Designing the Hairline by Dow Stough, MD - Arkansas

The hairline should restore symmetry, harmony, and proportion to the face without being perceived as artificial or unnatural. The trick is to establish a static hairline that by its shape and location will appear natural over the course of decades.

This means you shouldn't always have a low, youthful hairline. Patients must be reminded that the hairline must look natural in old age as well as in youth. Low hairlines look good in the teens and 20's, but awful in the 50's, 60's, 70's. A high hairline with temporal recessions generally achieves an excellent life-long result.

There are many advantages to this mature, conservative pattern. The higher the hairline and the greater the recessions, the less the amount of hair required to cover a given area. This pattern may give greater density and a more natural appearance than a low, round hairline. This hairline pattern is especially critical for patients with minimal donor hair.

In creating the hairline, a surgeon must focus on the future, not on the past, and should not consider the patient's previous hairline. The patient may desire the hairline of his youth, but what he really should have is a hairline that will age well and meet the constraints of donor hair volume and quality. Most patients want low, youthful hairlines - all patients need high, mature hairlines. Get what you need. You can't always get what you want.

JUST SAY NO

Patients, especially the younger ones, will want the hairline placed low and round. We do not give in to these desires. The initial transplanted hairline can be modified downward at a later date should the need arise, or should the patient have sufficient donor hair after the remainder of the transplant has been completed. On the other hand, surgically raising a low transplanted hairline is time-consuming, expensive, and fraught with difficulty.

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