Preface: Hair Restoration: A Sophisticated Art Form xv

Raymond J. Konior and Steven P. Gabel

Phenotype of Normal Hairline Maturation 317

William R. Rassman, Jae P. Pak, and Jino Kim

Hairlines change shape with age, starting at birth. A good head of hair is frequently present some time after ages 3 to 5 years. The look of childhood has its corresponding hairline, and, as the child grows and develops into adulthood, facial morphology migrate changes from a childlike look to a more mature look. This article discusses the dynamics of hairline evolution and the phenotypic variations of the front and side hairlines in men and women. A modeling system is introduced that provides a common language to define the various anatomic points of the full range of hairlines.

Phenotype of Normal Hairline Maturation 317

William R. Rassman, Jae P. Pak, and Jino Kim

Hairlines change shape with age, starting at birth. A good head of hair is frequently present some time after ages 3 to 5 years. The look of childhood has its corresponding hairline, and, as the child grows and develops into adulthood, facial morphology migrate changes from a childlike look to a more mature look. This article discusses the dynamics of hairline evolution and the phenotypic variations of the front and side hairlines in men and women. A modeling system is introduced that provides a common language to define the various anatomic points of the full range of hairlines.

Imposters of Androgenetic Alopecia: Diagnostic Pearls for the Hair Restoration Surgeon 325

Nicole Rogers

It is crucial that hair restoration surgeons understand the basic clinical diagnosis and pathologic condition of other hair loss conditions that are not always amenable to successful hair transplantation. In this article nonscarring and scarring mimickers of androgenetic alopecia are discussed. Nonscarring conditions include alopecia areata, telogen effluvium, and tinea capitis. Some of the more common scarring alopecias include lichen planopilaris, frontal fibrosing alopecia, and central centrifugal cicatricial alopecia. Less common inflammatory conditions include pseudopelade of Brocq, discoid lupus erythematosus, and folliculitis decalvans.

Nonsurgical Therapy for Hair Loss 335

Aron G. Nusbaum, Paul T. Rose, and Bernard P. Nusbaum

This article is an update of the currently available options for medical therapies to treat androgenetic alopecia in men and women. Emerging novel therapeutic modalities with potential for treating these patients are discussed. Because androgenetic alopecia is progressive in nature, stabilization of the process using medical therapy is an important adjunct to any surgical hair-restoration plan.

Patient Selection, Candidacy, and Treatment Planning for Hair Restoration Surgery 343

Raymond J. Konior and Cam Simmons

Patient consultation, examination, and selection are crucial for successful outcomes in hair restoration surgery. The hair restoration surgeon must take a holistic approach in identifying those patients who are and who are not candidates for surgery. In this article, an overview of the consultation, pertinent physical examination features relating to patient candidacy, and several treatment paradigms are discussed. Additionally, those findings that may lead to poor results and conditions that are contraindications to hair restoration surgery are reviewed.

Hairline Design and Frontal Hairline Restoration 351

Ronald Shapiro and Paul Shapiro

The authors’ techniques for creating a natural frontal hairline are presented in a video that accompanies this article

Creating a natural hairline is one of the most important elements of a successful hair transplant. This article discusses the key skills needed to design a natural hairline. These are locating borders of the hairline as well as understanding and being able to mimic the visual characteristics of a hairline. Methods to locate the major borders and how to adjust them based on donor/recipient ratio are discussed. The visual characteristics of different hairline zones are described as well as techniques to recreate these characteristics using follicular unit grafting.

Graft Harvesting and Management of the Donor Site 363

Kenneth A. Buchwach

The strip technique remains the most popular method of harvesting grafts. The challenge in every patient is to maximize the number of grafts while minimizing the scar. Fortunately, there are many ways to ensure that the donor site will be inconspicuous. This article reviews the details of planning for follicle graft harvesting, including formulae for assessing scalp laxity and calculating strip dimensions. The procedure is discussed in detail, from preparation of the donor site and estimation of graft total through closure of the incision. The author presents his preferences for the technique with rationale and surgical tips.

Follicular Unit Extraction 375

James A. Harris

The purpose of this article is to introduce the reader to the topic of follicular unit extraction (FUE) and to present an overview of the value of FUE to patients and physicians. In addition to this, the various methods and instrumentation for performing this method of graft harvest are discussed as well as some of the technique’s inherent advantages and disadvantages. Topics unique to FUE, including body hair grafting, plug/minigrafts repair, and donor area management are addressed as well.