There are some patients in which I think DFU's are extremely beneficial to the patient. The case I did 10 days ago is a good example.


This 34 year old man has fine caliber hair, and significant balding. He is on the way to having a Norwood type 6 pattern of balding and could easily become a Norwood type 7. He has a very large head which increases the surface area needed to cover when doing a transplant. The frontal 2/3 of this patient's scalp measures about 150 sq.cm while in most patients the frontal 2/3 scalp is usually 100 sq.cm. The area of his crown which is almost bald or has significant thinning is another 150 sq.cm. He has the potential for complete balding in 300 sq.cm. of scalp.

He is the breakdown of graft count and hair count on this patient:


In a case like this I will use DFU's in the central core area. I believe this gives a greater illusion of density using the exact same amount of hair per sq.cm compared to using only FU's. There is a chance that DFU's can look pluggy if not done correctly or when a patient has dark coarse hair and light skin. But done correctly in the appropriate candidates they should not look pluggy. To use DFU's correctly it is important to have technicians that are trained to cut and place them correctly. They need to be cut so they are the same size and so that the two Follicular Units line up one behind the other.

Here is a photo of the above patient 10 days after surgery. As you can see the central core [IMG]

[http://i288.photobucket.com/al...pFront.jpg[/IMG]area[/url] looks very dense but not pluggy.
Here is a close up of the central core with the area of the DFU's circled.

Here is a photo of the donor site:

I have included the link to Baxter, a patietn of mine who is similar to the one above. He also has a large surface area of balding. I used 400 DFU's in his case and he was presented at the last ISHRS meeting. Most physicians could not tell that I used DFU's and were surprised at the results he got with only one surgery. This is an example of how using DFU's I can get the appearance of more coverage using the same amount of hair if I only used FU's.

Bater One Year Results

In Summary I believe that in certain patients, using the same amount of hair, I get superior results using FU's and DFU's together then if I had only used FU's. Using the same amount of total hair I get a denser look in the central core area. This is useful in patients who have significant balding, fine caliber hair, and/or very large heads. It is also useful in women who have female pattern balding. I still use FU only in a majority of my cases, but I believe being able to use DFU's correctly is an important part of a hair transplant surgeon's armamentarium.

There are some patients in which I think DFU's are extremely beneficial to the patient. The case I did 10 days ago is a good example.


This 34 year old man has fine caliber hair, and significant balding. He is on the way to having a Norwood type 6 pattern of balding and could easily become a Norwood type 7. He has a very large head which increases the surface area needed to cover when doing a transplant. The frontal 2/3 of this patient's scalp measures about 150 sq.cm while in most patients the frontal 2/3 scalp is usually 100 sq.cm. The area of his crown which is almost bald or has significant thinning is another 150 sq.cm. He has the potential for complete balding in 300 sq.cm. of scalp.

He is the breakdown of graft count and hair count on this patient:


In a case like this I will use DFU's in the central core area. I believe this gives a greater illusion of density using the exact same amount of hair per sq.cm compared to using only FU's. There is a chance that DFU's can look pluggy if not done correctly or when a patient has dark coarse hair and light skin. But done correctly in the appropriate candidates they should not look pluggy. To use DFU's correctly it is important to have technicians that are trained to cut and place them correctly. They need to be cut so they are the same size and so that the two Follicular Units line up one behind the other.

Here is a photo of the above patient 10 days after surgery. As you can see the central core [IMG]

[http://i288.photobucket.com/al...pFront.jpg[/IMG]area[/url] looks very dense but not pluggy.
Here is a close up of the central core with the area of the DFU's circled.

Here is a photo of the donor site:

I have included the link to Baxter, a patietn of mine who is similar to the one above. He also has a large surface area of balding. I used 400 DFU's in his case and he was presented at the last ISHRS meeting. Most physicians could not tell that I used DFU's and were surprised at the results he got with only one surgery. This is an example of how using DFU's I can get the appearance of more coverage using the same amount of hair if I only used FU's.

Bater One Year Results

In Summary I believe that in certain patients, using the same amount of hair, I get superior results using FU's and DFU's together then if I had only used FU's. Using the same amount of total hair I get a denser look in the central core area. This is useful in patients who have significant balding, fine caliber hair, and/or very large heads. It is also useful in women who have female pattern balding. I still use FU only in a majority of my cases, but I believe being able to use DFU's correctly is an important part of a hair transplant surgeon's armamentarium.

Very informative! General question, but just how beneficial do you feel DFU's can be, re: density in the core, as compared to regular FU's? Like, appox what kind of a % boost in the illusion of density using these respective grafts can be achieved?

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*A Follicles Dying Wish To Clinics*

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Enough is enough! Give me documentation or give me death!

This is interesting. How exactly does this technique increase the illusion of density vs. just placing the same amount of hair in individual follicular units? Does it have to do with how the hairs layer on each other?

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My Hair Loss Website

Yes, it does have to do how the hair layer on each other. When we use only FU's we space them evenly apart. As I said earlier if would could pack all FU at a density of 80 to 100 FU sqcm then we would see no difference. But in a lot of cases we are restricted to densities of 40FU/sqcm because of limited donor and the large area of scalp we need to transplant. Thus when we mix DFU's which have two FU together in their natural donor density with individual FU's around them we end up blocking more light.
Dr. Paul Shapiro