This is a photo of a female patient who had a hair line lowering and rounding hair transplant surgery. This is sometimes known as forehead reduction surgery.

hair line lowering results

female hair line lowering before after photo


This patient did not like her square high forehead with receded corners.  She thought her hair line looked too masculine.  She considered a forehead reduction surgery to lower the hair line.  However, she was worried about the hair line incision scar.  She also wanted the hair line corners to be more rounded in appearance which a forehead reduction surgery could not achieve.


Forehead reduction surgery for women with a high forehead has been popular since the late 1990s.  Dr Sheldon Kabaker  in Oakland California is a well known and prominent surgeon who has been offering female forehead reduction surgery for many years.  It sometimes requires the use of tissue expanders to drastically lower one’s hair line.   Since 2006 Dr. Gal Aharonov in Beverly Hills California has been offering a slightly modified approach to the forehead reduction surgery.  His method has gained great popularity from all over the world.  With third party review sites such as, the hair transplant community saw a demand for women seeking an alternative to forehead reduction.  Potential problems of a forehead reduction surgery were the visibility of a scar along the hair line, and the limitations of creating an oval or rounded appearance.  While patients were happy with the drastic reduction in their forehead size, some were self conscious about their scar and would not wear their hair pulled back.  They addressed this with make up and sometimes a limited hair transplant procedure.

HAIR TRANSPLANT for hair line lowering:

An alternative for those women who did not want to undergo a forehead reduction surgery was a standard hair transplant procedure.  Hair transplant procedure involves harvesting donor hair from the back of the head to individually relocate single follicles to the front.  The limitations of a hair transplant procedure was that the results were not instantaneous. The transplanted hairs need to grow out from its roots. The advantage was a natural shaped hair line dictated by the artistry of the doctor creating the hair line.  There was no scarring along the hair line.

The results for this hair line lowering patient were achieved using Follicular Unit Strip Surgery (strip surgery) sometimes referred as Follicular Unit Transplant (FUT).   If Follicular Unit Extraction (FUE) method was used, it would have required shaving the back of the patient’s head.  This is something few women would accept. There is no shaving involved with the strip surgery and the incision around the donor area (back of head) is covered by the patient’s hair.  Even with the hair wet or hair up, the incision line (scar) will rarely, if ever be noticed.  This incision may be an issue for men who keep their hair very short.

scar of FUE versus Strip

FUE vs Strip scar on the day of surgery

If the incision is an issue for a patient, the alternative method of harvesting hair is known as Follicular Unit Extraction (FUE).  FUE harvesting is carried out manually by a highly trained surgeon or with an aid of the ARTAS robotic FUE instrument.  There are other machines available such as Dr. Harris’s SAFE system or the NeoGraft machine you may have seen advertised in airline magazines.  FUE method of donor hair harvesting may seem attractive for many patients because it is heavily marketed and advertised as a “no scar” surgery.  This is NOT an accurate statement and is shunned by doctors since FUE does leave thousands of permanent round scars.  Many patients have their FUE scars as well as strip scars camouflaged with Scalp MicroPigmentation.

FUE scar fixed with SMP

Moth Eaten appearance of a FUE scar Before and After SMP

This reinforces the fact that the latest technology and fancy robots are not always the best choice. For most women, a small linear scar on the back of their head may be a better option than shaving their head for thousands of FUE “dot” scars.  Think of a C-section scar under long hair vs a moth eaten appearance on the back of a shaved head.

According to RealSelf, the top 100 is awarded to RealSelf doctors for having an outstanding record of customer feedback and for providing credible, valuable insights in response to consumer questions about elective cosmetic treatments.

Reaself Top Doctor (TOP) is a recognition awarded to less than 10% of doctors on RealSelf. This status is earned by achieving high patient satisfaction (as reported in RealSelf reviews), getting favorable feedback on their expert answers, and after investing significant time answering patient’s questions in the community.

Dr. Rassman and Dr. Pak of New Hair Institute Medical Group in Los Angeles have a combined 35+ years in Hair Transplant Surgery and Scalp MicroPigmentation.

The doctors receiving this award were among the top 1% of our 13,000-member doctor community in 2015,” said Tom Seery, RealSelf founder and CEO.

RealSelf100_2015_TimesSquare top100

Dr. Jae Pak and Dr. William Rassman as Top 100 doctors featured in Time Square 2016



Even if your hair is thin all over how likely is it that you can give an appearance of thicker hair by moving some hair from less noticeable locations to the front?

This question covers a lot of territory:

1- If there is generalized thinning over the entire head and you are a male and the thinning is in the side and back of your head as well, you might have a condition called Diffuse Unpatterned Alopecia (DUPA). This condition is not good news, and these patients can not undergo a hair transplant as there is a poor donor area and therefore the doctor can not move enough good quality hair to cover the thinning area. Scalp micropigmentation (SMP) on the other hand, may be a good alternative (see:

2- If there is generalized thinning over the entire head and you are a female and the thinning is in the side and back of your head as well, you will not be a candidate for hair transplantation as the transplanted hair will have poor growth. Again as I said in #1 above, Scalp micropigmentation (SMP) on the other hand, may be a good alternative

3- If you are a male and you have thinning on the front, top and/or crown area and you are under 30 years old, the first treatment course we would be to try finasteride (Propecia) and give you a year to see if some of the hair thinning stabilizes or possibly reverses in some of these areas. If you stabilize or reverse the thinning process, hair transplants can be planned at that point in time if appropriate, however, you must work out the hair supply/demand issues with your doctor. Thinning in men evolves into balding and hair transplants do best in treating balding. When we perform a hair transplant on a young man, we advise the patient to use the drug finasteride to minimize any shock loss from the hair transplant surgery.

4- For women who do not bald but have thinning and a healthy donor area, the amount of hair that needs to be transplant may be limited by the size of the thinning area and the amount of hair one can transplant in a single session. If the thinning is great, the benefits of even a large hair transplant (say~ 2500 grafts) might not be enough to make an appreciable difference. In these situations, I might transplant a female in particular area (like the frontal area to strengthen the hairline or a central or right/left part to make the area look fuller). In this way there can be a partnership between styling and transplants. This is difficult to explain but worth a consultation with an expert in this field.

Most important, there is a balance between the demand for hair and the supply of hair as the doctor moves it around.

This patients Scalp MicroPigmentation SMP Review is a case of Alopecia Totalis. He has absolutely no hair on his body. Even his eyebrows you see in the photo is a prosthetic he glues on. SMP recreated a hairline and even his side temples. SMP even recreated a sideburn! Our website is

Scalp MicroPigmentation for Alopecia Totalis

Scalp MicroPigmentation for Alopecia Totalis

Scalp MicroPigmentation for Alopecia Totalis

Scalp MicroPigmentation for Alopecia Totalis

This is a young doctor who had a bad hair transplant in his 20’s and since then he has been forced to wear a wig / hair system which he was not happy with. He was worried about his professional image with patients and staff as the large scars on the back of his head showed if he cut his hair too short. His solution was Scalp Micropigmentation, to cover the scar and correct his hair line and side temple areas. After he had it done, he commented that his medical staff and his patients all love his new look. His scar may be noticeable in certain light and angles but it is not an eyesore as it use to be. He now will have the option to grow out his hair, if he wishes, using the SMP as a backdrop to make his hair transplant work look fuller.

NHI_SMP_to scar

New Hair Institute SMP Scar Concealment

NHI_SMP_side temples

New Hair Institute SMP Side Temples

NHI_SMP_bold hair line

New Hair Institute SMP Bold Shaved Look

The pictures say it all. The photo was taken before the final touch up to even out the hair line and evening out the SMP overall. Even before the final touch up you can see the dramatic change. His 10 year old boy commented, “Daddy, you have hair now!”.

NHI Scalp Micropigmentation before after

NHI Scalp Micropigmentation before after


Some people just want to keep their hair short. Some realize the comb over is not fooling anyone. They think about a hair transplant procedure but they realize they may not end up with a full head of hair with just one surgery (especially when they want to keep their hair short and they are completely bald Norwood 6). This corporate businessman in his late 30’s didn’t want to look like he was in his 50’s. He chose SMP.

NHI Scalp MicroPigmentation Before After

NHI Scalp MicroPigmentation Before After


Can I have a Scalp Micropigmentation (SMP) and later a hair transplant surgery? What if I want to grow out my hair as well? I don’t want to always keep my hair shaved.

You ask a great question! We have been combining SMP with hair transplant surgeries using FUE or Strip FUT. After all we are a medical practice that specialize in all aspect of hair restoration!

This patient came to us with a old hair transplant surgery scar. He had a strip FUT surgery which didn’t really give him a full head of hair and he just gave up with the idea of having a full head of hair. But he had the strip scar which he couldn’t hide when he decided to cut his hair short. So he went to local doctor for FUE to the strip scar. As we tell all our patients, FUE to the strip scar doesn’t really give perfect results when you are looking to shave your head. So he ended up with MORE SCAR, many ‘punctate scars’ from the FUE surgery. Needless to say he was angry and was very skeptical when he came to see us. We didn’t blame him. He didn’t trust any doctors at this point. Although Dr. Pak thought he would be a great candidate for the SMP procedure, he actually turned him down because the patient’s expectations seemed unrealistic with a bad attitude.

Eventually, the patient came back for another consultation and even saw other SMP patients in person at our monthly Open House Seminars (where prospective patients can meet with former patients and see an actual SMP or Hair Transplant surgery taking place).

This patient eventually had SMP to the entire scalp and covered his FUE scar and strip scar with great results. In the process he came to know and befriend Dr. Pak to trust his work. So after about a year he came back to Dr. Pak for a FUE procedure (about 1500 graft) to add density to the top and soften (corrective surgery) his front hair line from the old transplant work.

While the FUE transplant didn’t give him the full density, the SMP provided a cosmetic benefit to provide a look of fullness. Now he has the option to shave or grow his hair out long.

Old FUE and FUT Strip Scar addressed with SMP Scalp Micropigmenation

Old FUE and FUT Strip Scar addressed with SMP Scalp Micropigmenation

SMP Scalp Micropigment for a shaved look

SMP Scalp Micropigment for a shaved look

SMP Scalp Micropigment with FUE Hair Transplant for Fullness for Long Hair

SMP Scalp Micropigment with FUE Hair Transplant for Fullness for Long Hair

Can you have SMP to patchy areas on your face?

Here is an example of what we did for someone who was missing a patch of hair on the temple. It is known as triangle alopecia. While we generally can treat this with hair transplant surgery, this patient wanted a non-surgical approach using the SMP Scalp MicroPigment technique. He knows that he will need to keep his hair short on the temples to make it look natural (since SMP is not real hair).

Click on the photo for a larger image.

NOTE: This photo was taken immediately after the SMP session so you can see the redness on the scalp. The redness usually subsides in 1 to 2 days. He realized he needs to keep his hair shorter to achieve a blended look.

Tags: triangular alopecia, smp, scalpmicropigmentation

before_SMP_1 Before SMP

This patient talks about how others were upset that he was visiting a hair transplant clinic when he had so much hair! They didn’t know he had SMP.

head tattoo, not smp

This image was created by

head tattoo, not smp
Look at all of the tattoos shown here. Fascinating!

Tags: scalp tattoo