This 54 year old male had a surgery done about 10 years ago. He came in wanting a more natural hairline and better density.
Here are his 6 month post operative photos. He is very pleased with his results and should get more density as the new hair coninues to grow over the next 6 months.
His graft count was as follows:

1 Hair FU 679 # Hairs 679
2 Hair FU 1290 # Hairs 2580
3 Hair FU 470 # Hairs 1410
4 Hair FU 74 # Hairs 286
Total FU 2513 Total 4965

This 54 year old male had a surgery done about 10 years ago. He came in wanting a more natural hairline and better density.
Here are his 6 month post operative photos. He is very pleased with his results and should get more density as the new hair coninues to grow over the next 6 months.
His graft count was as follows:

1 Hair FU 679 # Hairs 679
2 Hair FU 1290 # Hairs 2580
3 Hair FU 470 # Hairs 1410
4 Hair FU 74 # Hairs 286
Total FU 2513 Total 4965

Dr. Shapiro,

Looks good so far...Very nice and vary natural. By the way, great pics with consistent lighting. No guess work here...SMG'S TRANSPARENCY is greatly appreciated...

Did you use any DFU'S on this patient? Furthermore, how do you determine who is a good candidate and who isn't one for DFU's as part of their HT procedure?

In addition, it seems that this patient has very good coverage even at this point in time in his procedure with only 2580 FU's. Doc, how do you determine at what density to plant the FU's through out the patients scalp?

I wish I could articulate my questions more appropriately, just crunched for time now...

Thank you,

__________________
My Hair Loss Website - Hair Transplant with Dr. Ron Shapiro

I can only imagine how much nicer this is going to look when the hair thickens. As usual, an awesome result Dr. Paul.

That would be a great result at 12 months! Great work doc!

__________________
2008 Dr. G – presumably 1,000 grafts / 2,142 hairs
2009 Dr. Paul Shapiro – 2,348 grafts / 4,258 hairs
2011 Dr. Paul Shapiro – 1,999 grafts / 3,624 hairs

My Hair Transplant Journey with Shapiro Medical Group

MIAI
This patient already had an old procedure using Multi Follicular Unit Grafts (MFU) so he is not a candidate for DFU's. There are many type of Multi Follicular Unit Grafts and Double Follicular Unit Grafts (DFU) are just one type of MFU.
Dr. Ron Shapiro wrote a good post on graft terminology which helps explain the different types of grafts. Here is the link. http://www.regrowhair.com/hair...t-graft-terminology/.

As I have pointed out, by using DFU's correctly in the appropriate patients I believe I get a better illusion of density with the same total number of hairs without sacrificing naturalness. Unfortunately this patient had larger MFU's which did not look natural, especially when placed in the hairline. Being a repair case I needed to place individual FU's between his old MFU's to give him a natural look. As you can see by proper placement of the FU's the pluggy MFU's blend in and he has a natural looking hairline. If he cut his hair short the hairline might still look somewhat pluggy. As long as he keeps his hair over 1 to 2 inches long it will look very natural. For many older men keeping the hair with this type of styling is not a problem. One factor to consider before having a hair transplant is what type of hair style is acceptable for the patient.

It is difficult to talk about density in this patient because of his previous surgery. I do not have his old surgical history from his previous surgeon. That surgery was done many years ago. Also, in repair cases I focus on planting the FU's strategically between the old MFU's in order to hide them and do not focus on how many FU'sq.cm I plant.
But in answer to your density question, there are many factors that go into determining what density I plan to plant in a case. The densities I plant can be anywhere from 25 to 80 FU/sq.cm. Some cases are appropriate for dense packing which I consider from 40 to 60 Follicular Units/sqcm. And there are the very rare cases in which I will plant at what I call super dense packing at densities between 60 to 80 FU/sq.cm. But in many cases it is more appropriate to plant at densities between 30 to 40 FU/sq cm. And if I am doing a person who is Norwood type 6 or 7 I many plant at densities between 25 and 35 FU/sqcm just to give a good frontal forelock pattern. The patients age, health status, degree of balding, family history, donor density, response to medication, hair caliber and quality, all are factored in when I decide what density to plant in a hair transplant surgery.

I hope this answer is helpful

Dr. Paul Shapiro

Dr. Paul Shapiro,

Thank you for answering my question.

In addition, I read the hyperlink from the doc and I beleive it gave me a good basic understanding of the graft terminology...

Thanks,

__________________
My Hair Loss Website - Hair Transplant with Dr. Ron Shapiro

Dr. Paul,

I am liking your work more and more. I look forward to seeing your patient results when I log on here. Looks sooooo Natural.
great job!