Enhancing Mid-Upper Facial Contours: Hairline Transplant Solutions for East Asian Women With High and Wide Foreheads

A high and wide forehead is a common congenital facial characteristic among East Asian women, often resulting in an imbalanced mid-upper facial proportion, diminished three-dimensional contour, and reduced femininity. Although this facial morphology is often congenital, such features frequently lead to appearance-related anxiety, affecting patients' confidence and social interactions.

This study aimed to investigate how a personalized hairline design strategy using follicular unit extraction (FUE), tailored to East Asian facial proportions, can enhance mid-upper facial contours in women with high and wide foreheads.

A total of 60 female patients with high and wide foreheads were enrolled, with a mean age of 33.3 ± 7.1 years. Preoperative measurements showed a mean mid-frontal height of 7.48 ± 0.46 cm and a mean intertemporal width of 14.66 ± 0.65 cm. On average, 3243 ± 1038 follicular units were transplanted at a recipient density of 50-60 FUs/cm². Postoperative assessments included improvements in forehead contour, naturalness of the hairline, and documentation of adverse events.

The average reduction in mid-frontal height was 1.33 ± 1.10 cm, and the intertemporal width was reduced by 1.47 ± 0.57 cm. On a 5-point Likert scale, the average satisfaction score for mid-upper facial contour improvement was 4.70, while the score for the overall hairline appearance was 4.52. Only minor postoperative discomfort was reported, with no severe complications observed.

Hair transplantation via FUE is an effective approach for improving mid-upper facial proportions in East Asian women with high and wide foreheads, resulting in a softer and more three-dimensional forehead contour. Surgical design based on East Asian facial and hair characteristics yields high patient satisfaction and favorable safety outcomes, supporting its broader clinical application.