Causes of Unnatural Hairline

I. Wrong Directions
II. Wrong Angles
III. Low Density
IV. Wrong Placement
V. Asymmetric Hairline

Creating a hairline is crucial for achieving successful results in hair transplantation. A significant number of patients complain about hairline issues following surgery. The position of the hairline is essential for determining facial perception.

Setting Up the Hairline

The proportions of the face are important when setting up the hairline. It should not be too low or too high. Following the 1/3 proportion rule is advisable. The distance between the Trichon to Nasion (Glabella) and Nasion to Gnathion needs to be measured equally. Avoid drawing the hairline closer than 7 cm from the glabella (the midpoint between the eyebrows).

It is also essential to consider the patient’s age. For younger patients, a conservative approach is recommended due to the high risk of losing existing hair over time. Remember that a high-density upper hairline looks more natural than a low-density lower hairline. A natural hairline should have small asymmetries, a transition zone, and be composed entirely of single hair follicles.

When creating the hairline, measure the distance between the lateral epicantus and frontotemporal angle. This distance should be equal on both sides. Small asymmetries related to the transition zone and zigzags are acceptable, but noticeable asymmetry will not look natural.

Directions and Angles

Proper direction and angles are crucial for a successful hair transplant. The angles and directions of hair follicles should match the natural pattern to achieve a natural result. New incisions should be created according to the patient’s existing hair. If there is no existing hair to guide the procedure, directions can be created as mentioned below.

Solutions for Hairline Problems

Hairline problems can be addressed with the following options, depending on the specific issue and the proportions of the patient’s forehead:

1. Creating a New Hairline:
   If the current hairline is not placed too low and the proportions are acceptable, a new hairline can be created by lowering it by 2-3 cm. This is often the easiest option. If the forehead proportions are not suitable and the hairline was placed too low, extracting the asymmetric side and placing only single grafts in front of the existing line is another solution.
2. Laser Hair Removal:
   Laser hair removal can be used to remove the lower portion of the hairline over 4-6 sessions, with monthly treatments. After the hairline is moved to a higher position with surgery, a new hairline can be created.