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

[Dr. Lindsey]

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