Hairline Construction and Follicular Isolation Technique

FITLocks

What makes a transplanted hairline look authentic? Well, one could write an entire book on the subject. On a basic level, the frontal hairline should be a soft transitional zone of single hair grafts between the bald forehead and the denser population of hair behind it. The very leading edge of the hairline must be soft, irregular, and ill-defined. Since human beings tend to create patterns when perform repetitious tasks, it might be said that not only should the hairline be made irregular, it should be made “irregularly irregular.”

Assuming a mastery of hair restoration surgery, a surgeon should be able to meet the above criteria for hairline design using the FIT or STRIP. The question is: is using single hair grafts enough to ensure naturalness? We would argue that it is not.

The leading edge of a *natural* frontal hairline is made up of single hairs that have a smaller diameter than the hairs that are ordinarily harvested from the donor area. The diameter is typically small enough that the hair’s exit point from the skin is not easily discernable.

When hair is harvested via strip from the donor area, particular in patients with coarse hair, the singles are often too course. This results in an “un-soft” transition zone where the exit points of the hair can be noticeable or even distracting to the viewer.

FIT is a harvest technology whereby many of these “hairline stumbling blocks” can be overcome. Since we harvest FIT grafts one by one without a scalpel incision, we can cherry-pick softer hairs from virtually any area of the donor region. So, for example, if a patient has unsuitably course donor hair for hairline work in the traditional strip-excision-zone, we need to look for softer single hairs in the nape area and extract these via FIT.

Attached are some photos that illustrate the aesthetic differences between using FIT grafts versus and STRIP grafts in hairline construction. The patient in the pictures started his hair restoration with another strip physician. He came to Dr. Cole for FIT to add to the hairline and temples. Note the coarseness of the STRIP grafts and visibility of the exit points from the skin. In contrast, the new FIT hairline and temple augmentation, while only 6- months out, offers a softer and subtler effect.