Handling Tissues Gently in Hair Restoration

My mentor always taught me, “Sam, no amount of ice can replace the gentle hand of a surgeon.”  Those words have remained fixed in my mind every time I approach a patient and his/her tissues.  Training for many years as a surgeon, I saw the full gamut of surgeons at work:  some with delicate hand movements and those that seemed to be Neanderthals struggling with bricks in their hands.  I have always tried to emulate the former.  It is so important that a surgeon no matter how technical and artistic he or she is that the surgeon remain extremely feather touch with one’s hands.  Brutal application of fingers can lead to inordinate swelling, discomfort and recovery time that would otherwise be avoided with gentle handling.  As my mentor said to me, there is no amount of postoperative ice that will cover the tracks of an aggressive, unrefined surgeon.

Gentle Graft Placement Illustrated

The consequence of being gentle in the world of hair restoration also involves the care of the graft-preparation team.  If the grafts are mangled during dissection and placement, the grafts either grow poorly or grow unnaturally.  The act of squeezing the hair shaft during insertion into the scalp will lead to a kinky, pubic-hair appearance.  All my team members are trained only to hold the graft along the cuff of fat and never by the hair shaft itself that leads to the aforementioned damage.  Being gentle in all things is a prerequisite to being an excellent surgeon and in the world of hair restoration is mandatory also for the accompanying surgical team.

Samuel M. Lam, MD, FACS is a board certified hair restoration surgeon in Dallas, Texas. To learn more about Dr Lam’s hair transplant procedures please visit our website www.HairTX.com or call 1-888-866-3388 to schedule a consultation.

The Female Hairline In Depth

One of my passions is female hairline reconstruction.  A large reason why is that it is one of the technically most challenging and artistically demanding parts of the head to do and to do right.  Unlike a male hairline in which all the hairs angle perfectly straight forward, the female hairline if done correctly goes in all different directions to make it appear as feminine and natural as possible.  In this article, we will discuss the two elements of a female hairline:  the macro hairline (overall shape) and the micro hairline (the details of how each of the angles are created when making recipient sites into which the hair grafts are placed).

The macro hairline, or overall hairline shape, in many respects is the exact opposite of a male hairline.  Men tend to have a more pronounced fronto-temporal recession with the curvature of the hairline aiming backward into these points of recessions.  A beautiful female hairline curves in the opposite direction with a rounded and closed fronto-temporal angle.  In addition, whereas it is important to create a conservative male hairline, a female hairline should potentially arc downward aggressively and be situated right at the forehead and scalp transition.  The goal is to create a rounded hairline to accentuate the beauty of a feminine face.

Female Hairline Restoration

Continuing on with the macro hairline, the hairline also consists of small protuberances that refine and break the linearity of the hairline itself.  In the midline a small widow’s peak will complement the female cowlick.  The design of the female cowlick will be reserved for the discussion of the micro hairline.  There can also be small protuberances approximately halfway between the cowlick and the end of the temporal hairline.  These are known as lateral mounds, a distinct entity found in many female hairlines.  These protuberances like the widow’s peak are only very slight:  take a look at women without high hairlines or without hair loss to observe what I am talking about.

The micro female hairline like the macro female hairline can be viewed almost as the opposite of the male hairline in many respects.  Whereas the male hairline typically is uni-directional, the female hairline is multi-directional.  Whereas the male hairline aims forward entirely, the female hairline principally sweeps to the side and back.  When designing a female hairline, the surgeon should look at ghost hairs (residual hairs that remain) as a guide or for female hairline lowering.  When there are no ghost hairs, the direction of the hairs behind the to-be-reconstructed hairline can be used as a guide for the design work.  In general, female hairlines sweep from the left to the right (in 70% of women) with the sweeping going in a whorl in the center of the scalp known as the cowlick.  The cowlick circles with the hair pointing backward toward the center of the scalp, which then must aim back forward as the hairs start to go back farther to the central-forelock region.  The hairs on either side of the central cowlick principally go to the side so for a left to right part the hairs from the left go across the hairline all the way from left to right and vice versa for the opposite design.  There are also less pronounced micro undulations in the female hairline as compared with the male hairline (what I termed the coastline effect in other blog articles.)  All of these nuances are important to remember as one designs a female hairline.  Matching experience with artistry is the key to creating both natural and feminine-appearing results.

Samuel M. Lam, MD, FACS is a board certified hair restoration surgeon specializing in female hair transplant procedures. To learn more about Dr Lam’s procedures please visit our website www.HairTX.com or call 1-888-866-3388 to schedule a consultation.

This video was taken 8 months after hair transplant for female pattern baldness and shows the before and after results of female hair restoration.  There is a companion video of the patient giving a testimonial after her hair transplant procedure but this one focuses entirely on the close up inspection of the transplanted result.

A close-up video of a hairline after a hair transplant is about the closest thing that is possible for a prospective patient to evaluate the naturalness of a result shy of being able to see the person live.  Notice in this video the fine hair grafts that are allocated to the front of the hairline for the most natural results and also the stronger 2 to 3 hair grafts placed behind it in the cosmetically sensitive area of the central forelock to provide visual hair density.  The sweep and shape of the female cowlick and the closed rounded shape of the hairline are all attributes to the female hairline that have been carefully and passionately recreated for an optimal aesthetic result.

Mary underwent hair transplant for female pattern baldness and tells about her experience and her results in this video testimonial.*  Please also see the accompanying post on her hairline as videoed close up to see the result more in detail.  We oftentimes think that hair loss really principally occurs in men but it is very common in women with a quoted percentage of 30% after the age of 30 years of age.  What may seem like a trivial degree of hair loss to others has had a profound effect on Mary’s life, as witnessed in this video testimonial.  A principal reason to shoot a video testimonial is to have a prospective patient feel comforted by another patient who underwent the procedure and to see what life-changing difference a simple hair transplant procedure can make for an individual.

Hair loss in women comes in three types.  The first type is a male pattern loss in which hair is receded in the hairline principally in the fronto-temporal region and rarely in the crown area.  The second type is a Ludwig pattern in which hair is lost as a diffuse pattern across the top of the scalp that can extend into the temporal region.  The third type, which is shown by Mary’s example, is known as a “Christmas tree” pattern in which the loss is principally along the front of the head tapering to be less involved posteriorly.  The Christmas tree pattern is observed with the woman looking down and the hair parted in the middle.  Mary’s loss was primarily in the central forelock, causing her considerable embarrassment and a loss of a facial frame to the face.  By targeting the central forelock and the anterior hairline, Mary has a much better frame to the face and easier styling options for her hair now.

*All video testimonials on this Web site are unpaid and uncompensated in any way.

Female hair transplant patient, Clarice, talks about her hair transplant results only four months following a hair transplant procedure for female pattern baldness/hair loss in this video testimonial.  Please note that all video testimonials on this Web site are unpaid and uncompensated in any way.  Clarice’s type of hair loss involved the anterior hairline and central forelock and caused her to have a loss to her facial frame and an inability to style her hair the way she wanted.

Please also note that this video is exceptional in that in most cases at 4 months there should be little to no hair growth.  Most individuals need to wait approximately 6 to 9 months to see significant growth.  Clarice was fortunate to see growth much earlier than most individuals so that point should be emphasized so as not to mislead anyone.  Further, not every female is a suitable candidate for a hair transplant procedure.  Clarice had exceptional density in the donor area that helped considerably in being able to cover the lost hair.  If the donor area in a woman is severely compromised so will the result of the procedure.  With considerable experience in women who lose hair at the Lam Institute for Hair Restoration, Dr. Lam is able to apply the appropriate judgment to explain to a prospective individual the odds of success in a specific clinical scenario.