Lets talk hairlines

Dear forum readers,
Hairline reconstruction is more important today then ever before.

I advise all patients to choose their final desired hairline in the first (or, atleast the initial few) hair transplants.

You do not want to run out of scalp hair and then realize you really wanted to go for a more agressive hairline.


It is important for prospective patients to learn the geometrical concepts involved in designing a hairline.
And, it is not very difficult.

I will divide the topic into smaller sections for ease of understanding.

The first one being LOOK.

Before learning to design a hairline, learn to LOOK and see the human face.

For starters, we shall discuss the non balding Asian/ Caucasian male face (at 30 to 35 years age).

There are 3 points, I would like you to concentrate on

A - the centre lowermost point of the hairline
B - also called the temple angle (the point where the front and sides meet)
C - the temple point (self explanatory term - the pointed tip of hair seen in the profile view).

The middle half of the hairline (in most adult males), runs parallel to the middle half of the eyebrow.

Look at any face/picture. Draw an imaginary line along the middle half of the hairline outwards (line 1).
Now draw another imaginary line over the mid half of the eyebrow and carry it outwards (line 2).

Non balding adult male - Line 1 and line 2 run parallel to each other.

When line 1 and line 2 diverge, that becomes a mature hairline.

Line 1 and 2 converge in feminine or teenage hairlines.


Thus, when you LOOK, you are now looking at the parallel configuration of the mid half of the hairline and the mid half of the eyebrow.

Now lets look at a few real life examples
http://images.starpulse.com/pictures/2007/03/11/previews/Mark%20Wahlberg-SGG-053091.jpg

http://l.yimg.com/img.tv.yahoo.com/tv/us/img/site/12/84/0000041284_20070710153005.jpg

Please note that the negroid hairline is an exception. There, often line 1 and 2 converge.
http://images.starpulse.com/pictures/2008/01/09/previews/Will%20Smith-ASG-008991.jpg

Let us look for some more lines.

When we look at the profile view, the lower arm of the temple point runs almost (not entirely) parallel to the outer half of the eyebrow.
http://www.bollynewz.com/wp-content/uploads/2008/05/aishwarya-abhishek.jpg

Look at a few people in daily life and you will understand.

That clears 2 basic concepts of the non balding, adult male hairline.

Now, we shall talk about “the bald look”? What exactly happens that the human eye percieves as the bald/balding look?!

What does the brain consider the bald look?

Let us go back to the original 3 points - A, B and C.

Hair may recede from one or all of the 3 points, exposing more scalp skin.

The more skin that becomes visible above the eyebrows, the more bald the look.
Few examples

Important - Each of the 3 points are equally important.
The following is a simplified version to help easy understanding
Person 1 : Point B may recede 3cms with minimal recession of points A and C.
Person 2 : Points A, B and C may all recede 1 cm.

The brain percieves an equal increase of visible scalp skin above the eyebrows. Thus, both the people look equally bald on a first glance.
This is an important concept to understand before you start designing new hairlines.


Now in simple to understand examples below, person 1 looks much more bald then the person 2.

person 1

person 2

When recreating a non balding hairline, each of the 3 points need to be restored. If, for example, point A and B are restored, but C is not, an element of baldness will still be percieved.

Similarly, restoring the point A, but not B will create the hairline with deep temporal recessions.

In the next step, we will learn how to determine points A, B and C.

Point A - the centre lowermost point of the hairline. Many among you may be aware of this formula, but I will repeat for benefit of others.

Measure the length, in cms, from the lowermost tip of the chin, to the point of intersection of the eyebrows (Glabella - Glabella - Wikipedia ). Let this length be Q.

Divide the length Q by 2.
Now measure from the glabella upwards.
The point A is located above the glabella at Q/2.

This is the lowermost location of the centre of the hairline.

Note : your hairline in teenage maybe lower then this.

The point C is the “temple point”. Its usually preserved in a rudimentary form in most patients suffering hairloss.

Point B - The lowermost point B is located at the intersection of

  1. A line drawn, through point A, parallel to the mid half of the eyebrow, and,
  2. A vertical line drawn through point C.

For a non balding hairline, restoration of point B is as important as the other two points.

Example 1
Point A and B require lowering to reach non balding levels.

Example 2
Point A nd B have been restored but not to the lowermost extent. This is slightly receded look.

Example 3

This patient has opted for a very high hairline with deep recessions.

» The point C is the “temple point”. Its usually preserved in a rudimentary
» form in most patients suffering hairloss.
»
» Point B - The lowermost point B is located at the intersection of
» 1. A line drawn, through point A, parallel to the mid half of the
» eyebrow, and,
» 2. A vertical line drawn through point C.
»
»
» For a non balding hairline, restoration of point B is as important as the
» other two points.

So Dr. I understand how you calculated A and B, but how to you calculate where C is? I know you said that its lower leg should run almost parallel to the outer eyebrow, but what about how far out it extends?

I am not sure that I agree with the general approach that you are taking. My impression is that the various point for any individual are dictated by the curvature of the forehaed in other words the change in angle from vertical forhead through to horizontal. Where the hairline is at the point that the change begins then this is the usual type I and when the angle is more than 30o from vertical where the hairline begins then the look is of hair loss.A simialr rule can be made for the temple points ???

Regards,
Marco

» I am not sure that I agree with the general approach that you are taking.
» My impression is that the various point for any individual are dictated by
» the curvature of the forehaed in other words the change in angle from
» vertical forhead through to horizontal. Where the hairline is at the point
» that the change begins then this is the usual type I and when the angle is
» more than 30o from vertical where the hairline begins then the look is of
» hair loss.A simialr rule can be made for the temple points ???
»
» Regards,
» Marco

Dear Marco,
Can you explain your point with a picture or diagram? It will be easier for me to understand.

Are you referring to the different skull shapes e.g.,

  1. Those with vertical forehead merging fast into a very flattish top/vertex
  2. Those where the forehead rounds from just above the eyebrows all the way to the top.

Regards,
Dr. A