Part 3: Hair transplants: Hairlines, angulation, techniques, Uni-Strand

Having worked as a Hair Transplant Consultant for 4 years, I field questions, myths, realities and wake up calls on a daily basis. I do so because I myself once looked in the mirror, saw hair loss and decided to get a hair transplant and received a horrible one at that. It took me years to find a fantastic clinic to restore not only my hairline but my confidence and happiness.

In this series of articles I am going into my favourite subject. Hair Transplant Hairlines!

In Part 2 of this series of articles, I began discussing the finer points of hairlines. I had started on Follicular Units (please see article 2) and in this article we get into the nitty gritty. You’ll either love this column or hate it. Hair Junkies enjoy.

Far too often in consults, I see those who simply care about price, nothing more, and I truly fear for them going to a bad clinic and getting a bad result like I had originally. In order to get a great transplant, you need to have a great staff (our average planter has transplanted 1-2 million hairs) and in order to keep them you have to pay them! I can tell you flat out: you will not get a good transplant for under the 7000-12000 dollar range if you are doing an area larger than your palm due to the cost of staffing and overhead. It’s just not possible. If you can tell, I’m very passionate about transplants and hairlines due to what happened to me. Hairlines are everything. They are the first thing someone sees when they look at you. They frame your face, define and work with your features or work against you.

Firstly, lets talk about hairline design. In a previous article I had touched on those wanting a perfect hairline and how a perfect hairline reads obvious transplant. Mother Nature always creates slightly imperfect features on us all and hairlines are no different. Thus, if you look at a good transplant, it is somewhat uneven and never perfectly linear.

Hairlines: I remember after I had been butchered, I went to every major clinic in Canada. In every consult, not one of the clinics or doctors ever discussed what I perceived to be a major concern: future hair loss and an age appropriate hairline. These two factors are a constant give and take.

Several Scenarios:

1) A 26 year old patient comes in and wants a very low hairline similar to when he was 18

2) A 36 year old comes in wanting a slightly recessed hairline with higher temple points

3) A 58 year old comes in and just wants to see a hairline.

These examples are very generic and sometimes a 58 year old does want a hairline like when he was 18, but generally speaking these stereotypes are quite typical.

WHY? Why is this?

The main reason is that without knowing it, these men are looking at their friends, relatives or actors on TV about their age and are seeing the natural hair line pattern for those WITHOUT hair loss which correspond to their age. I hope that made sense!

To elaborate: When a 26 year old looks at his friends without hair loss, many of them will still have a low hairline. When a 36 year old looks at his friends without hair loss, he probably wont realize it, but the majority of his friends with NO Hairloss naturally will have receded slightly in the temples when compared to their hairline at 26. When a 58 year old looks at his friends, he may not realize it, but those without hair loss will have receeded slightly more in the temples and hairline further when compared to their hairlines at 26, 36, 46 or 58. YES, THIS IS NOT HAIR LOSS! With age, we begin to grow hair in our ears, on our backs, our hair greys and for most of those lucky men without hairloss, part of aging along with wrinkles comes a more mature – or recessed (I hate using that term because most of us think hair loss which it is not) – hairline.

So the question is – when the 26 year old wants a 26 year old hairline, how do I make him happy knowing that if I give him a low hairline, he’ll be unhappy with that low hairline when he is 36 (remember, a hair transplant is permanent, whatever hairline you get, remains until the day you die) and especially at 58. Therein lies the problem and some middle ground of compromise must be made. Moreover, the hairline has to be appropriate to each individual’s face. If you have a more squared jaw line, a more squared hairline will likely suit you (i.e. Brad Pitt, Tom Cruise). If you have a thinner and longer face, a slightly recessed hairline (Ryan Reynolds) will suit you.

I realize Brad Pitt and Tom Cruise are in their 40′s and have perfect hairlines, but let’s ignore that for a while. Most of us naturally receed and there’s a lot of discussion about these men’s “natural” hairlines anyway.

There is also the issue of further hair loss and making sure you have enough donor hair for future loss (I’ll cover this subject in coverage).

So how do we make the 26 year old you happy while ensuring the 36 year old, 58 year old and 88 year old you doesn’t look stupid with a low hairline? COMPROMISE.

I usually ask a patient: What is the most recessed hairline you would be happy with? This is the question I would tell you to ask yourself when you look in the mirror. Often, patients don’t realize how happy they will be with even a recessed hairline due to the huge cosmetic difference the hairline makes.

I’ll use myself as an example. At 25 years old after my bad hair transplant. I went with a somewhat recessed hair transplant (I want to give you a photo, but I have no idea how to upload one on wordpress, I’ll get one for you eventually) hairline. I was worried after my bad hair transplant in which I lost 1500 grafts that if I blew 3000+ grafts I would not have enough hair if I went completely bald. When I hit my 30′s, I had no further hair loss, so I decided to slightly lower my hairline with about 800 grafts. I would now be considered a Class 1. It suits my age well at 30, although slightly higher than some of my friends, but as I age, my hairline will always be appropriate in my 40′s, 50′s, 60′s and hopefully into my 100′s.

That was a long article, but an important one. In Part 4 and later articles, I’ll talk about angulation, hair transplant techniques, and the one question everyone has: how many grafts are needed to give a full looking head of hair?

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