The creation of the female hairline is more complex as for men. This needs more density as well as coverage. a large area of scalp thinning with limited donor supply and demand for lower hairline is a challenge and needs very careful planning and distribution of hair follicles correctly. Although the hairline remains intact in female hair loss it is sparse and in an advanced stage of hair loss, it recedes as well. It is not always that female hair loss follows its pattern but some may have hair loss like male patterns.
The characteristic features of the anterior hairline of the female are cowlicks, widows peaks, undulations, temporal mounds, and low positioning As per Dr. Bernard Nusbaum study The average distance from mid-brow to the lowest central hairline point was 5.5 cm. the average distance from the central midpoint of the hairline to the lateral mounds was 4 cm, and the temporal points on average were located 1 cm above and behind the lateral canthus. Successful aesthetic restoration of a female hairline is dependent on accurately reproducing these features.
The mid frontal point or central point of the hairline is kept almost 5 to 6 cm from the mid eyebrow point. The implantation angle of hair follicles is at a much acute angle, almost parallel to the skin. The temporal mounds are convex. The temporal peak point is designed almost 1 to 2 cm above and behind the lateral canthus. The single thinned hair follicles are most anteriorly placed followed by a single hair follicles unit and behind this double to four hair follicles units are implanted to restore the hairline area. The strong multi follicular units are placed in the more aesthetically important area accept anterior hairline.
For female hairline design, Dr.J. Park has given the concept of 5A(area) and 5P(points).
His concepts provide much more details and more parameters to design female hairline. Dr.Garg follows the concept given by Dr. J.Park.
CASE I- Preoperative pictures showing the posteriorly place anterior Hairline and thinning in the frontotemporal area. The patient wanted to lower AHL.
The Hairline was Designed and Finalized
Around 2231 Grafts by Strip Methods were Harvested and Implanted. Results after 11 months.
CASE II – Female pattern hair loss with intact anterior hairline, but the density in hairline was low.