Hairline Advancement Surgery or FUE?
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Generally, risk of surgery is further hair loss or accelerated hair loss from the surgery itself.
Hairline advancement of hair transplant for a small job
Surgical Hairline Advancement (SHA) vs. Follicular Unit Extraction (FUE)
The more commonly chosen procedure to advance the overly high hairline is hair grafting. This is a typically less "surgical" procedure, involving the transplanting of 1200 to as many as 2400 grafts (depending on how much lowering is desired) in a single procedure, taking 3 to as many as 8 hours to perform (it is a very meticulous procedure). Every graft is placed into tiny recipient sites (0.5 to 0.8 mm in size) each one made by me- these sites then determine the direction, pattern, and angulation of growth to assure a natural appearance. The transplanted hairs typically fall out within 3 weeks, then start to regrow at 4 months, taking a full 10 months or longer for final results. The hair grafting procedure is ideal for hairlines that are thin or thinning out, for those who want a hairline that not only is lower but also is more rounded, and for those who opt not to have or are not good candidates for the SHA.
In your case, you sound like a much better candidate for hair grafting, but this needs to be decided in conjunction with your surgeon.
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FUE for Hairline Refinement
FUE allows for more freedom in hairline design, which is exactly what you need. An advanced FUE practitioner will typically be able to use donor hairs from the nape of the neck, which are finer in nature than hairs from the traditional donor zone, and are well matched to an existing hairline. FUE hairline refinement will be less invasive than a hairline advancement surgery and better able to address your detailed concerns about symmetry, shape and softness.
FUE vs. advancement surgery
First of all, FUE is a method for harvesting follicles for a hair transplant and the result can be no better than grafts harvested by the classical strip technique.
If you have dense hair in the front, it is doubtfull that one session of 300-350 grafts will do what you want. Normal non-balding density is the equivalent of 90-100 follicular units/square cm. Unless you have very fine hair, 50 grafts/square cm is the most that is done in one session.
The hairline advancement should be considered with caution if you are balding. It might work well under certain conditions, especially if you are not adverse to having grafts at a later time in life. If you are female this is not an issue.
Hairline lowering or grafting.
You will get a better result and much cheaper with an advancement if you want a significant lowering. 350 grafts is hardly anything if you count the hairs in 1/2 inch on your scalp. Hairline advancement which we developed with and without a tissue expander is a procedure that the surgeon must have experience with to get an excellent result. If you just need a small area get transplants.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.