Principles of hair line : Importance of Hairline Design

Principles & Importance of Hairline Design

Cosmetic procedures and surgeries are handpicked with the dream of resolution of the flaw with natural and undetectable look which is not obvious to others. Similarly hair transplant cosmetic surgery is chosen with the desire of maximum coverage of bald area along with extremely natural hairline design. The success of hair transplant cosmetic procedure lies not only in maximum coverage but also natural outcome.Decades ago the hair transplant procedure were at its infancy and were inefficient in providing natural outcome resulting in plugged hairs. In present times, the advancements and technology has raised the procedure over the years and is capable of providing fuller and natural look. Now the expectations have increased from the procedure and patient demands of high density hair transplant with natural look like natural existing hairs in single session.With the advent of latest technology, hair transplant surgeons have become more efficient in delivering natural hairline design. The hair transplant surgeons select the follicular grafts judiciously and plant them by keeping aesthetics and appropriate coverage in mind. Single grafts and multiple grafts are selected and planted appropriately to attain maximum benefit.

Like a painter use the finer paintbrush to draw the accurate lines in a painting and however finer the paintbrush is, a perfect painting needs to be made by a perfect painter. Similarly follicular unit acts as fine paintbrush for hair transplant surgeon and however density and texture of follicular units you get, perfection in hairline designing can be delivered by an expert and skilled surgeon. A better understanding of natural hairline design and recognition of visual characteristics can build natural hairline.

If the visual characteristics are not taken care of properly, it would lead to hampered naturality and aesthetics.

Here is presented an example where the follicles are arranged in straight line and with improper direction which makes the hairline look fake. Thus to maintain naturalness, it is important to place the follicular units in proper angle and direction,

So let’s figure out what are the principles of visual characteristics of natural hairline?

And how the artistic hairline design is built to efficiently reproduce the natural one?

Dr Suneet Soni is world fame and specialized in delivering artistic hairline design which makes the results look natural. He has been appreciated for his sense of art by national and international patients along with the celebrities.

Here we would discuss the step by step technique and approach to depict the ways to achieve natural hairline design and makes the results successful in terms of maximum coverage and aesthetics.

EXTENDED HAIRLINE REGION: WHAT IS THE CONCEPT BEHIND IT?

Extended hairline region is the area which lies in the front portion of the scalp including approximately 2-3 cm of depth which bridge the bald forehead to the area of central density. Most of the hair transplant surgeon focuses on only front line or the anterior border for hairline designing which is called transition zone. Ideally, for perfection in artistic hairline design complete extended hairline region should be taken into account.

Below the figure depicts the extended hairline region and its coverage on the scalp.

Extended hairline zone is important for overall appearance of hairline. The area covered by this region is approximately 30cm². This area requires a range of 600-900 follicular units to create initial density of 20-30 follicular units/cm².

The extended hairline zone comprises of Transition Zone (TZ), Defined zone (DZ) & the Frontal Tuft (FT). The arrangements of follicular units in these areas are as follows:

• The transition zone should have soft and irregular pattern.
• The defined zone should be more defined & dense.
• The frontal tuft should have the most definition.

All three components of extended hairline zone have their own contribution in enhancing overall appearance of the hairline.

Parts of extended hairline region:

The extended hairline region can be divided into 3 zones including:

Transition zone: This zone comprises of 0.5 -1 cm of the hairline initiating from the forehead. The designing in transition zone appears irregular and ill defined in the frontal area followed by more definite pattern as it reaches adjacent to defined zone. The natural hairline should be carefully observed to judge the various elements which have to be taken into consideration for transplanting follicular units in such a way to deliver natural results. This zone intends to deliver natural look.

Defined zone: The defined zone comprised of 2-3 cm width area lying behind the transition zone. In this zone attempts are made to arrange the hair follicles in a more defined way and with higher density. Multiple thick grafts are preferred in this zone to accomplish the goals. This zone intends to deliver the fuller looking hairline. In this zone the hairs are closely arranged to deliver the maximum coverage.

Frontal tuft area: This is an aesthetically important area present as an oval area in the mid frontal aspect overlying the central portion of defined zone posterior to the transition zone. This area in natural hairline has higher density then rest of the defined zone. This is the most crucial area in terms of aesthetic importance as is noticed first at the eye level when looked by someone from the front.

The knowledge of these areas is mandatory to bring the reflection of natural hairline and could be possible with an expert surgeon. Dr Suneet Soni; the head of Medispa hair transplant clinic is super specialized in the field of hair transplant and is certifies by authority bodies to perform hair transplant. With the appropriate knowledge his artistic skills plays a perfect blend in delivering best world class natural results.

WHAT TO CONSIDER FOR PERFECT HAIRLINE?

For artistic hairline designing, the surgeon should have excellent sense of art and Dr Suneet Soni has ample of it. There are some specific considerations taken into practice when you are looking for perfection in hairline designing. Dr Suneet soni believes in perfection and keenly observe every single aspect to deliver so. His innovative approach has rewarded him with appreciations from the national and international patients including celebrities. If you are looking for hair transplant in India then feel free to book an appointment with Medispa hair transplant centre.

Dr Suneet Soni has listed few considerations include:

1. It is better to use follicular units instead of using small slit minigrafts in all the extended hairline zones: Follicular units are preferred by surgeons in transition zone but there are mixed thoughts for using follicular grafts or small slit minigrafts in other zones of extended hairline regions like defined zone and frontal tuft. These areas need very high definition and density in the first session. In my opinion, follicular units with multiple thick grafts should be preferred to provide high density and definition. The reason for preferring follicular units is that they are smaller than the equivalent number of minigrafts. Thus they can be planted in relatively smaller slit which makes them lie closer together in single session. But yes, minigrafts should be preferred in one situation when the patient had very fine or white hairs where there are more chances of waste rather than to expect naturalness.

In this figure X depicts three or four group of follicular units and Y depicts three or four group of minigrafts

2. It is better to use properly trimmed follicular units : It is already discussed in the above section that follicular units are preferred more than minigrafts in extended hairline zones. But all of the follicular units have different dimensions and geometric sizes and shapes which depend upon the skills of the graft separator technicians and the technique opted for the hair transplant. Thus in that sense it is better to trim the follicular unit properly. It should be kept in mind not to dissect the follicular unit very skinny. The follicular units should be trimmed in “tear drop” pattern by removing excess of surface epithelium and leaving appropriate amount of tissues around the follicular units lesser on the superior side and more on the inferior side. This offers number of advantages over minigrafts as they are trimmed too much or too less. It needs ample experience and expert skills to perform the procedure with such excellence. Dr Suneet Soni and his team are highly skilled and experienced to perform hair transplant procedures with best possible outcome. He is enlisted as one of the best hair transplant surgeon in India.

Figure representing non trimmed follicular units and properly trimmed follicular units. Tear drop pattern of follicular unit has been presented in the figure.   Tear drop pattern favors close placement of follicular units than untrimmed ones.

3. It is better to use ample number of follicular units in the extended hairline region during the first session to deliver both naturality and density : The major drawback of hair transplant in the past was the shortfall in the number of follicular units used to cover this region. But now high density hair transplant is in trend and people often come to us with this demand. Thus to ensure naturality and high density sufficient numbers of follicular units should be placed in the extended hairline region including transition zone, defined zone and frontal tufts during the first session. The extended hairline region measures approximately 30 cm² in size including all three zones. To accomplish ample hair density in that particular area 20-30 follicular units /cm² should be transplanted. Thus, in total 600-900 follicular units are required to be placed in these zones to create appropriate density. These numbers of follicular units (20-30Follicular units/cm²) are considered safe to be transplanted by majority of hair transplant surgeons providing dense packing. Even more number of hair grafts might provide better results with dense packing but the results are controversial and not necessary to produce good cosmetic results.
4. It is better to selectively separate and selectively distribute the follicular grafts : It is mandatory to select the follicular unit to be placed at desirable locations to ensure both natural looks and ample coverage. One, two and three hair containing follicular units provides another method to control the hair distribution for appropriate density. Micrografts created by technique like impulsive graft cutting device described by Mangubat do not allow segregation of grafts of varying sizes. Thus the multiple grafts stays lumped together and benefit of selective distribution cannot be achieved.

The below mentioned picture represents the selective distribution pattern preferred by Dr Soni which are intended to deliver maximum hair density in the bald area. Single graft is planted in the transition zone and multiple follicular units are planted in defined zone and the fontal tuft area. The three hair follicle containing units are planted preferably in the frontal tuft area as higher density in that area provides high aesthetic value.

5. It is better to use “follicular pairing” : It is a very crucial step and only expert hands attempts do such modifications while transplantation. There are circumstances where more single unit follicular grafts are obtained which remains extra after planting them in transition zone. As defined zone and frontal tuft zone requires placement of multiple grafts one can attempt “follicular pairing”. This process intends to plant desirable number of single grafts by combing or pairing in the same incision presenting the hue of multiple grafts.

Dr Suneet Soni with his innovative approaches makes sure to deliver best hair transplant results with maximum coverage and appreciable looks. Medispa hair transplant centre has  his fame worldwide thus has been approached by many national and international patients for hair transplant tourism.

Figure representing follicular pairing as you can see the single follicular units are combined to form multiple hair follicular units and are planted in the single incision.

This technique is termed as “Recombinant follicular unit grafting”. The pairs combined could be as follows:

2 haired grafts: It is formed by combining 2 single unit grafts

3 haired grafts: It is formed by combining one single unit and one two haired follicular unit

4 haired grafts: It can be formed by planting combination of pair of 2 haired follicular units.

This technique is beneficial to allow increase in hair density at the desired bald locations without making more incision and also deliver natural looking results.

6. It is better to maintain proper angulations and direction of the follicular units to ensure the natural outcome : Angulations and direction are separate entities which needs to carefully taken into considerations to attain natural results. Angulation refers to the angle at which the hair emerges from the scalp. Direction refers to the hairs pointing towards which way after emerging from the scalp.

Dr Suneet Soni has an immense talent of artistic vision which fulfils the keen detailing in the hairline designing which only an artist can do. Very few surgeons are that considerate when it comes to hairline designing and Dr Suneet Soni is fortunate to have the inbuilt talent of artistic vision which makes him deliver best hair transplant in India.

In this figure the differences between the angle and direction of the natural hairs have been described. The maintenance of angle and direction in the transition one is mandatory so as to confirm the natural look.

Cowlick is presented as group of hairs which follows a different angle than rest of the hairs on the forehead in the middle area.  If the patient has existing cowlick and there are chances that it would get incorporate in hair loss in few years then it is better to leave that alone. But in case if cowlick is strong and would exist for a longer time then it is better to use the existing hairs to follow its direction.

In this picture cowlick is recreated as the patient had strong cowlick. The existing hairs were used to attempt the direction and angle of the transplanted hairs.

7. It is better to properly transplant follicular units on anterior border of the hairline:  One of the principles of hairline designing includes avoiding hairline too low on the forehead. The hairline is purely decided by the size and shape of the head and degree of alopecia. In patients with severe hair loss hairline can be raised by approximately 1-2 cms. In few cases “widow’s peak” can be used to provide illusion of lower hairline without spending too many hair follicular units in this area.

8. It is mandatory to properly plant follicular units in lateral border in hairline and fronto temporal triangle : In males pattern of hairline includes fronto temporal triangles on either lateral sides. Frontal portion is the superior area of this triangle and the temporal portion is the inferior border. The base of this triangle lies at the forehead side which recedes constantly along with the receding hairline and deepening the apex of the triangle. Single follicular units are basically used to fulfill the aesthetic requirement.  Including, the apex of the triangle should not be very blunt as will deliver unnatural look.

In this figure the method of formation of temporal triangle is explained. A line is drawn from the lateral epicanthis of eye to the point where it coincides with the remaining temporal hairs. These present temporal hairs can be taken as map to decide the inferior border of the angle.There are few rules which states the meeting point of frontal hairline and temporal hairline including:

1. Draw a line from lateral epicanthus of the eye to the remaining temporal hair.
2. The line created should not slope downwards towards the ear rather it should slope upwards or parallel looking from the sides.
3. In mild and moderate hair loss cases, when the temporal hair loss is less these above mentioned rules works well. The existing temporal hairs becomes the inferior border of the angle and “future transplanted hairline” will become the superior border of the angle. The apex lies at the point where the line from the lateral epicanthus meets at the temporal hair.
4. In advanced hair loss cases where it is difficult to find the meeting point on temporal hair because of more defined recession and dropping of lateral fringe. In these cases noticing visual hump could be of help. “Lateral hump” is a point located superior to the ear and is the semi circular area which extends from lateral fringe to mid scalp region. If you will notice at lateral profile of extensive bald patients, the lateral hump would still retain.

In this figure the placement of apex of temporal triangle is depicted in severe hair loss which is done after looking for “lateral hump”.

9. How to recreate a receded temporal hairline and temporal points :Recession of frontal line and temporal line contributes in changing the look of an individual and making the forehead look bigger. Earlier when the techniques was not that flourished hair transplant surgeons used to be reluctant in covering temporal line and temporal points. This was because after progressive hair loss there are high chances for it to look unnatural.

In rightly selected patients follicular units are used to recreate the receded hairline and building temporal line and temporal points. This makes the forehead looks smaller without lowering the frontal line or blunting the temporal triangles. It needs to be kept in mind to choose the right candidate for doing so.

In this figure the intersecting point of 2 lines have been shown where the tip of temporal point is determined. This point usually lie slightly lateral and above the lateral aspect of the eyebrows. The angle of transplanted hairs should be more or less flat or as close as possible. The hair should be directed towards the downwards and posterior direction towards the ear. The direction can also be judged by existing miniature hairs lying in the area priorly.

Dr Suneet Soni has a well build name not only in India but worldwide to provide the world class natural results with assured permanent outcome. His extensive work in the field of hair transplant has made him receive multiple awards by authority bodies at national and international level. Medispa hair transplant centre believes in using high loop microscope to perform every single step of hair transplant to keenly observe the details for perfection in the outcome. 

SYSTEMATIC STEP BY STEP APPROACH TO CREATE A NATURAL HAIRLINE

Dr Suneet Soni has revealed his secret of designing a natural hairline described in multiple steps which is replicated on the scalp with great sense of art. Because of his additive skills of artistic sense he has been known to perform best hair transplant in India. The following description depicts the step by step approach to design a natural hairline as per his innovative method.

These steps provide the initial framework and is built or tuned as per the requirement of the patients. Although there are many alternative ways to design hairline but Dr Suneet Soni has innovated the best out of them which is in the best interest of the patients. The steps are described as follows:

1. Draw the artistic hairline design: Before heading for the surgical procedure, the drawing of hairline is performed based on multiple factors along with the customized needs of the patients. Marking of anterior border, lateral border and fronto- temporal angle should be done. The extended hairline region should be drawn including transition zone, defined zone and frontal tufts. If the patient desires of a lower hairline it could be done by drawing in widow’s peak and moving the fronto temporal angle slightly forward.

In this image the initial markings are been shown which are done to design hairline. The crucial points marked are transition zone, defined zone, frontal tufts and lateral hump.

2. Make initial incisions as per drawing of anterior border of transition zones :These marking incisions are made around 1 cm apart and following irregularly irregular zigzag pattern. Some follicular units are transplanted anterior to and posterior to the drawn line which creates desirable macro irregularity providing natural look.  These initial incisions ensure that you are not losing your way out in preparing hairline. This also helps in playing safe with this crucial area deducting the chances of losing the initial design.

3. Prepare initial marking incisions at fronto- temporal area: The fronto- temporal angle is made by help of existing hairs on both sides of fronto temporal region. These existing hairs help in determining the angle and direction of the hairs to be planted. The markings are done alongside these hairs using them as landmarks.

4. Once the marking have been done, the incisions are then to be made in the defined zone before performing any other step in the transition zone : According to Dr Suneet Soni the better outcomes can be attained by getting in an orderly manner rather than going haphazard way. The defined zone should be started first prior to moving anteriorly to the more crucial transition zone. It helps in avoiding more flat hairline which could lead to fake looking results. It could be directly compared to the “wall paintings” where central portion is painted first followed by the outlines which give cleaner and arranged look. The incisions in the defined zones are placed as per delivering high density of around 25 follicular units/cm².  There should be no regular pattern and orientation of the follicular units and random placement should be preferred which will create unintentional skipped areas and uneven distribution of follicular units. 

5. Make the framework to design hairline in transition zone : Once the incisions in defined zone have been performed, it should be preceded with marking the incision ahead of it at the meeting point of defined and transition zone followed by reaching to transition zone in proper. This forms an initial framework of triangular bridges formed on either sides that connects transition zone with defined zone. The shape of these bridges on either side represents like an elongated triangle which contains 6 – 10 incisions. The base of this triangle lies in the defined zone. Then an irregular pattern is created in the transition zone to bring naturality to the results. This zone comprised intermittent hair density which makes this area look more natural.

In this figure xx depicts the marking of incision at the anterior border of the transition zone. YY represents the incisions that connect the marking incision of transition zone and defined zone. ZZ represents the incisions in the fronto temporal angle and lateral hump area using the existing miniaturized hairs to demonstrate proper angle and direction.

6. Multiple passes are made by keeping the pattern and basic framework same : Once the framework is created, multiple passes and artistic vision is used for refinement. These passes are built in “transition zones” which helps in filling the spaces but keep the pattern of irregularity same. Within the triangles it is better to put more incisions than between the triangles which provide ample hair density in that respective area. The irregularity and estimated pattern helped in providing naturalness and adequate density.

7. Transplant the graft by properly selecting the grafts according to the location with the principle of selective distribution and follicular pairing : As previously described the hair follicles are planted based on the principle of ideal selection of grafts along with follicular pairing if required.

8. Use “stick and place method” to fine tune the hairline : After transplanting the grafts successfully as per the requirements 100-300 grafts are saved for final brushing up to provide natural hairline. These grafts are then artistically planted at points where they are needed to make the hairline look very natural. Hair density is checked in extended hairline region for appropriateness and delivering aesthetically pleasing results.

This figure represents the before and after (8 month follow up) of the patient after following the similar steps explained above.

Dr Suneet Soni is well known for his innovative skills and approaches to design the best possible hairline which has been appreciated by both national and international patients including celebrities.

If you wish to have a desirable natural hairline; feel free to book an appointment with Medispa hair transplant centre in Delhi and Jaipur.