Hair Density


In an ongoing thread on the Hair Restoration Forums, community members are discussing miniaturization analysis and if it should be performed before a hair transplant procedure. Miniaturization analysis is the process where hair restoration physicians carefully inspect a hair loss patient’s donor region (with a magnification device) and determine whether or not miniaturization is occurring in the harvesting zone.

During the balding process, hairs miniaturize or grow thinner at each expansion (or anagen) phase of the follicular growth cycle. Because of this, hair transplant surgeons must ensure they are not harvesting and implanting follicular units that are miniaturizing and susceptible to future loss.  Granted, miniaturization can occur in any scalp hair, but donor hair analysis is extremely important in a successful hair restoration procedure.

In the discussion topic, two hair loss experts (Louise – a hair transplant technician and consultant for Coalition surgeon Dr. Cam Simmons and Coalition surgeon Dr. Glenn Charles) share their opinion of miniaturization analysis and it’s importance before a hair transplant procedure:

When inspecting/assessing your hair’s characteristics, physicians will look for miniaturized hairs in the recipient and donor regions. If the donor hair is miniaturizing, it will not last and should not be transplanted. Some clinics use magnifying loops or a Densitometer or a close-up camera. Dr Simmons inspects everyone’s scalp personally with magnifying loops and/or a Microvid camera. The Microvid camera is a hand-held device that can be moved around one’s scalp and the physician and patient can see the image on a computer monitor. The follicular groups can be easily seen as well as any miniaturization. If the hair is long enough to hide it, tiny patches can be trimmed to get a very close look at the donor hair.

This question comes from a member of the Hair Restoration Discussion Forums and Social Community:

After consulting with several recommended hair transplant surgeons I’ve come to the conclusion that most surgeons implant follicular unit grafts at a density of around 40 – 60 grafts per square centimeter. I’m curious, if I only want to restore my frontal hairline, why can’t the surgeon restore my hairline to the density I had before experiencing hair loss (80 – 100 grafts per square centimeter)?

Although I’m sure each hair restoration physician has specific opinions on implanting grafts at this density (and that final density is unique to each patient’s physiology), there are several reasons why I believe experts do not restore hairlines to an unaffected density:

First, I’m uncertain that the blood supply to the balding areas is sufficient to accept and properly nurture grafts at this density (80 – 100 grafts per square centimeter). Because of this, the graft survival rate and scalp trauma could both be greatly affected. Second, transplanting at this density could negatively affect surrounding native hairs (causing unnecessary damage).

Third, transplanting at this density would require a large strip (in a follicular unit transplantation -FUT case) or various extractions (in a follicular unit extraction -FUE case) for a small transplant area, which could lead to unnecessary scarring. Fourth, transplanting at this density does not take progressive loss into consideration. It seems like a great idea to densely pack or lower a hairline at a young age, but the results can be very unsatisfactory when and if future hair loss occurs. Furthermore, this also depletes precious donor follicular units.

Although hundreds of questions are asked and answered on the Hair Restoration Discussion Forums daily, the most common is likely hair loss patients asking how many follicular unit grafts are necessary to fill their balding scalp. Despite the fact that this question is quite common, it’s difficult to answer and unique to nearly every patient.

Various physiological and personalized factors determine the number of grafts required to cover balding scalp. Factors such as the size of the transplanted area, characteristics of the donor hair (circumference of the hair shafts – fine versus coarse and texture of the donor hair -wavy versus straight), desired density in the transplanted region, color difference between the scalp and follicular unit grafts, laxity (“looseness”) in the universal donor region, age, and hairline design all affect the number of grafts required for an aesthetically significant result.

However, despite the numerous variables associated with graft counts, there is a way to estimate the required number of follicular unit grafts in any given hair transplant surgery. The hair loss learning center graft calculator is a tool that allows patients to input their personalized information and calculate the number of grafts required for the desired amount of coverage.

The calculator takes variables such as current level of hair loss, the area of the balding scalp, and desired density in the transplanted area into consideration, and creates a helpful estimate of the required graft count. Although the tool is not a replacement for a consultation with an experienced hair restoration physician it’s a useful tool that can help many patients answer the infamous question: how many follicular unit grafts will it take to fill my balding area?
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Blake Bloxham – aka Future_HT_Doc

This question comes from an interesting thread started on the Hair Restoration Discussion Forums:

Which member has received the most follicular unit grafts throughout their series of hair transplant surgeries? How many grafts were available in your donor area? How many hair restoration procedures did it take?

Although this topic is discussed quite frequently, it’s difficult to provide a universal, generalized answer. Since each patient is unique, the maximum number of grafts available in the universal donor area, the number of hair transplant procedures necessary to harvest these units, and the number of follicular units that can be safely harvested vary. Variables, such as donor laxity (the “looseness” of the scalp), hair characteristics, level of baldness, type of procedure (follicular unit transplantation -FUT versus follicular unit extraction – FUE) performed, and density in the donor region all contribute to the number of available grafts, the number of procedures necessary to extract the grafts, and the number of grafts that can be safely transplanted.

Despite these numerous variables, members at the Hair Restoration Discussion Forums are discussing the issue and trying to discover which hair loss patient has received the largest number of grafts, how many procedures it took, and if there are units left in the donor area. Very large numbers, ranging from 10,000 to 13,000 grafts, 4 to 5 procedures, and different methods of extraction are being reviewed. Do you think you’ve received the greatest number of follicular units, or know the maximum number of units available in your donor area? If so, feel free to participate in the ongoing thread – Who has had the most work done?

This frequently asked question comes from a member of the Hair Restoration Social Community and Discussion Forums:

I’m investigating a hair transplant procedure and I’m wondering if it is possible to figure out how many follicular unit grafts my case requires? Should I post pictures on my hair loss weblog, or rely solely on my hair restoration physician‘s recommendation?

Estimating the appropriate number of follicular unit grafts for a hair transplant procedure is not an easy or standardized task. Several variables – such as donor region laxity, desired density in the transplanted region, and donor hair characteristics, make it difficult to offer static values.  Posting pictures, asking advice from seasoned members of the Hair Transplant Network, and consulting with several recommended hair transplant surgeons are all wise ideas, but do not paint the entire picture.

A comprehensive approach, where a hair loss patient defines realistic goals, keeps the aging process and natural hairline design in mind, consults with several knowledgeable sources, and creates a plan with their physician, gives the best chance at accurate estimation. Additionally, using a program like the hair loss learning center graft calculator helps create rough graft estimates and allows patients to efficiently move forward on their hair restoration journey.

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Blake Bloxham – aka Future_HT_Doc

Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum

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This hair loss question was answered by Dr. Glenn Charles of Florida who is a member of the Coalition of Independent Hair Restoration Physicians.  His professional answer is below.

I’m having a hair transplant on the frontal third of my scalp and as soon as it grows out I’m thinking about shaving my hair down to a grade 2 or 3.  Is this possible?

Dr. CharlesThe type of procedure you are having and the way your skin heals will really determine how short you will be able to cut your hair in the donor area after hair transplant surgery. I usually tell patients to be prepared to keep the hair a little longer in the donor area, but in return you will have more hair in the areas of thinning hair and balding. Like most things in life there is a give and take situation with hair transplantation. I admit that often I have patients where it’s very hard to find the scar in the donor area even after a strip procedure.  But I also tell my patients not to count on that being the result in their case.

Dr. Glenn Charles, D.O.

Bill Seemiller – aka Falceros
Managing Publisher of the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Social Network and  Enhanced Forum
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This insightful article was written by Dr. Michael Meshkin of Newport Beach, CA who is one of our recommended hair restoration physicians.

Some consider hair to be the most aesthetic part of the face. As such, baldness can dominate one’s appearance, drawing attention from a beautiful face. The hairline is where your scalp hair borders your forehead and frames your face, thereby bringing out the beauty and richness of one’s features. When the hairline starts to recede, one’s facial features also recede into the background. A primary reason for seeking hair restoration is to restore your appearance to the condition before hair loss. One of the more critical decisions in hair restoration is determining where your new hairline should be, which should carefully be discussed with your physician. The physician should follow several cosmetic rules to design the hairline.  The doctor should place the hairline in correct position. The doctor should use all of the cosmetic guidelines, rules and tools available for creating the hairline such as the following:

  • Rule of thirds- dividing the face in three equal proportions(described by Leonardo De Vinci)
  • Measuring more than 8 cm from the mid-glabellar point
  • Hairline not lower than the original hairline before hair loss began
  • Customize the correct shape of hairline individually such as:  widows peak, and correct flaring
  • Creating different shapes of forelock for people with limited donor area
  • Irregular soft and subtle hairline

Thousands of people across the world fixate on their favorite celebrities wishing they could achieve their fame, riches, and good looks. And for men and women suffering from hair loss, their eyes gravitate toward their adored superstar’s lustrous locks with envy.

Thanks to the advancements of today’s ultra refined hair restoration techniques, many men and women can restore a full and natural looking head of hair in only one or two hair transplant procedures. However, can our new head of hair really measure up to our favorite celebrity’s?

Recently, forum member “Julius” posted photos of one of his favorite celebrities and asked whether or not surgical hair restoration can give him Johnny Depp Hair. Join in the discussion to learn what can realistically be accomplished with hair transplant surgery, and get some insight on which celebrities have undergone surgical hair replacement.

Bill Seemiller – aka Falceros
Managing Publisher of the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum
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Our popular community is #1 in helping hair loss sufferers find credible information and treatments for baldness. To join dozens of active members who regularly answer questions, share their experiences, photos, videos, and more, visit our discussion forum.

Below, we’ve compiled some of the latest hot topic hair loss questions and answers we received from our Associate Publisher Bill Seemiller and expert hair restoration physicians.

Feel free to ask your own questions and get answers on our hair restoration forum or privately by emailing help@hairtransplantnetwork.com.

How Dense Packing Affects Hair Transplant Growth Yield

Why Rogaine Foam Isn’t Recommended for Women

Are Scalp Reductions Always Bad? (Dr. Michael Beehner)

Accutane Induced Hair Loss and Hair Transplant Surgery

Bill Seemiller – Falceros
Managing Publisher/Editor

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Our popular hair loss forum community is made up of thousands of balding men and women searching for real hair restoration solutions and dozens of prescreened expert hair loss doctors. See how we prescreen hair restoration physicians. Many of these physicians regularly contribute their expert opinions and advice on important issues related to hair restoration.

Below, we’ve compiled some of the most recent and vital input we’ve received from leading physician member of our community and presented them below for your benefit.

Are Hair Transplant Megasessions Safe? Learn why Coalition member Dr. Glenn Charles feels hair transplant megasessions are appropriate for some, but not all patients.

Hair Transplant Graft Survival and High Hair Densities: Discover why Coalition member Dr. Brad Limmer believes a 2 pass approach is often appropriate to help patients achieve the density they want.

Determining How Many Grafts are Required by Measuring Baldness: Learn how Coalition member Dr. Paul Shapiro determines the number of grafts needed to help patients achieve the coverage and density they want.

Bill Seemiller – aka Falceros
Managing Publisher of the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum
Follow our community on Twitter
Watch hair transplant videos on YouTube

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