Study of frontal hairline patterns for natural design and restoration.

[OBJECTIVE] Hair loss is one of the most noticeable esthetic problems of the mankind. Hair transplantation has been a highly effective technique in reducing wide foreheads and recontouring the hairline. Creating a natural hairline is one of the most important elements of a successful hair transplant. This study aims at the requirements which are essential in designing hairline morphometrics and natural frontline.

[METHODS] Standard photographs of the forehead region were obtained from two hundred young Turkish adults participated in this study. The hairline contour was classified into five groups as round, M-shaped, rectangular, bell-shaped and triangular. Measurements of the forehead region, such as the height of the forehead, widths of the forehead and supraorbital region were calculated as reference points.

[RESULTS] In women, the average height of the forehead was 58.3 ± 6.6 mm, the average width of the forehead and the supraorbital region was 129 ± 14.4 mm and 125.3 ± 13.5 mm, respectively. The incidence of the hairline shapes was seen as; round (28%), M-shaped (19%), rectangular (30%), bell-shaped (5%), or triangular (18%). In men, the average height of the forehead was 61.4 ± 9.7 mm, the average width of the forehead and supraorbital region was 137.1 ± 18 mm and 133.9 ± 15.9 mm, respectively. The hairline contour among young male adults was classified as round in 27%, M-shaped in 46%, rectangular in 31%, bell-shaped in 4% and triangular in 2%. The rectangular and M-shaped hairlines resemble a more masculine appearance, whereas round shaped hairline resembles femininity.

[CONCLUSION] Ideal reconstruction of scalp defects relies on a comprehensive understanding of scalp anatomy and detailed information of patient factors. The classification of the hairline and measured forehead reference lengths will be beneficial in the correction of wide foreheads. There were significant gender differences in the esthetic rankings of the hairline contour. Compared to women, both of the measured average forehead reference lengths displayed a significantly greater value in men. Our results clearly showed that sex difference affected the predominance of the contour type. The M shape was the most common, and the triangular type was poorly classified in men, whereas the rectangular hairline was the most common type among women.