Hairline Hair Transplant
Hairline Hair Transplants : Everything You Need To Know
One of the most common requests Dr Bloxham receives is to “fix” a receding hairline And why is this? First, the hairline is one of the earliest and most frequent areas where patients experience (and notice) hair loss. Second, it’s the most visible region of the scalp and one where the loss is most noticeable and creates the greatest feeling of self- consciousness. Third, erosion or recession of the hairline disrupts the normal “framing” or proportions of the face; this causes a very abrupt change to the way patients look and the way they are perceived.
A change in a patient’s hairline truly represents a change in their identity. Thus, restoring the hairline is crucial for many patients. Since frontal hair loss — particularly the hairline— is notoriously stubborn and typically non-responsive to medical treatments (IE: finasteride (Propecia), dutasteride (Avodart), and minoxidil (Rogaine), hairline hai transplants are the most effective intervention.
However, hairline hair transplants are highly visible and permanent, and must be performed properly by a hair restoration physician with experience and proven results.
The information below covers “everything you need to know” about hairline hair transplants. Read and absorb the information. It’s easy to rush or be “talked into” a hairline transplant — especially with the emotions and distress involved with new hairline loss.
However, hairline transplants are permanent and highly visible; they must be done right. And when they are performed well on the right patient, hairline transplants can truly transform and restore. Read on to discover what you need to know to become one of the hairline transplant success stories.
How To Create A Natural Hairline
When describing an ideal hairline during a consultation, the most common term patients use is “natural.” Patients may want a thick hairline or a low hairline or a hairline resembling their favorite celebrity, but, above all, they want a hairline that does not stand out as artificial.
A successful hairline transplant is one that truly goes unnoticed and just appears as a “nice hairline;” nothing more and nothing less. But how this does happen? How does a doctor create a transplanted hairline that does not look “pluggy,” “fake,” or “odd.”?
This is a detailed and fascinating discussion; Dr Bloxham has many YouTube videos reviewing hairline work which dive into the “nitty, gritty” details at length which are available for review; however, there are some basic tenets of hairline transplants which patients must be aware of in order to achieve a natural result.
The Right Shape and Height
One of the easiest ways to make a hairline natural is to simply pick the right shape! At first, this may sound odd; aren’t all hairlines the same shape? Actually, they are not Hairline shape is very unique and varies by factors like ethnicity, forehead shape, and gender.
For example, an African American male has a very different hairline shape compared to an Asian American or Caucasian.
If the lower, flatter — sometimes eve concave, and more symmetric pattern of a traditional African American hairline was placed on a Caucasian patient, for example, it would look out of place.
Similarly, if these three patients were all given the same “stock” hairline, chances are it would look unnatural on at least two out of three of the patients — if not all of them.
So, a good hair transplant doctor will be familiar with the intricacies of hairline shapes and chose a general outline that is appropriate.
Furthermore, a good doctor will make sure the hairline shape is specific and customized for the patient’s forehead and general upper face bone structure.
No two patients are the same; even in patient’s with similar ethnic backgrounds or those who even look the same, each hairline shape will be unique. This shape customization is important for creating a seamlessly natural hairline.
Hairline height must be carefully chosen as well. Not only must it match the patient’s background and general facial structure, but it also must age well overtime.
For example, a young patient who is likely to have advanced loss probably needs a hairline that starts a bit higher. It still must “reframe” the face and look appropriate, but it needs to stand the test of time.
Remember, transplants are permanent and the hairline a doctor rebuild is going to stay that way forever. A low hairline placed on a young patient with the potential for aggressive loss may look good now, but will likely look very unnatural in 20, 30, or 40 years once the patient things aggressively behind it — leaving a floating “band” of hair which must be dealt with.
However, a middle-aged patient with minimal loss and low probability of aggressive thinning may do well with a lower hairline
— as this is something that does look natural on patients who have a lot of existing native hair.
Hairline height and shape must be discussed thoroughly before surgery begins. If a patient isn’t shown examples of different hairline approaches or if a doctor seems dismissive of hairline customization or focused on a more “generic” hairline, patients should voice their concerns.
Hairline Hair Transplant Case Study
Dr. Blake Bloxham takes us through one of his patient’s surgeries, explaining his approach to restoring and reconstructing the hairline.
Hairline Hair Transplants: The Right Type of Grafts
A modern hair transplant involves the implantation of “follicular unit” grafts. Follicular units refer to the natural groupings in which follicles are found in the scalp. These groupings range anywhere from a single follicle to three follicles — in most cases.
Hairlines naturally contain mostly — if not exclusively — single-haired follicular units. Thus, recreating a natural transplanted hairline requires the use of only single-haired follicular units grafts. If grafts containing two or three follicles are used, the hairline will stand out as “pluggy” or bulky and look artificial. This is what some refer to as the “doll’ hair” appearance of old-style hair transplants (IE: “hair plugs”).
Patients must seek out a clinic capable of properly removing, identifying, storing, and implanting single-hair follicular units. Typically these clinics have experience with FUT surgery and an experienced technician staff, as this involves careful dissection of follicular units and the use of high powered microscopes to identify and separate grafts. A natural transplanted hairline must be built of fine, soft, single-hair follicular units.
Hairline Density
The density of the new hairline is also an important factor. While almost all patients say they want a “thick” hairline, sometimes this is more complicated that it seems. While we agree that density at the hairline with a significant number of natural single-hair graft packed closely together is a good thing, we want to avoid an abrupt “wall of hair” appearance to the hairline. Even dense hairlines with no natural hair loss still have a gradient or “build-up” in density; this means there will always be some less dense single-hair grafts in the very front which build to more dense singles-hair grafts as the hairline moves back.
This needs to be replicated with a transplanted hairline. If the single-hair grafts are placed so an immediate maximum density is achieved at the very anterior (frontal) edge, it may stand out as artificial At the same time, there cannot be too low of a density in the frontal area or too many low density singles in the front or the hairline may be too thin or stand out as artificial a well.
Hairline Hair Transplant Cost
Cost is important to patients; Dr Bloxham understands this and thinks it is fair to discuss this and be as transparent about it as possible. This is why we post our hair transplant costs directly on all of our practice websites (something virtually unheard of in the hair transplant field).
Cost of a hairline transplant is going to vary based upon how many grafts we need to use. Oftentimes a hairline transplant includes more than just the immediate hairline itself. A rebuild of strictly the hairline would be around 600 to 1,000 grafts; a hairline that would be part of a “frontal band” procedure would likely be somewhere around 2,000 – 2,500 grafts total; and a hairline involving lowering and temple work may be 2,500 grafts or more.
While cost varies, the above cost page (click link above) shows the price of a hairline transplant (and any associated areas) may vary from around $5,000 upwards of $14,000 — which is fairly average for the United States in general.
This may lead patients to wonder: Can a hairline transplant be done cheaper in places like India or Turkey?
The simple answer to this question is: Yes. The more pertinent question and the more complex answer, however, is: What will this cost you in the end? While cheap transplants in places like Turkey and India may advertise large sessions and lots of coverage at cheap prices, they do not purport their ability to produce natural, refine hairlines. This is because the tech-run model utilized overseas is built upon cheap labor producing mass quantities of surgery quickly.
This model of hair transplant surgery simply does not lend itself to the focused, careful, refined work needed to create
natural hairline. If a transplant overseas results in a hairline which looks unnatural and requires repair or refinement, a patient may end up spending more than they would have simply going to a hairline-focused clinic to begin with — even at a higher initial cost.
Roughly 20-30% of the work we perform at our group is repair or refinement; so take cost into consideration and work with a realistic budget, but do not let cost be the sole deciding factor or lead you to a hairline transplant repair.
Hair Transplant for Receding Hairline Only?
While restoring a receding hairline is the most common reason for a hairline hair transplant, it’s not the only reason. Some patients with no actual hair loss may still seek a hairline hair transplant. In some instances, a patient with a naturally high or very asymmetric hairline may seek a procedure to rebuild a lower or more symmetric hairline.
Other patients with hair loss due to trauma or prior surgery (particularly surgeries involving the upper face like “face lift” procedures) may seek hairline hair transplants as well. Patients with no natural loss must proceed carefully when considering a hairline transplant. Prior trauma may create a less hospitable environment for graft growth, and realistic expectations must be set before undergoing surgery.
Those with no loss and a naturally higher or asymmetric hairline require a very dense approach to match the thick surrounding native hair as well. Sometimes both these scenarios may require more than one “pass” to achieve the desired density. This is something that should be thoroughly discussed beforehand as well.
How Long Do Hairline Transplants Last?
Hairline transplants are designed to be permanent. This is one of the reasons why it is so crucial to “get it right” when it comes to hairline height, shape, density, et cetera.
The transplanted hair follicles are taken from the safe donor area or “SDA” on the sides and back of the scalp. This area is called the SDA because the follicles within it are immune to dihyrotestosterone or DHT — the hormone responsible for genetic male hair loss (and often genetic female hair loss).
Since these follicles are “immune” to genetic loss (they lack receptors for the DHT hormone to bind to), once transplanted, these follicles will continue to grow hair for a lifetime. While the native (non-transplanted) hair around the hairline may continue to thin overtime (and this should be taken into account), the transplanted hairline itself should be permanent and unchanging.
Hairline Transplant Side Effects
Hair transplants, in general, boast a very good safety profile. A hair transplant is minimally invasive procedure which involves no general anesthesia and is performed in an out-patient setting. Hair transplant surgery has been performed regularly in the United States since the late 1950’s with minimal complications. This includes hairline hair transplants.
However, any medical procedure involves risk. And risks involved with a hairline transplant are similar to any skin surgery. Any time the skin is cut, there is a risk of infection, prolonged bleeding, damage to blood vessels and nerves, and tissue damage (IE: necrosis). Thankfully, our group has never experienced any of these issues — as they are typically avoidable. However, they are still theoretical risks patients must be aware of before a hairline transplant.
Another potential side effect specific to scalp surgery is hair loss. This is typically referred to as “shock loss” and is caused by trauma to the underlying blood structure or to the hair follicles themselves. Shock loss can be temporary or permanent. Most temporary cases occur in healthy follicles which are simply pushed into a standard resting phase. This typically begins resolving after 3 months but can take upwards of 9 months to see a cosmetic improvement.
However, temporary shock loss typically completely resolves. Permanent shock loss occurs when unhealthy follicles (usually those already affected by the hair loss process) are traumatized by surgery. These follicles are pushed into a resting phase as well, but it unfortunately often serves as the “final nail in the coffin” and they simply aren’t strong enough to wake back up continue cycling normally. In this case, the loss is permanent.
Other “unwanted” but possibly not unexpected side effects include things like swelling (which is typically restricted to the forehead region but can be more widespread), redness, itching, temporary pain/discomfort, and sometimes some slight stomach upset from post-operative medications for pain and infection prevention. Most side effects are temporary and manageable with proper care and guidance from your surgeon.
Can You Get Just Hairline Transplant?
Yes, patients can undergo a procedure focused solely on the hairline without addressing any other regions of the scalp. However, this is an option only for patients with very minimal loss restricted solely to the hairline region. This is also a less frequent procedure compared to a larger “frontal band” surgery where a patient has frontal loss involving the hairline area and recession in the “corners” on each side of the frontal hairline.
In this instance, the hairline is rebuilt at an appropriate level but the “band” behind it is densely filled in as well. Loss in the hairline is typically accompanied by more general loss throughout the frontal band region, thus this is probably the most popular approach for patients with “hairline thinning.”
It is important to remember that native hair may continue to thin and recession may continue overtime. Therefore, any patient undergoing just a hairline procedure or a procedure focused mostly in the hairline region (like a frontal band) MAY continue to thin
and want more surgery to fill these areas at a later date
Create Hairline Lower than it Ever was?
Another strict hairline transplant request we receive is from a patient with no loss who simply wants to put the hairline lower than it ever existed. In other words, the patient wants a new hairline lower than their genetic hairline. As discussed previously in the article, this is possible. However, it must be approached cautiously. A good doctor will make sure that the patient is fully aware of what the request entails, that the proposed hairline is not so low where it will never appear natural, the patient has donor to complete the request, and there truly is no chance of genetic loss.
What Is the Best Age for a Hairline Transplant?
While there is no fixed age or age requirement for a hair transplant, there are som issues to take into consideration. First, performing a hairline transplant on a young patient (someone below the age of 25) must be done with consideration.
Young patients are often emotional and vulnerable, and it is imperative to make sure they fully understand the permanency of hair transplants and the possible progression of hair loss throughout the rest of the scalp.
Young patients often seek a low, aggressive hairline or want a “one and done” approach; they also often say they just want it to look good for a few years and “won’t care” in their 30’s or 40’s — which is very much untrue. Young patients need to understand that a hairline transplant should be started at a somewhat conservative level because it needs to age appropriately; patients will still care about their appearance in their “later years” and they want a hairline which looks natural. The proposed hairline needs to properly reframe the face and make the patient look normal for a “guy in his 20’s,” but also needs to be something that won’t look odd on a “guy in his 60’s.”
Young patients must also understand that transplants do not treat hair loss; the hair may continue to thin out behind the newly transplanted hairline and more surgeries might be necessary. This is another reason to start the hairline at a somewhat conservative level: if started too low, a patient may run out of grafts as they continue to thin and require very large amounts to cover from the new hairline to the mid-scalp or crown areas.
Finally, young patients must maximize their lifetime graft numbers by utilizing the donor are in the most efficient manner possible. This typically means starting with FUT (“strip”) procedures and then moving to FUE procedures at a later date.
A hair transplant above the age of 25 is more straightforward. It still must be done in an ethical manner and taking the “long-term” projection of the loss into account, but patients who undergo hairline transplants in their 30’s, 40’s, 50’s, and beyond have a somewhat better understanding of where the loss could be headed and how they may want things to age.
However, there is truly no “best” age for a transplant as long as the patient is fully informed and the doctor helps craft a hairline transplant with the long-term in mind.
How Many Grafts for a Hairline Transplant?
The number of grafts needed depends on the extent of hairline recession and the desired outcome. On average:
• A minor adjustment may require 600–1,000 grafts.
• More extensive restoration (involving more of a “frontal band”) could need 1,500–
2,500 grafts.
An experienced surgeon will assess your hairline and scalp to determine the precise number of grafts required.
Why Choose Feller And Bloxham For Your Hairline transplant?
Dr. Bloxham is known as a “hairline doctor;” not only are hairline transplants his passion, but he has hundreds of detailed results to prove this passion translates to reality. But don’t take this written word as a guarantee; visit our YouTube channel to see hundreds of examples of “wet comb-through” hairline videos where Dr. Bloxham thoroughly explains his process and then shows the most detailed presentations of hairline cases possible. This includes HD video of the hairline transplant being sprayed with water and combed through. If a hairline transplant looks good in this scenario, then it will likely look good in everyday life and likely look good on you.
But it doesn’t stop there. A quality hairline transplant result takes more than just a dedicated doctor who is good with his hands. It also requires very skilled technicians to perfectly prepare very refined grafts and carefully place these grafts into the very small and very tightly packed recipient incisions. At Feller & Bloxham Medical we use the smallest tools possible to make our hairline incisions and place these “slits” as close as the skin will allow. Only the most skilled technicians can locate and delicately place agraft into each and every incision. And these are the type of technicians we have on our team.
All of our technicians are trained by Drs. Feller & Bloxham, only work for our practice, and have years to decades of experience performing transplants exclusively. It takes a combination of a passionate and skilled surgeon and a highly trained and dedicated team to “pull off” a successful hairline transplant. We have this at Feller & Bloxham Medical and also have the results to prove it. If you are considering a hair transplant with our group, please ask us to prove this; I do not think you will be disappointed.
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