I've been reading many forums as I am making my hair transplant decision. I have only noticed one post on one forum in one patient where it was mentioned that the patient's 'scalp geometry' allowed great coverage with a small amount of grafts. I got to thinking-how come no one mentions this factor? We've heard about donor density as an individual factor as well as physical factors of the donor area such as elasticity, but how about the recipient zone geometry? For instance, if you have a 'blockhead', someone with a big flat vertical forehead and a large head, and compare them with a 'conehead' there should be difference in the number of grafts needed to cover the entire head. The conehead has a sloping forehead (therefore less linear space across the forehead for the hairline) and a smaller amount of cm2 for the top and crown area.
I'd be interested to hear from someone experienced in the community if this makes a significant difference in the number of grafts needed. If it does, by how much? 10-20%?

Ventuoguy,

Though scalp geometry (the size and shape of the head) isn't necessarily discussed, the "area of baldness" to cover is always discussed as an important factor.

The larger the area of baldness to cover, the more grafts that will be required to achieve adequate coverage and density.

But you are onto something. Scalp geometry is one of the many reasons why you can't give a generic answer to "how many grafts will I need to cover a norwood 5"? Size of the scalp, hair characteristics, average hairs per graft will all need to be considered to answer "how many grafts will I need..." To answer how many grafts are available, one must consider donor hair density and scalp elasticity, etc.

Best wishes,

Bill

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Ventuoguy

You make some escellent points and Bill is right on with his reply.

"Scalp geometry" not only affects the area to be covered but should also affect the shape of the transplanted hairline, which further affects the area to be covered.

Those patients with a broad forehead also need a broader hairline to look natural. A narrower hairline often suits a patient with a more conical head but the higher dome-shape still increases the surface area.

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Cam Simmons MD ABHRS
Canadian Hair Transplant Centre,
Toronto, Ontario, Canada

Dr. Cam Simmons is a member of the Coalition of Independent Hair Restoration Physicians