title: Use of nape and peri-auricular hair by follicular unit extraction to create soft hairlines and temples: my experience with 128 patients.
abstract: BACKGROUND
  Hairlines and temples can look unnatural due to coarseness of the safe donor area of transplanted scalp hair. Although the thinner caliber of nape and peri-auricular (NPA) hair would be ideal to create softer hairlines, they have not been used mainly because of concerns that they are nonpermanent.
  
  
  OBJECTIVE
  We assessed the outcome of NPA hair transplanted to hairlines and temples in selected patients.
  
  
  METHODS
  During November 2006 to November 2011, follicular unit extraction (FUE) transplantation using NPA hair was conducted in 128 patients following a shave test involving the visual evaluation of hair density and caliber of shaved head donor areas. The test was used to determine permanent versus nonpermanent donor areas. A questionnaire was sent to patients to assess satisfaction with their restored hairlines, with a follow-up questionnaire sent to those who initially responded.
  
  
  RESULTS
  Three-quarters of patients are good candidates for use of NPA hair to the hairlines and temples based on the shave test. Of 128 patients transplanted, 71% responded and reported a mean overall satisfaction of 8.3 (scale, 1-10). Patients saw full hair coverage at the recipient area at a mean of 9.6 months after surgery. Nineteen patients reported lost grafts. Thirty-three patients responded to a second survey and reported a mean overall satisfaction of 8.5 at an average of 4.6 years after surgery; only 5 (15%) new instances of graft loss were reported.
  
  
  CONCLUSIONS
  Soft, natural-looking hairlines can be created in select patients using NPA hair as a donor source by FUE hair transplantation.
  
  
  METHODS
  4 Therapeutic.
authors.affiliation: Dr Umar is a Clinical Instructor of Medicine, Division of Dermatology, Department of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA.
authors.forename: Sanusi
authors.initials: S
authors.lastname: Umar
mesh_terms: D000328:Adult; D000505:Alopecia / Q000601:surgery*; D004954:Esthetics; D005546:Forehead / Q000601:surgery; D006084:Graft Rejection / Q000453:epidemiology*; D006085:Graft Survival; D006197:Hair / Q000637:transplantation*; D018859:Hair Follicle / Q000637:transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D018579:Patient Selection; D012189:Retrospective Studies; D013518:Surgery, Plastic / Q000009:adverse effects / Q000379:methods*; D011795:Surveys and Questionnaires; D014182:Transplantation, Autologous / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult