This question was posed by a hair loss sufferer and answered by Dr. William Reed of La Jolla, CA who is a well respected member of the Coalition of Hair Restoration Surgeons. His professional answer is below.
Thank you for your inquiry. Hair transplant cost is dependent upon how many hair grafts would be necessary. The number of follicular unit grafts necessary is related not only to the surface area needing grafting but also the density of hair that is appropriate with the hairline that we would be creating and, thus, the stage of balding that we are mimicking. ( I know that’s a mouthful, but break it down and it makes sense, I think, and an attempted elaboration follows.) A higher hairline mimicks a more advanced degree of balding; the more advanced degree of balding not only receeds the hairline but drops the density of the remaining hair. A very modest degree of balding may often require the density than can be achieved only with two procedures depending upon the second important factor determining how many grafts you need: styling.
When one thinks about it, what we are trying to do with hair transplantation is get hair mass in an area of scalp that doesn’t have enough. Hair mass is the result of three things:
- Density, i.e., the number of hairs growing in the area / square inch
- The diameter, color and waviness of the hair shaft and
- The length of the hair and where the direction of the hair length is taken, i.e., styling. (If the hair length doesn’t stay over the bald area, the most isn’t being made of the grafted hair.)
Therefore, styling is critical in determining how many grafts you need for hair restoration surgery. I suppose this isn’t very surprising; there are always better styles for certain hair situations whether it be too much, too little, too wavy, etc.
So the lower you come in reversing your balding, the more hair mass your scalp is expected to have where it isn’t balding. Hence, the more important styling becomes. This makes sense, I hope. In the photo you sent, I have put a crude hairline that is high and mimics a moderate degree of balding. (You have no crown views, so I assume no grafts go there.) One procedure could work with this (of perhaps 2500 follicular unit grafts). You could wear your hair short or long. The more you come forward the more you need to style with the hair length coming forward as discussed above. Your hair has low color contrast relative to your scalp, so you can reverse your balding further in a progressively more styling-dependent manner than could a person with thick, black, straight hair on a pale scalp. At some point of progressively reversing the balding, the styling dependency becomes a sufficient nuisance that you will decide to opt for the freedom given by a second session that increases the hair mass by doubling (roughly speaking) the density of hair and, thereby frees you from styling dependency that dictates where hair direction goes and what it’s length needs to be.
The best next step, if you are still interested is to call Pam, my hair transplant clinic director, to arrange a time when we can discuss these matters by phone. Our number is 858-459-8600. Hair transplant costs are on our web site. It will be a pleasure to discuss these matters further with you.
Bill Reed, MD
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