Natural-Looking Hairline Restoration with Refined Hair Transplantation Techniques to Improve Facial Aesthetic in East Asian Females.

[BACKGROUND] An ideal hairline contour and balanced proportions of facial length have been referred as important components of a harmonious and attractive face. This study introduces a standardized procedure to restore a natural-looking and aesthetic female hairline with refined hair transplantation techniques.

[METHODS] A total of 36 female patients with imbalanced face contour who underwent hairline correction with refined techniques were included. In the frontal plane, widths and lengths of different anatomic landmarks were measured and reviewed. The patients' hairlines were designed to be more proportional with female hairline characteristics. Hair was harvested from occipital and post-auricular areas and then transplanted into the recipient area with progressive densities and appropriate directions. Follow-up evaluations were conducted for a year postoperatively by camera and measurement to observe face morphology change. The satisfaction with the appearance of hairline was scored before and after the surgery by both patients and the surgeon with a five-point Likert scale.

[RESULTS] Both patient Likert score and surgeon Likert score were significantly improved after the surgery. The proportion differences of facial length and width, difference between upper length and middle or lower length were significantly reduced after surgery. Of the 36 patients, 2 patients received a touch-up surgery to increase density in the frontal hair divergence. No significant complication as infection, scarring, or acute telogen effluvium occurred.

[CONCLUSION] For East Asian female with non-ideal facial proportion or face contour, this refined procedure could achieve aesthetic results in the hairline correction with natural -looking results and long-term patient satisfaction.

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