Hairline - the first impression of a hair transplantation

For a natural hairline it's important that only 1 and 2 hair grafts are used in the hairline. The grafts should be placed in a rather acute angle to the skin.

In many cases the grafts should point laterally in the lateral aspects (temples) of the hairline while they should point more anteriorly/forward in the middle part of the central forelock. However, each person is different and the design should be adjusted accordingly.

Unfortunately we have seen too many patients with a completely unnatural hairline with no proper direction of the grafts. In some cases the patient has to spend a considerable amount of time each day combing his hair to try to hide these serious shortcomings.

Other areas

It's important to ensure that the angle of the incisions are made correctly. Although the 3D direction may not be as visible as the hairline it does count when the patient wants to style and comb the hair. A too careless approach may force the patient to waste time combing the hair in order to hide the transplantation.

Density & coverage

Natural density varies in the range of 70-120 follicles/cm2. Density is usually higher in Caucasians and lower in Blacks and Asians. The cosmetic perception of fullness, volume or density is greatly influenced by the diameter of the individual hair shaft which varies between 0.06-0.15 mm.

Hair thickness & hair loss

Asians and Blacks tend to have thicker hair (greater diameter) while Caucasians have thinner and finer hair. In the initial stages of hair loss the patient or surroundings don’t see any cosmetic difference. When the hair loss reaches around 50% the thinning becomes noticeable.

Recommended density for transplanted hair

In many cases Dr. Hussain would recommend 20-40 grafts/cm2 for the first operation. The specific recommendation depends on age, stage and maturity of hair loss, patient’s expectations and other factors. If required more density can be added later. Again age is an important consideration: A 25 year old male with high temples and initial thinning in the crown may be recommended to wait for 5-8 years. On the other hand we may suggest 3500 graft to a 45 year old male with the very same pattern of hair loss.

We would advice against density-shopping commonly seen among young patients trying to restore their teenage-hair. A restoration of very high density in the hairline may look just fantastic at age 22 year, but the patient may run out of donor-hair few years later after another 1-2 operations. A dense front and a thinning or bald vertex may be less fantastic aged 28.

High density hair transplantation (in one or more sessions) is a luxury that not all patients can or should avail as it’s highly expensive and graft-consuming. And the patient may run out of both.

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If you have any questions about the Shanghai Center for Hair Transplant, or about hair trans-plants, follicular unit grafts, or anything else, please don't hesitate to contact us.

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