Dr Paul Shapiro has said in a previous post that dense packing should generally only be performed on people who are at least 30 and are unlikely to go beyond a Norwood 5. I was wondering do all coalition doctors have this standard. And if there are any forum members who have had dense packing and are less than thirty years of age? Cheers

Julius,

Others can chime in with more precise thought, but I think we need to first define what (we are considering) a densepack to be.

Also, since we are essentially dealing with donor management, how much donor one actually possesses is a monumentally important factor, along with the factors of age and likely pattern!

There have absolutely been cases posted on this forum of people sub-30 who had densepacks; whether these were appropriate, or whether Dr. Paul would consider them appropriate is a whole other story, and I think we'd have to evaluate them individually.

Again, I think we really need to define what we are saying a "densepack" is; I'm pretty certain Dr. Feller considered my case a "densepack", e.g.

Good topic.

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*A Follicles Dying Wish To Clinics*

1 top-down, 1 portrait, 1 side-shot, 1 hairline....4 photos. No flash.

Follicles have asked for centuries, in ten languages, as many times so as to confuse a mathematician.

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

Thanks thana, considering the result that makes sense, but at what density was your ht?
I would call anything over 45 grafts per cm2 dense packing and super dense packing anything over 60 grafts per cm2. Density also obviously depends on the numder of hairs in each graft.

I could be wrong but I think the majority of under-30 transplant patients who have gone to doctors who can 'dense pack' will have had this done, if you take your own definition of dense pack. In fact most will likely have had grafts transplanted to 60 or more per square centimeter. (I'm talking about at the leading edge of the hairline.)

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I represent Dr Rahal. I can be contacted for advice and to arrange consultations.

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

Wow! What is Dr Rahal's definition of dense pack? As for most hair transplants on patients under 30 having grafts transplanted at 60 or more per cm2, even on the hair line, wouldn't that scream ht? I thought that most hairlines where done with singles at 45-55 grafts per cm2 max? Would that even be ethical to super dense pack patients at that age considering their likely future loss? Cheers

In SMG's case, Dr. Ron developed his hairline techniques to mimic naturalness and provide density with the appropriate number of grafts per sq cm.

In most cases 40-55 fu cm/2 provides our patients with excellent results. We get maximum yield at this number, but Dr. Ron and Dr. Paul will occasionally go above this given the proper prerequisites as mentioned above..we still get max growth, but we only do this on a select patients.

The leading edge/transition zone is all singles of varying density (about 1cm wide) then the 1's and 2's closely placed together in the defined zone (2 cm wide_ followed by 2's,3's and 4's into the frontal core to prevent a see through look/block light.

Matt Zupan (SMG's Patient Educator) likes to use the forest analogy...the forest is always less dense on the edge, progressively getting more dense as you go in. The same can be said for mother natures hairlines.

A "Dense Pack" is only for patients who, after weighing ALL factors and in the estimation of the doctor, can afford to use a higher number of grafts that would normally be saved for future loss. Most patients are NOT candidates for this, contrary to what has circled the internet the past few years.

Each doctor will have their own techniques, including the amount of grafts, angulation, graft distribution, approach, etc... which a patient should take into consideration before pulling the trigger.

Additionally, one needs to consider the reputation, length of practice, transparency, consistency of results, patient care, staff and judge accordingly.

Take Care,
Jason

Edited for clarification.

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6721 transplanted grafts
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Dr. Ron Shapiro and Dr. Paul Shapiro are members of the Coalition of Independent Hair Restoration Physicians.

Julius, I'm honestly not even sure what my hairline density distribution is -- but it's something I'm actually pretty curious to know.

B, using 2-3 hair grafts behind the leading edge --> do you feel you guys do this, at least do it closer to "the edge", moreso than other docs who might be in question? I've thought most top docs would do this, but I suppose the philosophy and tecnique in just how close to the edge one goes could be varied (?)

Also, re: what Matt mentioned above....I'm pretty certain that with Dr. Feller the leading edge of my hairline *isn't* at the highest density, but that the zone behind the "leading edge" is where I had the highest density implanted.

Anyways, I'd agree that a "densepack" is really weighted against the individual charachteristics of an individual. I feel like I have good density, but that the number of grafts currently allocated *isn't* in line with a "densepack", in the sense that a disproportionate number wasn't invested in my hairline.

Were I to ever add grafts to my hairline zone I would definitely consider *that* a densepack, since the grafts being allocated would be a bit hair-greedy and basically pumping up an already solid region at the potential expense of a different region down the road.

__________________
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*A Follicles Dying Wish To Clinics*

1 top-down, 1 portrait, 1 side-shot, 1 hairline....4 photos. No flash.

Follicles have asked for centuries, in ten languages, as many times so as to confuse a mathematician.

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

I am about 35, and I had dense packing. I have about 60 per cm2 in my frontal hairline, and my doctor and I both agreed upon it.

Thanks for your replies, B spot are you saying that in most cases 40-55 grafts cms per cm2 are used in the hairline then a greater density past the transition zone? I had a previous discussion with Raj about the best density on the hairline and the rest of the head so that it doesn't show up under harsh lighting and we seemed to come to the consensus that a high mature hairline with about 45-55 grafts per cm2 at the hairline (using singles) and 55-65 on the rest of head would hold up and look naturally age appropriate. Forest, who did your procedure and at what stage on the Norwood scale were you? Cheers

I do agree that higher density on the hairline and less density on the head wont look natural under harsh lighting and people would easily know its a HT job.