaluating and Treating the Temporal Peak Region in Patients with Male Pattern Baldness

“…The first approach is to never graft the temporal peaks and routinely keep the hairline extremely high. Conversely, if the surgeon is reconstructing the hairline so that the distance from the hairline to the eyebrows is approximately one third of the face, 5 the temporal peak areas should be evaluated and most likely treated with one‐haired follicular units. The further the hairline is moved anteriorly, the further the temporal peak should be moved anteriorly and vice‐versa.…”

“…Conversely, if the hairline is placed from approximately 6 cm to 8 cm anterior to a line drawn in a coronal plane, between the external auditory meatus, the temporal peaks should be fully reconstructed (Figure 13). The frontal edge of the hairline should never exceed a point where the face is divided into thirds 5 …”

“…The frontal edge of the hairline should never exceed a point where the face is divided into thirds. 5 When performing these reconstructions, the author averages 20 incisions per square centimeter and has found the density to be satisfactory in most patients due to the shingling effect of the overlapping hair shafts. If additional sessions are performed on top of the head, this address can be further enhanced if further density is required.…”

Basic hair transplantation: 2007

“…Harvesting follicular unit grafts by removing them directly from the donor area gained popularity in the United States with Rassman and Bernstein's 2002 publication follicular unit extraction (FUE) and gained further momentum with Harris’ paper in 2005. Although this procedure has a number of limitations, it has proved itself to be useful when strip harvesting is not indicated (9).…”

“…Buffering the pH of local anesthetic solution with antacid, although successful in reducing pain, can decrease the effectiveness of the anesthetic solution, and permits analgesia to wear off prematurely. Buffering may also produce troublesome rebound bleeding in postoperative phases and is not recommended (9). A gentle leisurely approach is suggested to ensure maximum patient reassurance and comfort.…”