Hairline Calibration – A Key Step in Aesthetic Anterior Hairline Design

Hairline calibration is a key step in designing an esthetic anterior hair line (AHL).[1] The AHL separates the face from the scalp and defines the forehead. Although there are many variations in facial structures and features, the most attractive faces of all time — including our own — abide by the golden ratio (phi). Thus, it is important to design the AHL with a good aesthetic balance of the proportions of the entire face.

When determining the best AHL, a plastic surgeon must take into consideration not only the face structure but also the hair density, pattern and length. In addition, the plastic surgeon should ensure that a new hairline is not only aesthetically pleasing but sustainable over time.

A patient who came to Modena Hair Institute was suffering from androgenetic alopecia, a condition that results in gradual, progressive hair loss. The goal of his treatment was to re-establish an esthetic frontal hairline using follicular units extracted from the back of the head. The result was a natural, soft, feathered and irregularly broken-up AHL that will allow his hair to grow freely in the future.

The first step in AHL lowering is to check scalp laxity by performing a simple maneuver with the fingers. A point is chosen over the glabella and then moved superiorly by the fingertip. If sufficient scalp laxity is not present, a galeotomy can be performed to loosen the tissue and raise the AHL.

Adding to the complexity of the task is the fact that the reticles used for linear measurements (Standard Scale, Crosshair and Pinwheel) must be calibrated in order to measure accurately. In addition, grid reticles (Squared Grid, Counting Grid and Concentric Circles) need to be calibrated to measure precisely.

A hairline that is too high can make the forehead appear disproportionate and unbalanced. It is recommended that a female hairline be lowered to between 5 to 6.5 cm from the glabella to maintain a proper facial ratio.