Is hair restoration an artistic endeavor? Or in fact is it simply a rudimentary technical procedure in which hair is placed into the head and only the sheer number of grafts count? I will explain in a point-by-point manner why hair restoration is truly artistic in my opinion, focusing on three major elements: macro hairline design, micro hairline design, and recipient site creation/graft distribution.

Artistry in hair restoration requires good judgment when designing hairlines and making recipient sites.


  1. Macro hairline designMacro hairline design refers to creating the overall shape and position of the hairline, i.e., what is initially drawn on the head as a template upon which the micro elements of the hairline (see below) will be fashioned. Every surgeon making a hairline will create a slightly if not significantly different hairline based on experience as well as artistic interpretation. When I design a hairline, I am always looking at how that hairline shape would best match a facial shape, ethnicity, and gender. I also make sure that it will age well for someone. Every hairline I design I consider a work of art to make it not only look seamlessly natural but also wonderfully shaped to match a patient’s head to the best of my ability.
  2. Micro hairline design – The micro hairline refers to the recipient sites that go into the general hairline. When designing the individual sites, it is important that the hairline look natural from a distance but also even close up. I really spend an inordinate amount of time during the procedure looking at my work from multiple angles to ensure that my hairlines look as natural as possible. I really consider the micro hairline the final expression of my artistic design for the macro hairline.
  3. Recipient site creation and graft distribution – To me the recipient site creation is one of the ultimate expressions of one’s artistry controlled down to the very site angle and distribution. After I am done making my sites, I sit back for a minute, take a deep breath, and enjoy the glory of my creation. I simply love seeing my sites before the grafts go into them because they are a work of art. That is why I have so many photos and videos showing my recipient sites. I consider showing you my sites is like showing the seams of a handmade suit so that you can see the quality that goes into the production. I love blending in the technical and the artistic elements. When I attain a number of grafts for a given size given to me by my assistants from their graft preparation (e.g., 600 2 hair grafts, 500 3 hair grafts, etc.), I like to sit down and figure out how best I am going to allocate those grafts in a creative way for optimal effect for a patient. In fact, after I have created my work I always make a color-coded guide for my staff to know how to place the grafts but also so I have a written record of my distribution so when I see a patient come in with the grafts growing in nicely I can remember w hat I did.

Samuel M. Lam, MD, FACS, a board certified hair transplant surgeon in Dallas, Texas. To schedule a hair transplant consultation please call 972-312-8105, or visit for more info. To ask Dr Lam a question please visit our hair transplant forum.