Follicular unit grafts during hairline lowering procedure

Question: I was told by another surgeon that follicular unit grafts can be done at the same session as the hairline lowering/forehead reduction. Do you do this? And how much is the additional cost

Answer: I will only do grafts at the same time as a hairline lowering if they are needed in front of the temple hair. This can contribute to narrowing of the forehead. A maximum of about 600 can be done with this concept. The grafts are taken adjacent to the hairline advancement incision ends which are in the temporal areas. No additional scars are thus created.

I am opposed to harvesting grafts from the back of the head in the same operation for 2 reasons. The first one being that an incision in the back of the scalp along with one in the front could cut off critical blood supply to the scalp (a terrible complication I once have consulted). The second is that I am concerned as where to put a large number of grafts. I would expect poor survival and compromise to the circulation to the front of the hairline scar if they are densely packed in the front. I have no problem with doing traditional follicular unit transplant grafts 7-9 months after the hairline lowering has healed in order to get further lowering, to reshape the front hairline or to hide a visible scar then the hair is very thin. To do the 600 grafts along with the hairline lowering would add approximately $ 2500 to the hairline lowering charges.

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