Treatment of Hairline Distortion & Alopecic Scarring from Prior Cosmetic Surgery

The management of scarring from prior facial cosmetic surgery usually includes the restoration of the sideburn and other areas of distortions and the repair of alopecic scarring. Aesthetic restoration of the sideburn begins with the recognition of its natural appearance in terms of location, direction of hair growth, and feathered look. Of particular importance are the superior to inferior and anterior to posterior direction of hair growth and the fineness of the hairs, especially along the anterior and inferior borders. Areas of scarring, typically located in areas surrounded by hair, should be transplanted with larger grafts so that in the case that there is less than expected 90% of hair growth in the scar tissue, there is still the potential for sufficient coverage.

The technique of choice in these cases is follicular unit grafting (FUG) providing the 3- and 4- hair grafts for filling in the areas of scarring and the 2- and 3- hair grafts for augmenting density along the upper temporal and posterior side burn regions, and the finest 1-hair and occasionally 2-hair grafts for sideburn restoration and feathering along the leading edge of the restoration.

female hair restoration female  transplant hair

Before and after one hair grafting procedure to repair scalp scar.

Treatment for the Overly High Hairline

The hairline/advancement lowering procedure can lower the overly high hairline whether due to genetics, hair loss, or prior cosmetic surgery such as brow lifts. Most commonly, it is performed on women, where the high forehead can be shortened. In addition, it is possible to actually change the shape of the hairline, making it more oval or rounded by filling in the upper temporal/side regions, creating a more feminine appearance.

There are two techniques that can be used to advance the hairline, the most common is with hair transplants while the other is a surgical procedure that involves shortening the forehead while surgically moving the hairline forward. The hair transplant technique has many advantages as a technique for hairline advancement and as many as 2400 or more hair grafts can be placed in a single procedure with natural appearing results. The donor hairs come from the back of the scalp, which continue to grow from a lifetime. To provide a natural appearance, the hairs are transplanted primarily one and two at a time, with the finest hairs up front, the natural way the hairline grows.

The other hairline advancement technique is a surgical procedure that involves shortening the forehead while surgically moving the hairline forward. An incision is made along the front of the hairline, and sometimes along with shortening the forehead, the eyebrows can be raised up, if desired, so that a brow lift is performed. The result of this procedure is a fine line incision scar along the hairline which typically heals up to be barely if at all visible. This is definitely a bigger procedure than transplanting with hair grafts, but can be quite effective and produce rapid results.

hair restoration surgery for women female hair transplant

Before and after hairline advancement procedure of 1,900 grafts.

female hair transplant hair transplant for women

Before and after surgical hairline advancement and graft procedure.


The role of hair transplantation in women is becoming more recognized as an option in the treatment of the variety of hair loss conditions. Women are increasingly learning that they can benefit, as do men, from the newer techniques in surgical hair restoration. While there are certain inherent limitations in the results of hair transplantation for the treatment of FPB, it is my experience that, for appropriate candidates, these patients are among the happiest. For many of these women, the results of a relatively small number of hairs transplanted strategically into areas of maximum benefit can restore confidence and avoid the need for the wearing of a hairpiece or system.


Leave a Reply

Your email address will not be published. Required fields are marked *