Angle of Hair Transplantation

A good quality hair transplant procedure is combination of art, science and surgical skill. A person contemplating to undergo hair restoration procedure should know a little about the artistry involved in this procedure to have completely natural and aesthetically gratifying result.

Angle of Hair Transplantation

In a hair-transplant procedure, emphasis should be given to the natural hair angles and directions for optimal naturalness of the final growth as well as for an extremely good appearance of visual hair density.

What Is Hair Angle?

The hair angle refers to the degree of elevation of a hair as it exits the scalp, i.e., how much tilt upward or downward the hair graft is situated in relation to the scalp. This angle is usually 10 to 15 degrees in the frontal hairline.

What Is Hair Direction?

The hair direction refers to which way the hair points, i.e., whether the hair points toward the left or the right and the degree of deviation from the central antero-posterior line.

Angles and direction of transplanted hair in different scalp regions

Angles of hair transplantation depend on the region of the head to which the graft is to be implanted.

1.      Anterior hairline-: The angle along the frontal hair line ranges from 10 to 20 degrees. So the grafts should be placed at this low angle of 10 to 20 degrees and the direction has to be forward.

2.      The temple region-: The temple hairs have a very low angle which ranges from 3 to 10 degrees and vary in their direction and angles as one move around frontal temporal angle from the frontal arm where the hair point anteriorly to the temporal arm of this angle where the hair points posteriorly (backwards) in the temporal triangle and inferiorly (downwards) in the sideburn area. Similarly, the angles also vary from 10 degrees in the frontal component to as low as 3 degrees in the temporal component.

3.      The midscalp region: - The hairs in this region leave the scalp at an angle of 30 degrees in the frontal part and it increase to 60 degrees in the posterior part of midscalp. The hairs are directed anteriorly with gradual lateral fanning.

4.      The crown region: - The hairs in this region have a radial fanning with a whorl pattern and the angle ranges from 20-50 degrees. The upper half of whorl has medium to high angles (25 to 45 degrees) whereas lower half has angles ranging from 15-20 degrees. The hairs in the vertex spin tightly around a central point and then fan outwards. It is important to carefully observe the changing direction and flow pattern outlined by existing vellus hair. To yield a natural aesthetic result the number of hair grafts required are more and the surgeon needs to have good experience in vertex reconstruction.

Frontal forelock or cowlick

It is a challenging job for the surgeon if the hair in the frontal forelock (cowlick) is present. If the hairs are vellus (extremely thin and not growing) then this region should be completely implanted with the follicular unit grafts. However, if the hairs are thick and growing, the follicular unit grafts should be implanted in between the existing hair with extreme precaution to preserve the native hair.

Hair Curl

Careful attention should be paid to the curl of the hair in the graft. The curl must always curl down and into the skin in the same direction as the incision site. In our clinic, we take extreme precaution to maintain the curl downwards. This is made possible due to specialized implanters that are loaded in such a way that the curl of the hair is pointing into the cylindrical cavity of the implanter at the time of loading it with follicular unit grafts.