I have a high forehead since birth and dense hair.
Would you recommend a hair transplant or forehead reduction surgery?
My hair is wavy and a bit curly.
If hair transplant is better for me, then how many grafts would I need to lower my hairline
by 2-3 cm?
I have no hair loss problem.
Thank you for your question.
You submitted your question; a history that you have a high forehead since birth, that
you have dense thick hair and that you’re not suffering from any hair loss.
And you want to know how do you get more hair lower whether it’s by transplant or by a
forehead reduction.
So before answering that question there are some critical things to really understand
about the hairline and I would say that the most important thing is to think about where’s
the future of your hairline.
So you’ve submitted a photo for the front as well as from the side that shows the natural
male pattern hairline and what I would say is that you have to be concerned about what
would happen whether or not you had an incision, or whether or not you had transplants.
Should your hair start to recede?
When people have hair transplant and are seen later in their life as looking “pluggy”
it’s not because that their transplant was done badly, it’s because the transplant
had company and that the native hairs and the hairs that were transplanted looked good
together and the volume effect was nice but as life went on the person may or may not
have been on medications like Finasteride to try to slow down the hair loss progression
or they may never responded to it or they may have a side effect and whatever the reason
was they continue to thin and then what happens is that you see the individual grafts and
they look “pluggy”.
So let’s say you decide instead of doing that let’s do a forehead reduction.
Well, that forehead reduction requires an incision and that incision can be camouflaged
very effectively when there’s hair.
If the hair were to recede then the incision could be apparent.
So as often the discussion especially for younger people in their 20s or even 30s is
you have to think of the future and be prepared for what are the consequences of making a
decision.
So if this is a situation where your family history is such that everybody has lots of
think hair and no one recedes then the discussion about your options should be a balance of
what would happen if for any reason you did have some recession and that you had a choice
between an incision scar or the presence of grafts.
In our practice, we tend to lean towards doing grafts.
I think that because when we do our hair transplant surgery, we use this method called “Hair
Regeneration” which in a way can act in the right patient as a vaccination effect
if they are thinning and prevent progression of the hair loss in the area where we placed
the grafts and in addition, we maximize the effect of the benefits of the grafts.
It’s a well-known thing in hair transplant surgery that not all grafts make it when they’re
transplanted and that’s a terrible limitation when we you think about the limitation of
the graft source which is finite.
So every hair is gold and so, when our practice when we do a transplant we combine that with
hair regeneration to preserve existing hair as well as to maximize the survivability of
the hair grafts.
So I think that that would be worth considering.
Now that being said, understand that with hair transplant there are limitations in terms
of the density that is achieved.
So although, when you do your research you’ll find all kinds of claims about doing eighty
to a hundred hairs per square centimeter, it’s not about the surgeons technical skills
to be able to place the hairs but it’s about the survivability of the grafts.
With that being said, I always explain to my patients that if you are looking to lower
you hairline be prepared for two surgical procedures in order to achieve the optimum
density that will give you the results that you desire.
Because nature creates this type of density which is fantastic and beautiful but from
a surgeon’s perspective recreating that with one transplant is challenging and when
it’s right there in the front, it has to be done in a way that is natural and dense.
And typically, we have found that it takes two procedures to do that.
So I think that your next step is to meet and have consultations with doctors who perform
both procedures and learn about your options.
Think about the future and think of the possibility of hair receding in terms of how that will
impact the appearance should that occur.
So I wish you the best of luck.
I hope that was helpful and thank you for your question.