The objective of this chapter is to introduce the University of Kentucky IR4TD Lean Systems Program (LSP) and the concept of “True Lean,” as well as to discuss what we have observed to be critical challenges (derailers) to the successful implementation of Toyota Production System-(TPS)-based principles within non-Toyota organizations. This learning stems from experience teaching, coaching, and facilitating lean implementation activities in a wide range of industries over the past twenty-five years. Participants in the LSP Lean Certification program have been sent by over 175 companies representing industries from healthcare, steel, glass, ceramics, textiles, automotive, railroads, aerospace, commercial aviation, fast food restaurants, and food processing manufacturers as well as government, education, and NGOs. This chapter shares data collected from our staff and clients in an effort to help understand the current condition of lean in industry today and the major challenges confronting successful lean implementations.

INTRODUCTION

The design of the hairline is the heart of hair restoration surgery. No other part of the procedure will have as much impact on the patient's appearance, and it is the template on which present and future surgery is patterned. The hairline design requires an understanding of both intact and balding patterns in order to create a successful plan. Many factors must be considered, including age and donor supply. The importance of a good hairline design cannot be overemphasized, as improper design is one of the major reasons for poor outcomes and for the need of repair work.

Recession of the frontal hairline removes the framework of the face, often leading to a loss of self-confidence and esteem. Therefore, the goal of frontal hairline restoration is to reframe the face.

GENERAL APPROACH

The success of frontal hairline restoration depends on the creation of a cosmetically pleasing design that takes into consideration the patient's desires, donor supply, donor hair quality, and expected future balding. With good judgment and foresight, a proper design should remain beneficial and natural for a lifetime time.