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Aesthetics & Hairline Design in Hair Transplantation


Dr. John Cole

Reprinted with permission by Dr. John Cole
www.forhair.com

John P. Cole, MD

Beginners' workshop

Aesthetic is from the Greek meaning Things perceptible by the senses. Aesthetics is defined as the science of the conditions of sensuous perception.

Therefore when recreating the hairline we must achieve an aesthetic result that appears as natural when viewed by the eye. Nature must be recreated.

However before we undertake this we have to judge the patient’s expected degree of hair loss during his life and the limits of his donor hair. Age is a factor. The earlier he starts to go bald the more severe his hair loss may become as he grows older. The younger the patient the more demanding he may be. He often wants a lower hairline that may not suit him as he grows older. He may run out of donor hair.

Much time may be required to explain all this to him and to reach a satisfactory compromise.

Many people such as Norwood, Carlos Uebel, Ron Shapiro, and Dow Stough have described the hairline placement in the past and this talk would not be complete without mentioning them.

The words saw tooth, zigzag, no hairline and the rule of thirds have all been used.

What is a hairline? It is not a line like a brick wall. It is a zone of irregularly placed hairs gradually increasing in density as we move superiorly. However there are some constraints in its creation.

  • The hairline is 8-9cm above the glabella
  • The recession at the temples is in line vertically above the lateral canthus of the eye.
  • The line joining these two points when viewed from the side is horizontal.
  • There is a widow’s peak of some degree.
  • There are two lateral peaks
  • There are some irregular hairs in the front hairline.
  • The artistry comes in being able to create the irregularity prevalent in nature together with the above constraints to aesthetically frame the face.

The ultimate compliment was offered from a bikie patient thrilled with the result. I had given him back the hairline he had in his mug shot in 1982!

Some time ago I devised a method called the snail track technique in which I use two lines to create pockets into which I place different densities of hair.

Snail Track Design

The size of the widow’s peak and lateral peaks vary in families, ethnic groups and hair colour. In summary the hairline placement is an important and integral part of hair transplantation. If in doubt as to
the placement, place it high as it can always be brought  forward later.

John P. Cole, MD

Information about this article

Article #  299
Title Aesthetics & Hairline Design in Hair Transplantation, Dr. John Cole
Date 09/27/04
Source Reprint with permission from
Dr. John Cole, www.forhair.com
Forum Hair Transplant
Archive Hair Transplant
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