What is the greatest hair density that a hair transplant doctor can safely transplant into an area with existing natural hair without risking shock loss?
Rarely is there any answer that is cut and dry when it comes to hair transplantation. The answer to this question really depends on a number of factors.
One such variable is the amount and density of the native hair that hair is being transplanted in between or around. The greater the density of the natural hair, the less dense transplanted hair should be packed in and around the native hairs.
It also depends on whether or not a physician is using chubby or skinny grafts. The hair transplant surgeon’s use of chubby grafts creates a need for larger incisions than when using skinny grafts. The use of chubby grafts may limit the hair restoration physician’s ability to densely pack follicular unit grafts in a single area when appropriate – especially when in and around existing native hair. Larger hair grafts calls for larger recipient incisions which when packed more closely together can increase scalp trauma which may facilitate the risk of permanent shock loss of weaker vellus hairs. Though terminal hairs (unless they are transected during hair transplant surgery) aren’t at risk for permanent shock loss, densely packing too many chubby grafts may hinder hair growth yield due to overtaxing the scalp’s blood supply.
Additionally, dense packing depends on the number of hairs per follicular unit graft. Follicular unit grafts with more hairs would be less densely packed than those with fewer hairs mostly due to the size of the recipient incision. The larger the graft, the larger the incision, which can lead to the same problems as presented above.
I would suggest however, not to get too caught up in the numbers but rather the cosmetic appearance of the hair transplant. Keep in mind that hair characteristics will ultimately play a huge role in determining the final appearance of the hair transplant. A hair transplant patient with 70 follicular units per square cm with thin blond hair may appear thinner than a hair transplant patient with brown thick hair follicles of 50 follicular units per square cm.
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