Temporal Hairline Research Articles

Hairline indicators of craniofacial clefts.

The review of a complete series of Tessier craniofacial cleft patients presenting to the South Australian Cranio-facial Unit has identified within the hairline a regular marker of clefting. Tongue-like projections of the temporal and frontal hairline pointing in the direction of their respective clefts have been identified for Tessier clefts numbered 7 to 14. No hairline indicator was revealed in "southbound" clefts numbered 0 to 6 without "northbound" extension. The hairline markers of laterally and superiorly bound clefts are a complementary element of the Tessier classification system.

Male face lift in continuity with lower blepharoplasty.

Rhytidectomy in the male is always more complicated than in the female. We present important modifications of the usual female-type face lift procedure that solve problems peculiar to the male patient. We describe a combined procedure of male rhytidectomy in continuity with the lower blepharoplasty incision. This technique increases the aesthetic results significantly. It provides an increased mechanical advantage in rotation and elevation of the cheek flap which is necessary to correct adequately the frequent redundancy and marked sagging in the lower face and neck often witnessed in the aging male patient. The preauricular non-hair-bearing portion of skin is left undisturbed with no change in the appearance of the sideburn. There is no elevation of the temporal hairline. The operative technique is fully described with emphasis on the complications we observed and how to avoid them. The results presented justify the slightly visible scarring that may occur in the temporal area which heals extremely well and is very acceptable aesthetically.

Face-lift stigmas.

In this analysis of postoperative results in rhytidoplasties, the author points out some characteristics that announce the operated face. These characteristics include: retraction and elevation of the temporal hairline; straightening of the eyebrows; serious preauricular scars; deformation of the tragus; frequent hypertrophic scars in the mastoid region; and unevenness of the retroauricular hairline. These stigmas are sometimes unavoidable, depending on the patient's anatomy and the extent of the surgical procedure required to achieve the aimed-for young look. They can be improved, however, if one utilizes some alternative technical procedures and carefully observes each individual patient, avoiding the undiscriminating use of the same technique in different cases.

Hairline aesthetics and styling in hair replacement surgery.

Punch grafting and flap surgery are proven methods of correcting baldness. Using either method, the location and shape of a new hairline on the frontal and temporal scalp is one of the most important aspects of hair replacement surgery. If the hairline is not aesthetic, the results can be unacceptable or even devastating for the patient and surgeon alike. The principles of planning the frontal and temporal hairline are presented using punch grafts as well as flaps. Postoperative styling of the "new" hair will vary depending upon the method used to transfer the hair (flaps or grafts), the local factors involved (texture, direction, density, tufting, etc.), as well as the patient's preference. The various advantages and disadvantages of styling possibilities with each method are presented. These factors should be discussed with the patient preoperatively.

Preservation of the female sideburn.

Routine face-lift incisions in the temporal hair line may be unsatisfactory because of one or all of the following reasons: Production of an area of baldness immediately in front of the ear; presence of wide unsightly scar in the temporal hairline; loss of hair in the temporal area; and disfigurement of the temporal hair and sideburn. In order to conceal the deformity, the patient is limited to certain hairstyles. The problem is exaggerated in patients with sparse hair or who undergo a secondary rhytidectomy. A solution is an incision at or in the edge of the hairline in the temporal hairline. The technique has been used in over 200 patients during the past 3 years with excellent results. Specific points including location of incision, caveats in technique, and pre- and postoperative results are discussed.

Reconstruction of the temporal hairline

Reconstruction of the temporal hairline is usually discouraged because of unsuccessful results. A technique using punch hair grafts and “micrografts” is presented that has shown good cosmetic results.

MALE PSEUDOHERMAPHRODITISM DUE TO STEROID 5α-REDUCTASE DEFICIENCY

PETERSON, RALPH E.; IMPERATO-MCGINLEY, JULIANNE; GAUTIER, TEOFILO; STURLA, ERASMO Author Information

Male pseudohermaphroditism due to steroid 5α-reductase deficiency

A new inherited form of male pseudohermaphroditism has been investigated in a pedigree of 24 families with 38 affected males. At birth, the affected males (46 XY) have a clitoral-like phallus, bifid scrotum and urogenital sinus. The testes are in the inguinal canals or labial-scrotal folds. The Wolffian structures are normally differentiated; there are no Mullerian structures. At puberty a muscular male habitus develops with growth of the phallus and scrotum, voice change and no gynecomastia. The subjects have erections, ejaculations and a libido directed towards females. They have decreased body hair, a scant to absent beard, no temporal hair line recession and a small prostate. Testicular biopsy reveals a normal testis. The mean plasma T levels in affected adults are significantly higher, and the mean plasma DHT levels are significantly lower when compared to those in normal subjects. The plasma T:DHT ratios range from 35 to 84 compared to 8 to 16 in normal subjects. After the administration of hCG, the T:DHT ratios in affected male children range from 74 to 162 compared to 3 to 26 in the control subjects. In affected adults, mean plasma LH and FSH levels are significantly higher than in normal subjects. In the affected subjects, the metabolic clearance rates of T and DHT are normal, but the conversion ratio of T to DHT is less than 1 per cent. The endogenous mean urinary E:A and E-OH:A-OH ratios, and the urinary E:A and E-OH:A-OH ratios after the infusion of radioactive T are significantly higher than in normal males. Inheritance is autosomal recessive with some sibling sisters showing the same biochemical defect, and obligate carrier parents showing an intermediate defect. These data support our thesis that the defect in these male pseudohermaphrodites is secondary to decreased steroid Δ 4-5α-reductase activity. The affected subjects provide a clinical model for delineating the roles of T and DHT in sexual differentiation and development. This entity also demonstrates an inherited disorder of steroid metabolism in which the basic enzyme deficiency resides in the target tissues.