Good day doctors.
I am 22 y.o.
female and was born with a high hairline and an odd cowlick which exacerbates said condition.
The highest dimension from the top of my eyebrow to the highest point in my forehead is exactly
3inches.
I would like at the very least, an entire inch of hairline advancement.
I am not sure of undergoing surgery for this (reverse forehead lift whereby the hairline
is lowered through tissue expander placement) or what is currently more appealing to me:
hair grafting.
Thank you for your question!
At the age of 22, you have done a very good thorough job research about your options regarding
a naturally high hairline and your options.
You're asking about included a tissue expander, reverse forehead lift versus hair grafting
as well as you expressed a concern about the cowlick and the direction of the hair.
So I am in a unique position because I am certified in facial cosmetic surgery so I
do perform forehead lifts, face lifts and etc.
And I'm a specialist in hair restoration, so I basically have all the options in front
of me when I see patients like yourself.
Here's how I make some of these decisions.
I look at skin elasticity and I look at the risk of relative scaring that can occur from
a procedure like a reverse forehead lift.
Now in your situation, I think that you have to take into account that any procedure you
consider still has a large league when you talk about a more surgical type of procedure
like a reverse forehead lift versus a hair transplantation procedure.
So I would say that practically speaking, financially speaking, it might be more practical
to consider hair grafting.
And so, let's discuss hair grafting which is probably what I would recommend if you
were to be sitting in our office for consultation.
What your goal is, is to create a lower hairline but in creating a lower hairline, you have
to be mindful of how close the hairs are placed in order to look natural.
Many people come to our practice and the first thing they will say is: listen is my hairline
up here, and this applies to both men and women.
Well you could start doing a lower hairline at that level but you won't get the same level
of density that would look natural.
And so, you may have a lower hairline and the hairs will be too far apart and you will
need several procedures to get to your desired goal.
So one strategy to consider is to slowly lower the hairline from the point where it is most
dense and transition from there downward.
Now that would be based on the number of graphs that are available as well as the thickness
and quality of the hair so that's one thing to consider.
The other thing to be aware of is in terms of the cowlick.
A procedure that might be helpful is to actually take hairs from the cowlick and transplant
them in away so that the direction is of the hair is more advantageous to get better coverage.
So this is a complex concept but that I think it would be helpful when you're ready to go
ahead and do the transplantation procedure.
Something to also be made aware of is that you're not going to come across unless you
do your research really aggressively is something we've been doing in our practice and that
I have been able to advance over the past 2-3 years.
And that is the use of something called extra cellular matrix.
In traditional hair transplantation, a certain percentage of hair are lost regardless of
how well the transplant is done.
The factors such as the hairs being outside the body for a particular amount of time,
the surgical technique employed, the amount of bleeding that occurs.
All of those being equal there is always a certain percentage of hairs that don't make
it.
Well, what we are being able to successfully do is use this material in a specific way
that allows our hair transplantation to do a little bit better than patients who we've
had in our practice who didn't receive this type of care prior to this new technique.
Essentially, extra cellular matrix heals by duplication of tissues that is caught injured
and so this results activation of adult stem cells which we have observed.
Hair counts actually seem to heal more hairs than our actual transplant and this we are
able to document.
In addition, if someone has any hair thinning then that thinning hair, based on genetic
patterns such as male or female pattern hair loss, reverses and the hair is thicken.
This is based on the concept that the progenitor cell which become less capable or become defective,
if you will at a certain point, causes hair to thin actually become restored and protect.
So think of progenitor and protect, protect the hair follicles so that they are able to
thrive.
So again to summarize my recommendation, I would recommend transplant over surgical forehead
surgery as well as the redirecting of hair follicles from the cowlick basically extracting
follicular units and then changing the direction and considering the use of extra cellular
matrix technology that we have been in the forefront over the past few years with hair
transplants surgery.
So there's a lot for you to also consider and I hope this is educational for you.
Thank you for your question