The interaction between art and science plays a very prominent role in achieving natural and aesthetically pleasing results in Hair restoration surgery.
It is essential that the surgeon and the patient understand the natural process of ageing and the way hairline changes with age. This is important in achieving an age specific and face specific hairline. In many ways hair restoration is a flawed science as we are trying to replace an area that had a lot of hair with a lot less hair. Hence it is important to strategize and make the best use of available hair.
Facial Aesthetics in humans is defined by the golden ratio. This number, universally recognized as ideal, is usually rounded to 1.62. It is also known as phi (Φ) in Geometry, Fibonacci numbers in India, feng shui in Asia, and divine proportion. This ratio 1:1.62 is nature’s symmetry and occurs naturally in life. Da Vinci himself used it when he drew the perfect human male body in his famous work the Virtruvian Man. The premise behind this is that the closer a face or object is to the golden number 1.62, the more beautiful it becomes. And hence a male ticking all the boxes close to the ratio, but with lack of hair can in theory be classified as unattractive.
The simplest formula to use is to measure the length of the face and divide it by the width at the widest part of your face. The closer this number is to 1.62, the more beautiful it is judged to be subconsciously.
Dr Stephen Marquartdt developed a facial mask as a measurement of classic beauty to help plastic surgeons align facial features for more symmetrical accuracy based on a series of rectangles, triangles and decagons. Lack of hair or a receding hairline can severely compromise the ratios.
In men however, we make use of the Golden ratio to define attractiveness in a different format called the Adonis Index. This index takes into account various features of the body like the width of the shoulders relative to the waist.
As a rule of thumb, we divide the face into three equal parts.
We divide the face into from the forehead hairline to a spot between the eyes, from between the eyes to the bottom of the nose, and from the bottom of the nose to the bottom of the chin. If the numbers are equal, a person is considered more beautiful.
When I consult my patients, I generally tend to qualify anywhere between 15-20% for a FUE hair transplant. This is primarily due to discrepancy between donor supply and demand to get a meaningful outcome.
However, what gets me excited is when I see clients with Norwood 3-5 presenting with a great donor area and a stable hair loss pattern. Under such circumstances, we can really utilise the principles of artistry and produce aesthetically solid results.
The factors I consider whilst assessing someone for the suitability of a FUE include,
Age
Stability of hair loss
Ethnicity
Facial characteristics
Tightness of scalp
Scope for future transplants
Expectations
Family history of hair loss etc.
I always insist that the client does sufficient research before undergoing a hair restoration surgery. It is one surgery that if performed poorly can lead to a lot of anguish with little room for repair. We live in a world based on evidence. Hence I always insist that the client does not buy everything that is promised. If it’s too good to be true, it sure is.
A well performed surgery can do wonders for your confidence and add a spring in your step. However, a poorly performed surgery can have disastrous consequences.
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