FUE for the repair of unnaturally designed or low hairlines in men with androgenetic alopecia: a retrospective, multicenter observational study

Hairline reconstruction in men with androgenetic alopecia is one of the most frequently requested and technically challenging procedures. Patients are often dissatisfied with designs that are too aggressive, straight, or rounded and may seek corrective surgery, which requires specialized planning and execution. We describe our approach using follicular unit excision to repair unsatisfactory hairline designs. A retrospective, multicenter observational study was conducted. A total of 20 men with a median age of 37.5 years who underwent follicular unit excision (FUE) repair of unnatural hairlines were included in the study. A serrated punch was used in 68.4% of cases, with a median size of 0.8 mm, and a single rotation movement of the extraction device was used in 70% of cases. The rates of total and partial transection were high. Approximately four out of five patients showed no visible scarring or pigmentary alteration at 6–12 months, and only 28% required a second corrective procedure. Patient-reported outcomes were highly favorable, with 95% expressing satisfaction or high satisfaction. FUE is a valuable and versatile technique for correcting poorly designed or excessively low hairlines. These results not only demonstrate the technical difficulty of these cases but also highlight that the majority of them can be successfully corrected with a single intervention. Corrective FUE is a practical and effective option for repairing an inappropriate hairline design when performed with meticulous attention to technical nuance.