View Full Version : Dr. Lindsey discusses "Don't do this" hairline too low in young man

Dr. Lindsey
05-04-2015, 06:38 AM
Its been a few years but I have a few threads discussing how there are only really 3 big errors to avoid in picking a hair transplant surgeon. And careful research BEFORE you commit all but assures you won't have at least 2 of these. Scarring (number 3) can be a little unpredictable but you ought to be able to minimize your risk of terrible scars too.

So just to remind readers.

Mistake 1 is big scar. Careful surgical technique and strip width management usually limits significant scarring. Doctors have so many cases, that the prospective patient ought to be able to see a few examples of the doctor's own scar results at the initial consultation if not before by viewing the doctor's work on his website, videos, or forums. Simply stated, if you can't find any examples...ask to see some. I am very vocal and have posted numerous times that each and every year I get about 8 perfect scars that you can't see with a #1 cut, about 110 really nice scars that are easily covered with a #3 or #4, and 4 crappy scars that need a #4 or 5. And I honestly tell people I just am not sure of who will get those 4 crappy ones...or I wouldn't do them... So in general, the prospective patient ought to have an idea of what scar ranges he might get after the initial visit.

Mistake 2 is too little hair over too much bald head. This takes the form of either spreading out donor hair so as to try to give a little hair all over, or "preventative" hair transplants which some doctors say will let the patient avoid a big case and it can be repeated with future thinning, or the budget conscious patient/clinic trying to fit a surgery to a payment plan. Hair is like sex and money...for many people. You have to have enough to make you satisfied...and that means pack the area you are trying to address. If one doesn't have enough donor hair to do everything, its far better to do the frontal third well than to sprinkle a little hair all over. About half of the patients we see at an initial visit have figured this out, of the half that haven't I can convince half of them of this reasoning. The forums are pretty good at educating people on this one too.

And mistake 3 is putting the hairline too low, particularly in a young guy who wants to look like all of his other 25 year old buddies, but who has the genetic probability of losing a lot of hair. I see this one all the time. You buy a HT to last you decades, so the hairline has to factor in your supply of donor hair, your best "guestimate" of future needs and hairloss pattern, and avoid leaving you with a hairline that looks cool at age 25...but looks goofy at 40 or 50.

This young guy walked in last week with a full head of hair. I said "what are you doing here, you have more hair than anyone I've seen this month..." and he laughed and asked for FUE into a scar on his head.

"So how did you get your scar?"

"I had a hair transplant 4 years ago."

Now the kid looked fantastic, he needed absolutely no hair and had a hairline that looked fine at age 25, 30, or 40....so I figured someone just sprinkled hair around his thick hair covered top... and yes indeed he had a 4 inch by 1/3 inch scar on his right donor region from an 800 graft strip. (Mistake 1).

Then I get close to his head as he explains that he had the hairline done with 800 grafts...and I put on my glasses...and yep, you can see lots of sparse hair follicles placed too low on his head. I asked him if I could get a pic.

So I think we can improve his scar but he has limited options on this too low hairline. He can simply shave it every morning like he's been doing..which works quite well cosmetically. He can FUE them out..but that is a lot of little holes and I think the scars from them will be noticeable on his youthful skin... He can laser the hair, since he has really dark hair and light skin..but that could hit some of the good hair at his hairline and cause new hairline trouble. And he can electrolysis the hairs, which painful and not cheap, but that is probably his best option.

Anyhow, you younger guys...DON'T get your hairline made too low...plan for the future, and if you do do your hairline (and we do lots of hairlines in younger guys--but they are hairlines which have temporal recession and should "age" well) put enough hair in the hairline to make a hairline. I don't think 800 were placed in this young man's hairline but that is what he said he got.

4 pics, 3 with flash to show the dark dots, one without flash that is a little fuzzy but he'd shaved this area 2 hrs before the visit. Look not at the nice hairline but at the dots below where his grafts were placed.

If we do a scar repair on him, I'll try to get a better pic.

Dr. Lindsey McLean VA

05-04-2015, 08:27 AM
Hey Dr. Lindsey, thanks for the post, this is actually relevant and something I'm been confused about for a while.

You mentioned a hairline that would look cool at 25 but goofy at 40 or 50; what do you mean by this? Wouldn't that just be the same as any guy who doesn't have hair loss?

I just googled like "celebrity hairlines" and let's take these as examples:



Eminem is apparently 42 now; either no hair loss or he's had work done, but I think that looks perfect (his face is another story). But I wish my hairline were that shapely. So why hesitate to give a hairline like that to a patient at 25? Or do you mean you'd hesitate ONLY if you're expecting more, severe loss on that patient?

Or did you mean a different kind of hairline entirely or something?

Dr. Lindsey
05-05-2015, 06:38 AM
Boy he looks p'ed off about something...

No as to the "goofy look"...I see a number of guys each year who are now 40 to 50 but had an HT done in their late 20s or 30s...and had the hairline placed where all their friends had their hairlines at that age. Now as they are my age...they have this straight across the forehead hairline and 50 year old skin....and recession or thinning of the hairline behind that low hairline that they have to conceal or chase with surgery.

Simply remember you're likely to age...and you are buying a hairline that needs to look ok at 50 EVEN if you don't have a hairline at 25 and are getting a case at that age....you will age but those transplanted hairlines won't. So plan accordingly.

I hope that helps.

Dr. Lindsey

05-05-2015, 08:04 AM
I was always under the impression that committing to an HT meant that you would HAVE to get additional procedures, likely at least two of them (unless you were like 50 years old already). Are you saying that you try to make your procedures be more, let's say, "standalone" so that you're not expecting a person to REQUIRE future procedures? That even if he only ever got one HT, he'd be fine forever?

Since I'm a future one-of-those-guys (lol) who's considering an HT at age 30 and wants to go from about NW2 to the NW1 hairline in the pictures, and I...

1.) expect future surgeries and
2.) realize that in 15-20 years I may have a hairline lower and broader than most other people my age,

then donor supply willing, would you feel comfortable going ahead with that? Is there anything else I would need to know?

P.S. As far as #2 goes, David Bowie might be a little decrepit looking these days at 68, but I think he'd be 10 times worse without his hair!

Dr. Lindsey
05-05-2015, 08:14 AM
Some guys will get by with one case, most will need more... sorry to be vague but I can't predict...even family history is only a guess. What I'm trying to get at here is put the hairline where it will look good as you age. And if that is a higher hairline than you want at age 25...well that is the right thing to do. It is not the right thing to do to give a kid a low hairline with no discussion of how the face/hairline ages normally....which I end up seeing all to commonly. And some of those guys are kids I told NOT to do just this...they went elsewhere and got it, now are "up a creek" with limited options.


05-05-2015, 09:14 AM
Much appreciated!