Hi Docs, thanks for the great site, it really helped me figure out my options. I finally got a check on what I thought was a receding hairline after seeing my brothers lose their hair and after a couple of checks with a hair specialist in the UK I was told I have a matured hairline but no apparent signs of real balding, recession or minituarisation. I was told that there was no apparent need for me to use Propecia or Minoxidil. I am aged 32 now and my hairline looked to have matured by around 21 and hasn’t moved noticeably since then.

My question is that you tend to mention on this blog that a Norwood 2 is approximately a mature hairline and you don’t consider this male pattern balding from a surgical standpoint – but on your New Hair Institute site you show Norwood Class II patients and count that as hairloss that could be treated surgically? Would this be strictly for a cosmetic adjustment of the hairline? (I realise it’s all cosmetic surgery but as in there’s no balding to cover, just a hairline change). Although I’m happy with my hair more or less, I’d still prefer a slightly straighter (closer to juvenile) hairline as I have quite a high, thin forehead and I’d be interested in surgery simply as a cosmetic adjustment.

Thanks for any clarification.

Hair loss is not a medical illness. Hair transplant surgery is considered cosmetic surgery. If you want to enhance your appearance, it is your choice. So for those with a Norwood class 2 or a mature hairline which is more like an early Class 3 pattern, we can certainly treat it.

The point I generally make in my medical practice and here on BaldingBlog is to have open communication between the patient and doctor. We give our opinions on what may be too low of a hairline and how it may not be age appropriate, but in the end each and every patient has a right to choose their own “look” and hairline.

There is nothing wrong with, as you put it, a cosmetic adjustment.

We received a few comments and a bunch of emails from people with questions about the patient results we posted late last week, so I wanted to provide some follow-up info. Here’s a before/after (2781 grafts):

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The hairlines are always chosen by the patient in conjunction with the doctor performing the surgery. In this particular patient, I was the surgeon and we bonded well. His hairline was chosen to reflect my own individual hairline, a mature hairline in the truest sense of the meaning. I would put the hairline anywhere he chose, provided that it was a reasonable placement. In this case, the hairline was placed one fingerbreadth above the highest wrinkle of his furrowed brow. This man is in his 50s, but even if he was 25 years old this would not be an unreasonable hairline location. Hairlines should always stand the test of time.

Also, the fact that no one noticed the hair grow out is important. It is like watching grass grow — you never see it grow, but you see the change when you look back on the brown dirt where you placed the grass seeds. Hair is no different.

His results are typical for individuals with hair that is medium coarse character. He had no problem showing off his results, because he knew that he would be a good educational example for us. When he came to one of our Open House events prior to his surgery, he met with many patients who had results like he had, so a result like this was his expectation. Those expectations were clearly met.