Hair Restoration or Hair transplantation surgery is performed at our Joint Commission certified facilities. The number of grafts transplanted are based on the density of grafts in the back of the scalp referred to as the “donor area”. This rule of thumb applies to both “FUT” (also called “strip method” or “FUE”). The area to be transplanted is measured and the patient reviews the markings with the doctor and the technicians. The patient may be completely awake during the procedure with just a local anesthetic drug applied to numb the areas of the scalp. The patient may also have intravenous or IV sedation sometimes referred to as “twilight” anesthesia.
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Hairline Lowering, Filling, and Rounding Out Options?
Good day doctors. I am 22 y.o. female and was born with a high hairline and an odd cowlick which exacerbates said condition. The highest dimension from the top of my eyebrow to the highest point in my forehead is exactly 3inches. I would like at the very least, an entire inch of hairline advancement. I am not sure of undergoing surgery for this (reverse forehead lift whereby the hairline is lowered through tissue expander placement) or what is currently more appealing to me: hair grafting.
Thank you for your question!
At the age of 22, you have done a very good thorough job research about your options regarding a naturally high hairline and your options. You’re asking about included a tissue expander, reverse forehead lift versus hair grafting as well as you expressed a concern about the cowlick and the direction of the hair.
So I am in a unique position because I am certified in facial cosmetic surgery so I do perform forehead lifts, face lifts and etc. And I’m a specialist in hair restoration, so I basically have all the options in front of me when I see patients like yourself. Here’s how I make some of these decisions. I look at skin elasticity and I look at the risk of relative scaring that can occur from a procedure like a reverse forehead lift. Now in your situation, I think that you have to take into account that any procedure you consider still has a large league when you talk about a more surgical type of procedure like a reverse forehead lift versus a hair transplantation procedure. So I would say that practically speaking, financially speaking, it might be more practical to consider hair grafting. And so, let’s discuss hair grafting which is probably what I would recommend if you were to be sitting in our office for consultation.
What your goal is, is to create a lower hairline but in creating a lower hairline, you have to be mindful of how close the hairs are placed in order to look natural. Many people come to our practice and the first thing they will say is: listen is my hairline up here, and this applies to both men and women. Well you could start doing a lower hairline at that level but you won’t get the same level of density that would look natural. And so, you may have a lower hairline and the hairs will be too far apart and you will need several procedures to get to your desired goal.
So one strategy to consider is to slowly lower the hairline from the point where it is most dense and transition from there downward. Now that would be based on the number of graphs that are available as well as the thickness and quality of the hair so that’s one thing to consider. The other thing to be aware of is in terms of the cowlick. A procedure that might be helpful is to actually take hairs from the cowlick and transplant them in away so that the direction is of the hair is more advantageous to get better coverage. So this is a complex concept but that I think it would be helpful when you’re ready to go ahead and do the transplantation procedure.
Something to also be made aware of is that you’re not going to come across unless you do your research really aggressively is something we’ve been doing in our practice and that I have been able to advance over the past 2-3 years. And that is the use of something called extra cellular matrix. In traditional hair transplantation, a certain percentage of hair are lost regardless of how well the transplant is done.
The factors such as the hairs being outside the body for a particular amount of time, the surgical technique employed, the amount of bleeding that occurs. All of those being equal there is always a certain percentage of hairs that don’t make it. Well, what we are being able to successfully do is use this material in a specific way that allows our hair transplantation to do a little bit better than patients who we’ve had in our practice who didn’t receive this type of care prior to this new technique. Essentially, extra cellular matrix heals by duplication of tissues that is caught injured and so this results activation of adult stem cells which we have observed. Hair counts actually seem to heal more hairs than our actual transplant and this we are able to document. In addition, if someone has any hair thinning then that thinning hair, based on genetic patterns such as male or female pattern hair loss, reverses and the hair is thicken. This is based on the concept that the progenitor cell which become less capable or becomedefective, if you will at a certain point, causes hair to thin actually become restored and protect. So thinkof progenitor and protect, protect the hair follicles so that they are able to thrive.
So again to summarize my recommendation, I would recommend transplant over surgical forehead surgery as well as the redirecting of hair folicles from the cowlick basically extracting follicular units and then changing the direction and considering the use of extra cellular matrix technology that we have been in the forefront over the past few years with hair transplants surgery. So there’s a lot for you to also consider and I hope this is educational for you. Thank you for your question
There is much discussion about FUE vs FUT or strip method. Proper examination and discussion about the options are necessary. You will meet with Dr. Prasad who will go over the details of your options.
Dr. Prasad’s development of Hair Regeneration technology has made a significant difference in hair transplant results. Higher yield in graft survival and thickening of thinning hair has been greatly appreciated by people familiar with hair transplantation surgery.