The following thorough response to this thread from the Hair Restoration Social Community and Discussion Forums, was written by forum member “weweregods.”
1) Hair characteristics – If the hair diameter is large, course, and of a wavy texture, the hair transplant physician won’t need to pack the area as densely because these characteristics help with the illusion of density.
2) Density of the donor – If the donor area is dense, then there will be more follicular unit grafts to use for transplanting, which may factor into the decision to pack denser. Not everyone has 90 grafts/sq cm. Some may have much more and some much less.
3) Density of natural, non-miniaturizing hair – If the doctor transplants denser than the surrounding hair then the transplant will look strange. Ideally, the physician wants to create an illusion that will blend the natural and the transplanted hair in a smooth way.
4) Scalp laxity – The laxity of the scalp also factors into how dense the transplanted area will be as it may limit how many grafts may be taken from the donor area.
5) Positioning of the hair – Some doctors can transplant the hairs so that they grow parallel to the scalp and may, for instance, design a hairline that appears denser because it grows very near the scalp.
6) Technique – Some doctors have designed special instruments that allow them to transplant higher densities than others. This is one of the MOST important factors in considering a hair restoration physician, as some doctors use huge scalpels and can only transplant at low-density. Many “hair mill” chains even use multiple-bladed tools.
7) Area to cover – The greater the balding area you have to cover, the lower the density may be because of the limitations of your donor and potential for future hair loss.
8) Potential for future hair loss – If you lose more hair, you’ll want to have grafts left in the donor for another transplant and you may need another if you lose hair behind the transplanted area. There can be no guarantee that you will not lose more hair, so physicians want to make sure that the area will look as natural as possible if you lose hair behind the grafts.
9) Age of the person getting the transplant – The younger the person is, the more time they have to lose more hair.
10) History of hair loss – This includes family members that have a history of loss as well as how long the patient has been losing hair, their pattern, how much hair they’ve lost in that time, etc. Physicians must take this into account when considering how aggressive they may be while still being a bit conservative.
11) Medication history – The doctor will want to know how long the patient has been using hair loss treatments like Rogaine (minoxidil) and Propecia (finasteride) in order to judge if the hair loss has stabilized.
12) Patient expectations – Hair Transplant doctors must keep the patient’s expectations within reason considering all the factors above.
As you can tell, there are many factors for the doctor and the patient to balance before a hair transplant should take place. The results of surgical hair restoration can vary from patient to patient but, with the right choice of doctor, you can make it an educated guess and come out looking great!
~ Hair Restoration Forum member “weweregods.”