Management of Cowlick in Female Hairline Correction Surgery.

Purpose: To investigate the results of two grafting methods to manage CLs in the FHL of women.
Background: The present study was performed to investigate the results of two grafting methods to manage cowlicks (CLs) in the frontal hairline of women.
Methods: Patients were categorized into two groups based on the grafting method: the matching with the original hair direction (MOD) group and the matching with the CL hair direction (MCD) group. Satisfaction ratings were compared between the two groups.
Results: Among 80 patients, 77 had a single CL and 3 had a double CL. In the MOD group, 7 of 12 (58.3%) patients underwent a touch-up procedure for density enhancement with an average of 123 follicular units; the average patient and physician satisfaction ratings were 4.84 and 4.60, respectively. In the MCD group, 7 of 68 (10.3%) patients underwent a touch-up procedure for density enhancement around the CL; the average patient and physician satisfaction ratings were 4.64 and 4.50, respectively.
Conclusion: In female hairline correction surgery, the surgeon must choose between MOD and MCD by considering the location, shape, and pattern of the CL; the facial shape; and the patient's preference. Delicate graft placement is required to obtain natural-looking results.
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