Hairline design in hair replacement surgery.

This article attempts to guide the reader through all of the considerations that must be made before settling on the best hairline for a given individual patient. Five essential components to the hairline's design and construction are considered in detail: the height of the hairline, the general contour of the hairline, the intersection of the hairline's lateral arms with the side fringe, creating macrocontouring and microcontouring, and, finally, the direction and angulation of the hairs along the hairline. The pros and cons for using either the hemioval or the flared hairline contours are outlined. The author's strong preference in most patients is the flared design. A step-by-step method for drawing the hairline is given along with several "checks" to be done after the final drawing to confirm its proper orientation to the other landmarks of the head and scalp. The various choices for direction of hairs in the hairline are presented and discussed, with the author's preference stated for curving the hairline direction through the front-central aspect of the hairline. Six pitfalls are mentioned that should be avoided in hairline design. The option of adding anterior temple transplantation along with that of the hairline is explored. This area's contribution to framing the face and supporting the frontal hair is emphasized. A few comments on creating a female hairline are then made, particularly concerning the need to create a shallower and gently curved recession on each side.