Hey guys, I've been looking around at a lot of the transplant photos on this site, both very large and very small sessions, and I have a question about some of the smaller sessions I've seen. I was looking at the "1000-1999 graft" session category and I mainly saw pictures in which the patient had the majority of the grafts concentrated in a very small area; however, I saw some patients in which they appear to have achieved adequate coverage over a fairly large area with a relatively small number of grafts. Examples: 1205 grafts, 1628 grafts, and 1420 grafts. My question is this: how are these patients achieving the look of density and coverage with such small sessions? Or is it some kind of an illusion?

You are right, I actually really like what was done with the first one with 1205 grafts, he was almost bare in the front (especially on the sides in the front) and thinning in the crown but with just 1205 grafts they covered it up well. Perhaps someone more knowledgeable can comment on this.

Hamilton,

"Illusion" is a term commnonly used when referring to hair transplants since it's impossible for people with extensive hair loss to restore a full head of hair. Though the number of grafts significantly contributes to overall coverage and density, there are a number of other factors to consider. Below are listed a few for your consideration.

1. Amount of existing natural hair: As you can see in most of the hair transplant photo examples you presented, most of the patients had a good amount of natural hair before surgery. When hair is transplanted in between and around the existing natural hair and grown out, it looks a lot denser.

2. Hair Length: Most of the before pictures in the examples above show very short hair whereas the results show the hair fully grown. Though there is no attempt to deceive here, it's important that prospective patients look sharply and consider how hair length contributes to the illusion of hair density.

3. Hair Characteristics: Thicker hair has the ability of creating a greater illusion of density than thinner hair.

4. Hair Style: Certain hair styles will make your hair appear thicker, especially due to the layering effect (hair covering hair)

5. Hair Placement: Strategic placement of the transplanted hair can significantly aid the illusion of density, such as the shingling effect (hair placed like shingles on a roof to minimize the appearance of empty spaces when light shines on the hair/scalp).

6. Hair Density: Though numbers of 50, 60, and even 70 follicular units per square cm (FU/cm2) sound impressive, in many cases this many grafts are not needed to create an adequate illusion of density. Patients are often satisfied with much less and can reserve plenty of donor hair for subsequent procedures if desired/needed.

I hope this helps you in your research.

Best wishes,

Bill

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Bill is right. Plus, donor hair caliber is a big issue. Think of hair like trees that you want to cover an open field with. If you have thin asian hair, like thin arbor vitae trees, it will take lots to give any significant coverage. If you have leyland cypress trees, like a wavy fairly thick european decent person's hair, it takes less, particularly with good color matches. And if you have mature Oaks or willows, like a middle eastern person's thick curly hair, or a black person's hair, it takes even less to give really nice coverage.

Dr. Lindsey McLean VA

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William H. Lindsey, MD, FACS
McLean, VA

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

Hamilton:
Efficient use of grafts is everything in HT. Doctors who are achieving great results WITH a minimal use of grafts should be congratulated, not the ones who are achieving high density like 50, 60 or 70 grafts/cm2. I don't see anything impressive with doctors using 3000+ grafts on a NW 3 patient.

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I am not a doctor. The opinions and comments are of my own.

HT with Dr. Cooley on Nov 20, 2008
2097 grafts, 3957 hairs
Proscar, 1.25 mg daily, skip the 5th day, started Nov 2007

My Hair Loss Blog - Hair Transplant with Dr. Cooley

Right Latinlotus, who cares what the number is, as long as the patient is happy.

I would guess about 40% of my consults have been to a competitor who suggested a bigger case, just to transplant into currently existing good hair--and raise the price.

Do what needs to be done efficiently and spend your money or donor hair at a later date.

Dr. Lindsey McLean VA

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William H. Lindsey, MD, FACS
McLean, VA

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

Hamilton.....thanks for posting this thread

the 1205 case of Dr. True's that you pointed out was the right number for that particular patient, in considering his persistent forlock, age (late 20's), how he wanted the hairline designed, saving some in the hair bank for future progression, wanting the ability to where hair shorter thus the scar result just as important to him, etc. It easy to find high numbers of grafts alluring but there are so many variables for each patient. And if you get a high yield out of a procedure, this always helps. This patient is also using Propecia.

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Patient Services Director for True & Dorin Medical Group

Dr. True and Dr. Dorin are members of the Coalition of Independent Hair Restoration Physicians

dr. Lindsey:

my first consultation was with a famous FUE doctor who told me that i need 3500 grafts minimum! I guess he needed that number because he expects maybe half of the grafts to die...He also told me that he will try to achieve 75 grafts/cm2 density to give an illusion of density. The funny thing is that my natural donor density is a little less than 75 grafts/cm2...Needless to say i did not fall for this bs. I did more research and I am so happy finding this site.

All other doctors that i consulted recommended about 1800-2500 grafts.

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I am not a doctor. The opinions and comments are of my own.

HT with Dr. Cooley on Nov 20, 2008
2097 grafts, 3957 hairs
Proscar, 1.25 mg daily, skip the 5th day, started Nov 2007

My Hair Loss Blog - Hair Transplant with Dr. Cooley

I am having hairloss with the age of 25
Can anyone help me on what medicine should i go for? the most effective one.

Also, rember what Pat says: Count HAIRS not graphs (more slices doesn't make the pizza bigger)! Unfortunately, there are some doctors that don't give both numbers to us on this forum.

For example, lets take Dr. A and Dr.B:

Dr. A harvests 3000 graphs with an average hair count per graph of 1.9, which equals 5700 hairs.
Dr. B harvests 3000 graphs with an average hair count per graph of 2.4, which equals 7200 hairs.
That is a 26% difference in the total amount of hairs. So, to just look at graph counts to compare results, can be quite misleading.

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S5H

My Hair Loss Website - Hair Transplant with Dr. Keene
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3700+ Grafts with Dr. Keene 8/26/08 & 8/27/08
9600+ Total Hairs