Understanding Natural Hairline Design
1.Important Scalp zones and landmarks in hairtansplant: Frontal zone, temple zone, vertex
The scalp bones are 8 in total:
- Frontal bone (os frontale- frontal bone)
- Wall bone (os parietale- parietal bone)
- Arterial skull bone (os occipitale-occipital bone)
- Temporal bone (os temporale-temporal bone)
- Basic bone (os sphenoidale -sphenoid bone)
- Ribbon bone (os ethmoidale-ethmoid bone)
1.1 Os Frontale (Forehead bone)
It is the only bone that forms the anterior upper wall of the skull, the forehead region. The horizontal part of the orbit, which forms the ceiling, articulates with the sieve bone and the basement bone. It also articulates with the nasal bones, maxilla, and cheekbones of the facial bones. In this region, the growth directions of the hair are usually at 15-degree angles.
1.2 Os Temporale (Temple bone)
Os temporale is a double bone that participates in the structure of the skull base and lateral lower wall. In this region, the hair generally grows downwards. The exit angle should be 15 degrees or less.
1.3 Wall bone (os parietale- parietal bone)
It is the only bone that makes up the posterior lower part of the skull. Part of the occipital bone, part of the skull dome and part of the skull participates in the formation of the base. It is defined as the vertex or crown, which is the highest point of the upper crown of the hair. It is in round or oval form. The development of vertexin hair loss is backward. It is the area of the scalp with a complex structure with the special distribution of the hair. In this area, hair loss starts right in the middle and opens towards the environment. It is an area where hair transplantation can be difficult with many features. Men are the more ideal patient group in hair transplantation with the vertex region features. Especially whrol, the existence of a spiral here and its configuration is extremely important. In the crown, the whrol is on the right and clockwise for almost all patients. In cases where it is on one side, the narrow area is defined as a wide area b. In the narrow area, that is, in the a area, the hair spirals at sharp angles. In the wide area, that is, in b, the angles of the hairs are more perpendicular than in a, or even 90 degrees.
1.4 Preoperative considerations: age, sex, patient expectations, degree of donor availability, facial contours, hair characteristics, ethnicity
In general, the two areas that attract the most attention in hair transplantation are the hairline and the crown area. Ethnicity, age and face shape are of great importance, especially when creating a hairline. While the blacks, asians hispanics, hairline is generally straighter, the line is more inclined in, European and Caucasian races. In addition, the hairline of a young patient should not be the same as that of a middle-aged patient. Blondes have a softer front line, and brunettes have harder transitions. Since the hair of brunettes is thicker, it is more important to evaluate singlehair follicles in the front line. In addition, the hairline to be used in round-faced people should be different than those with sharper lines.
“Advanced balding equals to reduced donor availability. Conservative planning allows more realistic outcomes to be achieved”
Finding the mid frontal point(MFP) is important to create natural hairline. We follow “Rule of Thirds” and 70-mm minimum height rule for creating MFP. According to the researches in adult males naturally occuring MFP is 70 mm or slightly higher.
Naturally occuring hairlines are always irregular to some degree with macro and micro irregularities. In hair transplantation hairline needs some of irregularities too for natural results. Widows peaks will enchance a natural lookings.
Microirregularities are more subtle and cover the entire lenght of hairline. They together with the creation of a transition zone, reduce the appearance of an unnatural design of hairline.
3.Receipent site creation
3.1 Hair placement angles
There are many ways to create beatifull patterns on receipent area. When creating the receipent site there are some tricks to get natural results and first is hair placement angles.
Here is the directions below creating a natural whorl in vertex area.
Good distributed hair directions of our patient 10 days after hair transplant
Good distributed hair directions of our patient 10 days after hair transplant-2
4.Distribution of 1,2,3,4 hair FU’s
The patient you see below, it is clearly seen how the distribution of the grafts affects the result. The patient’s feedback, he said that even his environment did not believe that he had hair transplant. This result shows us how important the distribution of grafts is in hair transplantation.
ALL PICTURES USED IN THIS ARTICLE BELONGS TO CLINISTA AND ITS CONSENTED PATIENTS
Written By Dr. Ergen : https://www.researchgate.net/profile/Onur-Ergen-2