THE IMPORTANCE OF THE HAIRLINE
The frontal hairline is singularly the most important feature of the entire head of hair. It is the aspect of our hair/skin interface that we, and others, see first. When we look in a mirror, or walk into a room, when someone sees us and makes eye contact for the first time, the hairline stands out. On a subconscious level, beyond the rational, it speaks volumes about our age, attractiveness, suitability as a mate, even about our health and vitality.
Why is the hairline of such significance? It frames the face. This simple statement belies the artistic and cosmetic impact of this all-important frontal zone. One of the reasons that many men with frontal balding instinctively go for the comb-over? effect, is that it creates a hairline of sorts; it frames the face at the top and at the temples. The problem is that it is so patently obvious to everyone else as an attempt to disguise the balding.
Framing of the face is an artistic metaphor. Imagine a painting without a frame. It may be a pleasing image, but it is incomplete. Add a nice, tasteful frame and voila! You have a complete, aesthetically appropriate presentation. Similarly, frontal hairline balding takes away the frame; restoring the hairline restores the frame. The resulting appearance is one of youth, vigor and vitality.
PLANNING THE HAIRLINE
Often, hairline planning is a compromise between the patient and the surgeon. This does not imply that the patient does not know what is best for him, or that the physician is wiser. What it does imply is that people have a tendency to want the hairline too high or too low. The low, rounded adolescent hairline will look inappropriate on a 40 year-old man. In fact, it may lend a caveman or Neanderthal appearance to his visage. Young men in their early twenties may require repeated explanation of the reasons for not creating an adolescent hairline for them. They still remember quite vividly (unlike the middle-aged man) their own, low hairline at the age of sixteen. Often, they are rather distraught about their loss of hair, and do not identify with their future selves at thirty, forty, or fifty. This is where the ethical hair restoration surgeon must explain and counsel for the patients benefit, rather than playing on fears and illusions in order to make a quick profit.
Conversely, a middle-aged man seeking hair restoration surgery may fear that a hairline that is not adequately receded at the temples may seem unsuitable for his age. The fact of the matter is, that a hairline placed too high accentuates the balding, by focusing attention on the wide, high expanse of the forehead and frontal area. This concept may be easy enough to visualize if properly explained.
At any rate, if one must err slightly to the extreme, it is always better to start slightly too high, than with a hairline that is too low. One can always, in a second session, bring the hairline down by artfully adding follicular units in front of the existing border. Still, it is much more desirable to get the hairline right on the first try. After all, the primary goal of almost all first hair transplant sessions is to re-establish the hairline and frontal region, in order to frame the face. This facial framework achieves the most dramatic cosmetic and visual effect of hair restoration surgery.