Planning for the Hairline in hair transplant

Planning of hairline design and follicular grafts placement is of extreme importance to the successful aesthetic and natural final result of a hair transplant. It is one of the most intricate aspects of the procedure. It is difficult to master, and therefore this is the area where the most mistakes are made.

Men with Male pattern baldness (MPB):

While planning a hairline it is essential to remember that hair loss continues to occur throughout life, and the number of hair follicles available for transplant from the donor area are very limited. If planning is improper one may run out of hair before covering the entire bald area. It is a good idea, in most cases of MPB, to correct the front one-third or front half of the scalp and leave out the crown region completely or first complete the front region of the head and then decide whether there are enough follicles left in the donor area to cover the crown.

We divide the scalp into three zone for the purpose of transplantation; frontal region, mid-scalp, and vertex (crown).

To create a hairline, we draw a line from the midline anterior most point or mid-frontal point (MFP). Usually we place this point at 7-11 cm above the midglabellar line, approximately at the point where the fore head transitions from being vertical anteriorly to gradually sloping posteriorly.

The next step is to draw a curved from the mid-frontal-point (MFP) moving upward and to the lateral side of the apex, which is the highest point of the fronto-temporal recessions.

During transplantation in the frontal and mid-scalp regions, attention should be paid to the mid-portion of the posterior hairline, which must not exceed the vertex transition point (VTP). In front of the “VTP” the hair direction starts changing. The hair in the crown region are whorled and there is radial swaying through 360 degrees.

The method of hairline placement pattern depends on a variety of factors such as the age of the patient, nationality, extent of present baldness and possibility of further hair loss as well as expectations of the patient. An isolated frontal forelock may be planned if the patient is extremely bald or very young patient with a possibility of getting extremely bald in the future. This is one of the safest ways to give a satisfactory appearance in in a person with very extreme baldness.

The Crown:

Hair transplant in the crown area is not as cosmetically satisfying are the hairline. In general, men are less concerned about the vertex area as they do not notice it and hence are unwilling to treat it. Limiting crown transplantation just to one or two sessions to provide light coverage is a good solution, which is usually satisfactory for the patient and also leaves hair in reserve if further transplant is required in the future.


The natural hairline is slightly wavy (or feathered) and irregular. Recreating the natural hairline is the most challenging and skillful part. If a straight hairline with sharp angulations is created this gives an unnatural, wig like appearance. A zone of evenly spaced single hairline is carefully defined. In front of this zone, micro-irregularities employing three to four single-haired FUs are utilized in clusters as well as random scattering. Single-haired FUs, are placed in an erratic manner in front of as well as between hair clusters. With this method the hairline is softened and abrupt straight lines are avoided. A zone of gradually increasing hair density in the hairline is created, approximately 5-10 mm in width. Consult our experienced hair doctor in Bhubaneswar for further information.

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