Eyebrows play a defining role in how the face is perceived. They frame the eyes, influence expression, and contribute to a sense of identity that is often underestimated until it is lost. Whether due to overplucking, genetics, or medical conditions, thinning or absent brows can significantly affect how a person feels about their appearance.

At the Lam Institute for Hair Restoration in Dallas, Dr. Sam Lam approaches eyebrow restoration with the same philosophy that guides all of his work: precision, artistry, and long-term, natural results. As a globally recognized hair restoration surgeon, Golden Follicle Award recipient, and author of the only multi-volume FUE textbook series, Dr. Lam focuses on restoring what is naturally yours rather than creating something artificial.

When it comes to choosing between microblading and surgical eyebrow restoration, the right answer depends on your goals, expectations, and willingness to pursue a permanent solution.

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What is Microblading?

Microblading is a form of semi-permanent tattooing that simulates the appearance of eyebrow hairs by depositing pigment into the skin. It is designed to enhance shape and density visually, typically lasting one to two years before requiring touch-ups. While it can be an effective option for some individuals, it remains a surface-level solution that does not involve actual hair growth.

Dr. Lam does not perform microblading but can recommend trusted providers in the Dallas area.

How Dr. Lam Takes Eyebrow Restoration to the Next Level

Surgical eyebrow transplantation is one of the most technically demanding procedures in hair restoration. It requires not only the placement of individual hairs, but also careful attention to the direction, angle, and flow of each graft. Even small deviations can produce results that appear unnatural and are difficult to correct.

Dr. Lam performs eyebrow restoration using advanced follicular unit extraction (FUE), harvesting individual hair follicles from the back of the scalp and transplanting them into the brow with meticulous precision. Every graft is placed to follow the natural curvature and orientation of eyebrow hair, ensuring that the result blends seamlessly with the surrounding features.

Eyebrow shape is not one-size-fits-all. It varies based on gender, ethnicity, facial structure, and personal preference. Dr. Lam works closely with each patient to develop an individualized design that enhances the eyes and restores facial harmony. The result is not just fuller brows, but a more balanced, natural-looking face overall.

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Can Microblading Be Combined With Surgical Eyebrow Restoration?

In some cases, yes. Patients who have already undergone microblading or permanent makeup may choose to keep it as a background layer and have hair transplanted over it to create a more natural, three-dimensional appearance. Others may prefer to remove the pigment first and start with a clean slate. The right approach depends on the existing shape, color, and your overall aesthetic goals.

Learn More With Dr. Lam

Choosing between microblading and eyebrow restoration is not about which option is universally better, but which is right for you. Dr. Lam takes the time to evaluate your concerns, discuss your goals, and recommend a solution that aligns with a natural, long-term outcome. To learn more about eyebrow restoration in Dallas, schedule a consultation with Dr. Sam Lam at the Lam Institute for Hair Restoration.

Hair loss is rarely just a physical change. For many people, it reshapes how they see themselves in the mirror, how they move through a room, and what they allow themselves to do — or avoid doing — each day. Whether it’s skipping photos, rethinking a hairstyle for the hundredth time, or simply feeling like a stranger in your own reflection, the emotional weight of hair loss is real and significant.

At the Lam Institute for Hair Restoration in Dallas, Texas, Dr. Sam Lam has built a practice around the understanding that restoring hair means restoring the person. As a Golden Follicle Award recipient and the author of the only multi-volume FUE textbook in existence, Dr. Lam is one of the most recognized hair restoration surgeons in the world. The following patient stories reflect what that level of care looks like in action.

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A Subtle Change That Made a Big Difference – Case #98609

For Sky, a 40-year-old woman from Chicago, the decision to pursue eyebrow restoration came down to one simple frustration: she was tired of feeling like she couldn’t leave the house without her brows on. A product of the 90s overplucking era and someone who doesn’t wear much makeup, she had spent years relying on a daily routine just to feel presentable for something as ordinary as a grocery run.

One day after her eyebrow transplant, Sky described her pain as a one out of ten. She was eager to get home and watch the healing process unfold. Her before and after at one year speaks for itself.

Restoring Density, Not Just Hair – Case #103326

This 64-year-old patient came to Dr. Lam with hair loss stemming from a brow lift scar, hormonal therapy, and female pattern hair loss — a combination that had caused significant thinning along the front and sides of her scalp. At seven months post-procedure, she described watching the growth come in gradually, noting that the new hairs were still fine baby hairs but already looking full. “It’s getting better and better,” she said. She was delighted and newly able to wear her hair back, something that hadn’t been an option before.

Reframing the Face with Hairline Restoration – Case #101516

For this 48-year-old patient, six months after FUE to the frontal half of his scalp, the most telling sign of success was the absence of any reaction from the people around him. Nobody said a word — not because they weren’t looking, but because it didn’t look like he “had work done.” Dr. Lam walked through a close-up comb through of the grafted area on camera to illustrate the point: grafted and non-grafted zones are indistinguishable, the hairline natural from every angle and distance.

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Why Patients Travel to Dallas for Hair Restoration

Hair restoration treatments typically require only a brief stay in Dallas. For many patients, the confidence of working with a surgeon of Dr. Lam’s caliber makes the trip an easy decision. His Joint Commission-accredited facility, boutique one-surgeon model, and IV sedation protocol set a standard of safety and comfort that is rare in outpatient hair restoration.

What to Expect at Your Consultation

Dr. Lam personally evaluates every prospective patient — analyzing hair loss pattern, donor density, scalp characteristics, and long-term trajectory. He discusses your goals honestly and builds a plan around what will actually serve you well, not just what’s easiest to perform. Approximately one-third of prospective patients are counseled toward alternatives, reflecting his commitment to outcomes over volume.

Combining Hair Restoration With Facial Rejuvenation

For patients also considering facial procedures, Dr. Lam’s sister practice, Lam Facial Plastics, offers a full range of facial rejuvenation surgery, including blepharoplasty, brow lift, and deep plane facelift. Coordinating hairline restoration with facial work yields a harmonized result — addressing the face as a whole rather than in isolated parts.

Schedule Your Consultation

If you’re ready to explore what’s possible, contact the Lam Institute for Hair Restoration to schedule a personal consultation with Dr. Sam Lam. For those also interested in facial rejuvenation, Lam Facial Plastics is available at the same location. Natural results, individualized planning, and a team that genuinely cares about your outcome — that’s what every patient who walks through the door receives.

People constantly ask me, “How do you fit painting, exercise, language learning, and everything else into your schedule?” I get this question so often that I decided to break down my approach in detail. My system revolves around maximum efficiency, strategic multitasking, and what Tony Robbins calls “NET”: No Extra Time. NET is about transforming dead time into productive moments. You’ll see how I apply it throughout my day.

The Foundation: Consistent Sleep Schedule

Every single day, I’m up at 5:30 AM. My internal clock is so calibrated that I don’t need an alarm. The key here is maintaining this schedule even on weekends. When you sleep in on Saturday and Sunday, you create sleep latency – essentially jet lag within your own week. Your Monday becomes that much harder.

Now, I’m not suggesting you become so rigid that you miss out on life’s special moments. If a celebration or important event will keep me up late, I’ll gladly make that choice. The goal isn’t to become a robot, but to create a foundation of consistency that actually enhances your freedom and energy levels.

Morning Efficiency: Exercise and Creative Time

The moment I wake up, I head straight to my home gym. This setup alone saves me what used to be 45 minutes round-trip of driving, parking, and transitioning to an external gym. To maximize this efficiency, I sleep in my workout clothes and place my gym socks directly in the workout space the night before. My gym sits next to my bedroom, eliminating any friction that might tempt me to skip a session.

My exercise routine follows the American Heart Association’s minimum guidelines of 2.5 hours weekly, but I’ve structured it strategically: 30 minutes of treadmill on Monday, 30 minutes cycling on Tuesday, 20 minutes of rowing on Wednesday, weight training Thursday through Saturday with varying durations, and complete rest on Sundays. When I know travel will interrupt this schedule, I simply extend other days to maintain my weekly commitment.

Here’s where NET comes into play beautifully: those 45 minutes I saved by eliminating gym commute time? That becomes my daily painting window at 6:00 AM. Every morning, I’m in my art studio (also strategically located near my bedroom) with brush in hand. But I’m not just painting — I’m simultaneously absorbing podcasts, news, or any other educational content that feeds my mind and keeps me in tune with current events.

Nutritional Strategy and Morning Prep

At 6:30 AM, I shift into breakfast preparation mode. My morning meal consists of carefully selected nuts, seeds, and supplements designed to support my overall health. Even this 10-minute preparation window becomes productive time as I continue listening to enriching content. I’ve learned to drink my nutritional shake while showering and getting dressed, eliminating the need for dedicated consumption time.

Commute as Classroom

My drive to work transforms into language learning time. The mental stimulation helps maintain cognitive sharpness and adds an element of fun to my commute. I rely on Pimsleur, which I’ve found to be the most effective method for rapid language acquisition.

Over the years, I’ve tackled French, German, Spanish, Italian, Greek, Chinese, Japanese, Portuguese, and Russian through this system. However, I must emphasize – don’t attempt this if you’re not naturally adept with languages. Safety always comes first, and I don’t want anyone having accidents because they’re trying to conjugate verbs while navigating traffic!

When I’m not studying languages, my commute becomes time for podcasts, audiobooks, or spiritual content that continues my morning learning momentum.

Sacred Time: Spiritual Practice

Once I arrive at work and complete my patient consultation and surgical marking, there’s typically a 30-minute preparation window while my nursing and anesthesia teams ready the patient. I retreat to a quiet back room for Bible reading and prayer.

I’m reading through the entire Bible with my church congregation this year. This time remains absolutely sacred and non-negotiable. On Fridays when my schedule starts later at 8:30 AM and I don’t have surgery, I deliberately arrive by 8:00 AM to preserve this crucial 30-minute spiritual window.

Surgical Efficiency: The RLF Principle

During procedures, I employ RLF (rate limiting factor) analysis. I continuously anticipate 5-10 minutes ahead, ensuring my team understands upcoming instrument needs, suture requirements, and procedural steps.

I never rush and I remain methodical in every movement, but I ensure everything I need is ready before I need it. For example, while harvesting fat for transfer procedures, my staff begins processing while my second assistant and I work on the blepharoplasty portion. By the time fat processing is complete, we’re ready for injection without any waiting period. If processing runs behind, we seamlessly transition to the neck portion of the procedure.

Maximizing Micro-Moments

Throughout each day, I’m constantly identifying tiny windows of opportunity. When a patient runs 10 minutes late, that becomes 10 minutes to write blog content, create and upload videos, or handle correspondence.

This is where my lunch strategy becomes crucial: I practice intermittent fasting on weekdays, skipping lunch entirely. This serves dual purposes.

First, those lunch hours become dedicated academic work time. During these windows, I’ve completed countless interviews promoting the ISHRS Congress, finished lecture presentations, managed extensive email correspondence, and tackled various projects. My most recent textbook, published in 2023, was completed almost entirely during these “found” moments: lunch hours, travel time, early mornings, and other brief windows throughout the day.

Second, if I’m performing a lengthier procedure like a facelift or fat transfer, I would be stuck eating lunch at 2-3 PM, disrupting my evening dinner schedule with family.

Family First: Protecting What Matters Most

When I leave the office, my focus shifts completely to my family. This precious time remains almost entirely protected from academic and business intrusions. While I do serve on three boards that require quarterly meetings (and occasional academic responsibilities arise), I’m strategic about scheduling these commitments to minimize family impact.

I’m reminded of a textbook dedication I read years ago from a co-editor who wrote something like, “To the family I have not seen, thank you for allowing me to write 23 books.” That was very sad to me. Even before I had my own family, I knew that wasn’t the path I wanted to take.

With my own children, I’m even more committed to this principle. I’ve managed to write 12 textbooks while maintaining strong family relationships, proving that efficiency and productivity can actually enhance rather than diminish the quality of our personal time.

Evening Routine: Decompression and Connection

My evenings are designed around family connection and healthy decompression. I’m typically home between 5:00 and 5:30 PM, excited to enjoy quality time with my wife and kids. These moments are the highlight of my entire day.

My wife and I prepare healthy dinners together, creating space to relax and connect after our respective days. However, Friday nights are date nights where we venture out to explore our favorite restaurants instead of cooking at home.

By 9:00 PM, we’re settling in for the evening, and I’m consistently asleep between 10:00 and 10:15 PM, seven days a week. This gives me approximately 7.5 hours of sleep, perfectly positioning me for that next 5:30 AM wake-up.

The Philosophy Behind the System

What I’ve described might seem incredibly regimented, but the opposite is actually true. This structure creates freedom. By maximizing efficiency in certain areas, I’ve made space for what truly matters: meaningful work that helps my patients, creative expression through art, continuous learning, spiritual growth, and deep family connections.

The system works because it aligns with my values rather than fighting against them. Every “efficient” choice I make serves a larger purpose of creating time and energy for the people and activities I love most.

Transform Your Confidence Today

The same meticulous attention and systematic approach I bring to life optimization guides every hair restoration in Dallas procedure I perform. If you’re ready to address hair loss with a solution that respects your busy lifestyle, let’s discuss how modern techniques can restore your hairline and confidence. Schedule your consultation at the Lam Institute for Hair Restoration today to explore how we can efficiently deliver the natural-looking results you deserve.

There is a rising tide of polycystic ovary syndrome (PCOS) in the world over the past decade that may be related to diet, environmental toxins, or other unknown causes. For whatever reason, PCOS has become more prevalent and is plaguing women in many ways, one of which is hair loss. PCOS is a condition that manifests as having multiple cysts on the ovaries, which can lead to a production of excessive androgens, that can in turn worsen hair loss, usually androgenetic hair loss, or a male-type of hair loss pattern. Although there is no definitive cure for PCOS, there are many ways to at least reduce or manage the symptoms including hair loss issues.

There are essentially three different ways (all of which can be important) to manage PCOS’s effect on hair loss in my opinion. First, the overall condition of PCOS can be improved with trying to reduce the toxin load on the body. That goal can be accomplished through improved diet, in particular low-glycemic foods including whole grains, legumes/vegetables, nuts/seeds, and fruits. Of course, as a hair surgeon, I am not the best person to offer that advice but I am a big fan of dietary improvements, as I was losing hair in my crown 15 years ago when I was 30 pounds overweight and have kept that weight off and my hair has fully restored since then with no ongoing therapies. Of course, stress reduction, exercise, etc., are all important ways to control the disease. The second major way to manage PCOS’ effect on hair loss would be biochemical therapies that target the excess androgen and insulin resistance. For example, spironolactone (an antiandrogen), metformin (an diabetes medication to control insulin issues), and oral contraceptives can be important. Again, as a hair surgeon, I will not be prescribing these medications but your general practitioner or ob-gyn will most likely be involved in helping you or an endocrinologist.

The third method to work on PCOS would be natural therapies that target the hair loss in a unique fashion. These are the innovations that I have come up with that are the focus of this blog. I have devised a technique using hyper-dilute Botox to work on managing the condition along with some of its untoward effects like hair loss, emotional issues, etc. It is a technique that I am in the process of patenting and I am almost two years into the process, so I cannot discuss the exact method that I am using to manage this condition in this blog but suffice it to say that it is very effective and can be part of a global strategy to improve the hair loss effects of PCOS. Another very potent therapy that can be instrumental to manage hair loss in patients with PCOS is hair stem, which involves very high concentrations of plant-based, bio-identical growth factors delivered to the scalp without needles or pain. The results I have seen have been stunning and fast with a success rate of 80 to 90% that are observable within 2 to 3 months. With the advanced technology/machinery that I use for my hair stem therapies, I can deliver transdermal (through the skin) penetration with no needles, pain, or recovery in as little as 60 minutes. Finally, I have invented a product called Folliflo purchasable in my office or on Amazon that consists of a shampoo, conditioner, and conditioning serum spray. It is all natural and plant based. I just completed a double-blind, prospective, placebo-controlled, two-arm study that shows significant improvement in hair shedding and hair density in women with shedding and thinning hair. I can’t wait to publish and present the data. All of these therapies are synergistic, that is, they work well together for optimal results, especially when combined with improving lifestyle and overall health for individuals with PCOS. These supportive natural therapies are truly revolutionary and can be part of any treatment that I offer to help sufferers of PCOS.

Have you ever wanted a fuller beard of moustache? This is definitely a growing trend, which has been inspired a lot by observing men with bushier beards out there and also a lot of social media posts recommending it. Sometimes they are hilarious posts like men who have small chins who look great with a beard and then who don’t look so good shaven. Other posts show AI generated images of celebrities and individuals with and without beards to prove the point that facial hair is in.

But what if you can’t grow a beard and you really want more hair on your face. Some men have tried Rogaine (minoxidil) with limited results. You can grow a little more hair on the face but typically not a ton and most men give up after a few months because of the hassle and the lack of great results. Are there any other methods to grow facial hair short of surgery? The answer really is no. You cannot grow hair in areas where there are none except for the above-mentioned minoxidil, which can provide some limited, unpredictable, and temporary results. When it comes to surgery there are two major options for donor hair used to refill the face: beard and scalp hair. How about body hair? Long-term studies have shown that they simply don’t hold up after 5 to 7 years not to mention body hair usually does not provide an excellent match.

No doubt, beard hair is usually the preferred source of donor hair but where do you get it if the whole point is that you don’t have enough beard to begin with? If you have just some patchy hair loss or your beard is simply not full enough, you will usually have enough beard below your chin, an area where most men would shave that area anyways. You can then take the beard hairs from the area below the chin using FUE (follicular unit excision) method to replace the lost hair on the face. In fact, Dr. Lam’s specialty for which he has many fly-in patients is a so-called “beard-to-beard transplant” where he is stealing hairs from under the chin and placing those hairs on the face in a strategic manner. There are many advantages of using beard hair. They are as follows: (1) you do not need those hairs under the chin anyways (2) you do not use precious donor from the scalp that can be used to restore hair for the scalp (3) beard hairs are a perfect match for beard hairs since they are the same caliber, color, etc. (4) donor areas in the beard rarely present visible scarring even in dark-skinned individuals who want to stay shaven under their chin (5) if you wanted to shave your scalp (since FUE in the scalp is not entirely scarless since it cause some tiny dots visible with a shaved head) you can do so. So why doesn’t everyone just get a beard-to-beard transplant then? The answer is twofold. Technically, it is much more difficult to harvest since hairs grow in all different directions and are loosely attached compared with the scalp, but as mentioned Dr. Lam specializes in beard harvesting, all of which he performs himself. The second issue is limitation of beard hairs. As mentioned, especially in someone wanting a lot of beard hairs, that is the person who also does not have a plentiful supply of hair under the chin. Further, to limit the risk of visible scarring in the beard donor area, Dr. Lam does not take all of your beard hairs in a single pass. Your body requires surrounding or neighboring beard hairs to regenerate the color in the skin after collecting nearby beard hairs via FUE.

So how about scalp hairs as a donor source? Scalp hairs can be used to supplement beard donor hairs or be used entirely in replacement of them depending on many factors like skill of the surgeon, lack of beard donor availability, etc. The biggest limitation when it comes to scalp hair is ensuring a proper scalp-to-beard hair match. For example, if someone has fine, red hair on the scalp but bushy, curly, dark-brown hair in the beard, then using scalp hair would simply not work. That would be an extreme example. If the caliber and color match are close but not perfect then the answer sometimes is using scalp hairs and blending with beard hairs when the match is close but there are insufficient number of donor beard hairs. Scalp hairs can be harvested using FUE just like the beard but using scalp hairs for the beard in someone who is already losing hair on the scalp may be an unwise use of grafts since if you allocate say 1,500 to 2,000 scalp hairs for the beard, those are hairs that can never be used for scalp hair restoration. Further, as mentioned, if the person with thinning scalp hair wants to shave his head fully in the future, there could be donor scarring visible appearing as light dots on the back of the scalp.

This short blog only scratches the surface of the complexity of the subject. For example, Dr. Lam also uses beard hairs to reconstruct scalp hair loss in certain individuals. Only through an in-person or virtual consultation (in which you send in photographs) can Dr. Lam determine your candidacy and the method that would be most suitable for your facial hair restoration.

Hair transplant surgery is more than just a medical procedure — it is a blend of science and artistry that, when done correctly, delivers natural, life-changing results. Dr. Sam Lam, a globally recognized leader in hair restoration, was recently featured in the New York Post, where his expertise and meticulous approach were highlighted. With years of experience and a commitment to excellence, Dr. Lam has transformed countless lives through innovative hair transplant techniques.

The Artistry Behind Hair Transplant Surgery

Many people don’t realize that hair restoration is not just about replacing lost hair; it’s about designing a natural-looking hairline that complements the patient’s facial structure. A skilled surgeon must consider factors like hairline shape, density, angle, and direction of hair growth. Dr. Lam approaches each procedure with an artistic eye, ensuring every transplant results in a seamless, undetectable appearance. His attention to detail allows patients to regain their confidence without the tell-tale signs of surgery.

Understanding Hair Transplant Techniques: FUT vs. FUE

When considering a hair transplant, it’s essential to understand the two primary techniques used today:

• Follicular Unit Transplantation (FUT): This method involves removing a thin strip of scalp from the back of the head, from which individual follicular units are meticulously transplanted.
• Follicular Unit Extraction (FUE): In FUE, individual hair follicles are harvested directly from the scalp one at a time using a special device, eliminating the need for a strip incision.

During your initial consultation, Dr. Lam will carefully assess which strategy best suits your hair loss pattern, scalp characteristics, and long-term goals.

Common Misconceptions About Hair Transplants

Despite the growing popularity of hair restoration, several misconceptions still exist, such as:

• “Hair transplants look fake.” With today’s advanced techniques and Dr. Lam’s high-level skill, hair transplants look completely natural. Gone are the days of plug-like grafts.
• “Transplanted hair falls out.” While newly transplanted hair may shed initially, it regrows permanently in its new location, following a normal hair growth cycle.
• “The procedure is painful and requires a long recovery.” Modern techniques, including FUE, allow for minimally invasive procedures with little discomfort and a fast healing process. Dr. Lam’s Joint-Commission accredited facility allows for surgical procedures with minimal to no pain, as you are sedated during the transplant, which is unlike 99% of clinics out there.

The Journey to Hair Restoration: What to Expect

Dr. Lam and his team ensure patients are fully informed and comfortable throughout their hair restoration journey. The process includes:

1. Consultation: The first step is a personalized assessment to determine the best treatment plan for your hair loss needs.
2. Pre-Operative Preparation: Patients receive instructions on how to optimize scalp health before surgery to ensure the best possible results.
3. The Procedure: Dr. Lam carefully extracts and transplants hair follicles using precise techniques for a natural look.
4. Recovery and Aftercare: Patients receive detailed guidance on post-surgical care to promote healing and maximize hair growth.
5. Final Results: Within a few months, transplanted hair begins to grow naturally, with full results typically visible after about a year or less.

Take the Next Step

If you’re considering hair restoration, trust an expert who combines medical precision with artistic excellence. Schedule a consultation with Dr. Sam Lam at the Lam Institute of Hair Restoration in Dallas to explore your options for renewed confidence.

Hair loss is often thought of as a condition that primarily affects men, but many women also struggle with thinning hair and balding. In a recent discussion for the International Society of Hair Restoration Surgery (ISHRS), Dr. Sam Lam, a renowned hair restoration surgeon based in Dallas, and Dr. Shadi Zari, a board-certified dermatologist from Saudi Arabia, shared their expertise on diagnosing and treating female hair loss. Their conversation highlighted key medical and surgical approaches that can help women regain confidence in their hair.

The Prevalence of Female Hair Loss

Dr. Zari noted that about 70% of the hair loss patients he sees are women. However, only a small portion — approximately 5-10% — ultimately undergo hair transplantation. This is because many female patients benefit from medical treatments rather than surgery. In contrast, Dr. Lam’s practice sees a nearly equal distribution of male and female patients, with about 30% of his surgical cases being women.

Medical Treatment Approaches for Female Hair Loss

Both experts emphasized the importance of medical therapy as the first line of defense against female hair loss. Dr. Zari typically starts with topical minoxidil, the only FDA-approved medication for genetic hair loss in women. For women who are not planning to become pregnant, he may also prescribe oral treatments such as low-dose minoxidil, finasteride, or dutasteride, as well as autologous therapies like platelet-rich plasma (PRP) and micrografting.

Dr. Lam, on the other hand, has moved away from biochemical treatments in favor of more natural therapies. He focuses on plant-based growth factors delivered without needles, which he finds effective and less invasive. Additionally, he has developed a hair spray called Folliflo, which helps manage shedding and enhances hair growth.

When Is Hair Transplantation an Option?

Hair transplantation for women is more complex than for men, as female pattern baldness often involves diffuse thinning rather than distinct bald patches. Dr. Zari shared research showing that many women with advanced hair thinning also have compromised donor areas, making them poor candidates for hair transplantation. He advises patients to try medical treatments for at least a year before considering surgery, as this can improve both the thinning and donor areas, leading to better transplant results if needed.

Dr. Lam takes a different approach, believing that hair transplants can be beneficial for more women than traditionally thought. His technique focuses on strategically placing grafts to restore volume and coverage, using patterns such as the “T/L” shape to improve the frontal hairline and parting areas. He also emphasizes the importance of stabilizing hair loss before surgery to ensure long-term success.

Surgical Techniques: FUE vs. FUT

Follicular unit extraction (FUE) involves harvesting individual hair follicles from the donor area. In contrast, follicular unit transplantation (FUT) removes a strip of scalp containing multiple follicular units, which are then transplanted.

While Dr. Zari performs a mix of FUE and FUT, he prefers FUE for its quicker recovery time and ability to selectively extract healthy grafts. However, Dr. Lam exclusively uses FUT for women, arguing that it preserves overall donor density and produces optimal results without requiring head shaving.

Take the Next Step Toward Hair Restoration

If you’re a woman in the Dallas/Fort Worth area struggling with hair loss, expert help is available. Dr. Sam Lam at the Lam Institute for Hair Restoration in Plano, Texas, specializes in advanced, personalized treatments for female pattern baldness. Schedule a consultation today to explore your options.

A large part of my practice in hair restoration involves fixing bad hair transplants performed elsewhere. I also correct many types of problems that lie beyond simple male pattern baldness (also called androgenetic alopecia). I have fixed bad scars from trauma, cancer, facelifts, etc. I also work on restoring overplucked eyebrows and lower hairlines in women born with this condition.

There are endless permutations of things I do to restore hair in patients of both genders and all ethnicities and ages. To detail how I correct all of these problems would require a textbook or several, as I have personally written and/or edited 9 authoritative textbooks on hair transplant surgery.

This blog will focus only on how I correct unnatural hairlines — rather than on how I manage donor-site problems like overharvesting, bad linear donor scars, etc. I will not discuss other issues that may be encountered in hair surgery either, but instead, I will break down what makes a hairline natural and what makes a hairline unnatural.

What is interesting is that I have many patients who fear having an unnatural hairline; they view it as a dead giveaway that they’ve had a fake transplant. In fact, I can guarantee that they can only spot a minority of bad hair transplants out there.

The simple reason is the lack of experience and training required to gauge a fake hair transplant. I have been practicing hair transplants for close to 25 years, and it took me 5 years to discern bad transplants that are not obvious to a layperson. You develop an eye for bad work.

We are used to just thinking of 4-mm round plugs (“doll’s head” look) or the linear appearance of the outdated Juri flaps that weirdly arch across the scalp. But we may not think of subtle errors in graft placement like compression, wrong angles, etc., and may entirely miss a hairline that does not follow the basic tenets of design.

Along these aforementioned lines, I will divide hairline concerns into “macro” and “micro” problems. The macro hairline is its overall shape and position. Think of the initial line that is drawn at the beginning of the transplant to show where the proposed hairline will go. Where is its position and what is its overall shape?

The micro hairline refers to the actual transplanted hairs and would be composed of two subtypes of errors:

• Problems with recipient sites (the little slits that the surgeon makes into which grafts are placed)
• Graft placement (the grafts that are placed into the surgeon’s design by the assistant team)

We’re also going to just focus on the male hairline since rules are different for men and women in terms of the macro hairline. For the micro hairline, there are universal principles for both men and women but also slight differences that, again, will not be covered in this blog.

Instead, the blog will focus on macro and micro problems in bad hair transplants. By understanding what makes a bad transplant, you will be able to determine what constitutes a good hair transplant.

My wife asked me, “Why does it matter if you are the only one in the room who can tell the transplant looks fake?” My answer was twofold: “Hair transplantation is an art, and the standard should not be compromised based on an onlooker’s inability to tell it is fake. Second, I want the transplant to look so natural that even I cannot tell it was done.” Those are my goals for a natural hairline.

I have told a story many times to my patients. A few years ago, I was on a cruise that prompted my wife’s question. I saw this gentleman who was worth probably $100 million and clearly had a hairpiece that was shabbily maintained as well as asymmetrically positioned. I could see the separation of the fabric from the scalp. He also had bad linear donor scars visible from the back side. Finally, I could see his transplants into his temple revealed poor recipient site design (angles too high) and poor graft placement (too large and also compressed in shape).

I never told the man that I knew his result looked really bad because I didn’t feel the need to embarrass him about a bad result, which he may actually love. However, I did ask my parents and my wife, who were on the cruise with me, if they could see anything that I was talking about. All of them replied that they could not. They thought his hairline appeared 100% natural.

My entire family is super smart. My mom is a genius at math and business. My father is a retired physician. My wife was a theoretical math and astrophysics major because, as she said, they were the easiest majors for her because she never had to open a book. They are not idiots, but they couldn’t tell because they simply do not do hair transplants for a living.

Macro Hairline

Okay, with that preamble in mind, let’s discuss the rules governing a proper macro hairline for a man and how surgeons violate these rules all the time, especially on social media.

The first rule is that the lateral end of the hairline must end at the lateral canthus, that is, a vertical line drawn upwards from the outer edge of the eyelid. Unfortunately, I have seen far too often this line drawn further laterally (that is, toward the ear) to accommodate excessive temporal hair loss.

As the founder and ongoing director of my St. Louis hair transplant course for 16 years, I can tell you that beginner-to-intermediate students make this error routinely. In fact, this past year, I had a student who had been practicing hair transplants for 5 years break down in nervousness when she consistently drew the hairline too far laterally by about a centimeter.

Is a centimeter a lot? Absolutely! Even 2-3 mm lateral to this hairline will not look right, at least not to me. Am I a harsh judge? Yes. But hairline design has no room for compromise when you want to achieve absolutely seamless and natural results.

The second most common error I see with bad macro hairline design is a downsloping hairline from the side view. What does this mean?

Think of it as a rounded corner of the hairline, something very commonly seen on social media posts touting great results (or even more frequently, men coming into my office asking for the side of the hairline curved downwards). This hairline is egregiously fake and is what I call a “female hairline.”

Any man after puberty does not have a rounded hairline, with two exceptions:

• Someone who has had a bad transplant
• Someone who actually retained this natural curve after puberty (about 1% of the population)

In fact, I had a male staff member with this hairline shape. However, you would never design this hairline in a male with recession because it would not naturally exist in someone with a balding pattern. The two conditions (balding scalp and non-balding hairline) simply do not co-exist.

You also risk that, as the recession continues, this hairline will continue to look progressively unnatural and may not be fixable if you have expended so many grafts to create it that you run out of hairs over time. There are so many subtle problems of the macro hairline that I have filled textbook chapters explaining them. But these are two simple yet significant mistakes that I wanted to highlight in this blog.

Micro Hairline

What are examples of micro hairline problems? The first I see that is very common is a hairline that actually looks like a line; that is, it’s simply too straight. A hairline, in reality, is not a line, even though you initially draw it as a line with an eyebrow pencil. The closer you get to it, the less like a line it actually looks.

Think of a coastline. From a distance, it looks relatively straight. But the closer you zoom into it, the more irregular it appears. There are small outcroppings and islands as you approach the coastline more closely. That is how I describe to my students how a natural hairline should appear.

Angulation and Direction

Another problem that involves bad recipient site design concerns the angulation and direction of the recipient sites. When the sites are too vertical, they look “surprised.” That is, standing upright, which reduces visual density and also looks starkly unnatural.

Recipient sites should also flow naturally in the direction of the hair and not be splayed open or misdirected asymmetrically. A detailed description of every permutation of bad recipient sites lies beyond the scope of this blog.

However, one important point is that poorly designed recipient sites not only make the placed grafts look unnatural but can also make graft placement unduly traumatic because inconsistent angles make it impossible for the graft placer to know how to place the graft into the site.

If the graft does not perfectly fit the site, then there can also be many negative consequences:

• If the graft is too large, it may not survive or could become compressed so that the natural spacing between follicles disappears and the graft looks like an old-fashioned plug graft.
• Conversely, if the site is too large for a smaller graft, then the graft will fall into the site and cause pitting where the skin surface looks like a sunken dimple.
• If the site is too shallow for the graft, then the graft may look “cobblestoned,” meaning that it causes a bumpy, irregular skin surface.
• If the graft is traumatically inserted, it may grow out crinkly, like pubic hair. If grafts that are too large are placed in the hairline, the hairline will look grafty and unnatural.

These are just some of the many problems that can result from an inexperienced team and/or inexperienced surgeon.

Recap

As one can see in this blog, an unnatural hairline can be created from any number of missteps leading to anywhere from minor to devastating problems. Hairline design requires an artistic eye, technical skill, and an excellent team with commensurate skills, with perfection executed in every step.

My team and I at Lam Institute For Hair Restoration look forward to taking care of you, whether it’s to create a natural hairline or to fix one. Contact us today to schedule an appointment.

I am writing this post after finishing a 30-minute rowing workout at 6 am on a Sunday morning on vacation. I have never been an athlete. In fact, I was always the last to be picked in high school for any sport team because I was that bad. Perhaps that is a good thing since now I do not suffer from any lifelong injuries to nurse. I am also late in life to get married and have kids. I didn’t get married until my mid 40s and now at 56 have two small children who are just about to turn 4 and 6 years of age. In my last textbook, I wrote about how to train as an athlete when you are a surgeon because you must be in peak physical condition to perform your work. Unlike an athlete though, a surgeon has a much longer professional lifespan, so health maintenance becomes a higher order of necessity over a much more protracted window of time. The two longest and meticulous procedures I do are FUE hair transplants and comprehensive facial surgical rejuvenation of the face and neck (combined upper/lower blepharoplasty, fat grafting, deep-plane facelift, deep neck lift, lip lift, etc.), both of which I routinely perform. I am actually happy that I perform a variety of taxing surgeries on my body rather than just one because it gives my body challenges in different ergonomic positions to limit injury. Not only do I need to be in top form to do these procedures but I need to limit injury and to avoid an early retirement. I also need to be in good shape and alive to see my kids grow up. That begins with the reason to do what I do or, more simply put, my why. As many books that I have read, which I will share momentarily with you, talk about is to start with the why. In this blog, I will talk a little bit about the what, that is, what I do to help you if you are looking to become more fit, but you must start with your why, as a motivating factor to keep you going in a quest that is not easy to sustain day in and day out.

As everyone talks about, nutrition is key. I start each morning with a healthy shake consisting of various nuts (almonds, walnuts), seeds (sesame, basil, chia, ground flax, sunflower, pumpkin, hemp), spices (turmeric, cinnamon, ginger), vegetables (frozen kale, at times frozen broccoli), and other great stuff (lion’s mane, whey protein, cardamom, dandelion root, cacao beans, olive oil, CoQ10 liquid, flax seed oil) and I blend it in nut milk (don’t use oat milk, which has a high starch load). It takes me 5-10 minutes to prepare this every morning, and I do this 7 days a week. I also take daily supplements of Omega-3s, vitamins, and those specified for my metabolic health by my physician. I do intermittent fasting and skip lunch Monday through Friday, which helps me on days where I am doing 6-hour cases anyways and would not be eating lunch. There is controversy about intermittent fasting now with proponents and detractors on both sides. I believe that it is good for my health overall, as I supplement my protein load with whey protein in the morning (which is what the detractors now argue against intermittent fasting). I have prepackaged meals that our nanny prepares for me for weeknights except when my wife and I go out for date night on Fridays and, of course, other special occasions, or vacations. For me portion control is a big problem, and having prepackaged meals rather than a buffet of food is very helpful. Another great thing to get is a continuous glucose monitor (CGM) that can track your minute-by-minute glucose levels and see what foods spike your glucose levels unfavorably with repeated, large spikes causing more risk of prediabetes and diabetes onset. Read the book Glucose Revolution by Jessie Inchauspé for a lot of helpful hacks, and the CGM model I use is Stelo by Dexcomm (stelo.com) since they are catering to a cash-paying, non-insurance (that is, non-diabetic) market. It costs less than $100 per month with two sensors each lasting about 15 days. Once you get your understanding of what foods cause you the most problems, you do not necessarily need to keep wearing one. My stepsister Celia is also a great resource for me, as she is a health coach (@celiawchen on Instagram)

I work out 5 to 7 days a week with an average of 6 days a week. Exercise is critical for overall health. I try to vary it up every day: I do biking, hiking (treadmill on an incline), rowing, and three days of weights (arms/shoulders, legs, chest/back) every week with HIIT (high-intensity interval training) as parts of these workouts. I add additional HIIT with compound movements and Pilates on the weekends when I can as well. I wasn’t doing weights until about over a year ago but was greatly inspired by a book, Outlive, by Peter Attia that argues that our muscle mass starts to degrade over the decades and we need to plan for how weak and frail we will become in our 70s and 80s if we do not start now. I religiously perform a minimum of two and a half hours of elevated cardio work per week (that includes weights, which I avoid on delicate surgical days), with the prescribed weekly time as recommended by the American Heart Association. By the way, I use Peloton to track and to do my workouts. I own the Tread, Bike, and Row and use their weight classes. You can follow me @samlammd on Peloton if you like. I have not missed a 2.5-hour time/week for the past year and usually exceed that goal. I no longer go to the gym mainly because I have a very efficient morning routine where I build in time to paint, which is a ritual that I can’t give up and I am sure adds to my overall health as well. I also do a chiropractic adjustment in the style of fascial/muscle adjustments rather than bone popping (and definitely no neck cracking, which I believe is dangerous) along with a weekly sports massage. I also try to get 7 hours of sleep a night and track my sleep with my Apple Watch (which is a recent purchase). On weekends I do not deviate from my Monday through Friday routine, waking up at 5 am and going to sleep at 10 pm, but adding a short 30-minute nap when I can. I also avoid all alcohol, tobacco, drugs, and caffeine in my life.

Beyond these fundamental techniques on living healthier, I believe that my family and my faith are huge contributors to my overall health and sanity. They are a bedrock to my existence and I cannot understate how important they are in my life and my overall health and wellbeing. I also believe that I am a very passionate person and that my career and my avocations also provide me a deep sense of fulfillment and joy. I am very active academically on four boards and will be running the Annual Congress in Berlin for the International Society of Hair Restoration Surgery next year, which all give me deep satisfaction and meaning. I also use my art as a charitable vehicle and have raised over $100,000 for abused children through my art and also a considerable amount against human trafficking through the profits from my twelve textbooks I have written. You can follow my art on Instagram @samlammd. I am constantly innovating in my professional career as a surgeon, thinking and creatively developing improvements in both surgical and non-surgical techniques, which is fueled by my ongoing hunger for better results (follow me on Instagram @lfpdallas [for face] and @hairtx [for hair]). All of this drives me, motivates me, and gives me profound satisfaction. I hope that some of these tips you may incorporate into your life and also drive you to live a healthier and happier life, which it has done for me.