Density it frontal 1/3

[Chops]

What would you say the typical graft density is that top docs such as Shapiro or H/W plant in the frontal 1/3 is? Would an average of 45 grafts/sq cm be high enough for complete naturalness, assuming you have medium to thich hair?

[Chops]

What would you say the typical graft density is that top docs such as Shapiro or H/W plant in the frontal 1/3 is? Would an average of 45 grafts/sq cm be high enough for complete naturalness, assuming you have medium to thich hair?

[Reyes]

Yay! I get to do homework on this one! I'll get back to you soon...

[Bill - Seemiller]

Chops,

 

Creating a natural looking hairline with appropriate hair density was recently discussed and debated by leading hair restoration physicians in the field at the annual ISHRS 2008 scientific meeting. Where some physicians believe that most patients won't need above 35-45 follicular units per square centimeter (FU/cm2) in the hairline, some will transplant up to 70+ FU/cm2. Those hair transplant surgeons who use less density in the hairline argue that most patients look great with less and it helps to reserve the finite donor hair supply for future hair transplants if needed/desired. Those who use higher hair densities argue that it blocks more light from shining through to the scalp, creating a greater illusion of fullness and density even under harsh lighting conditions. Dr. Keene of AZ also hypothesized and has anecdotal data that suggests that natural hairline density may not exceed 45 FU/cm2. If this proves to be true, higher densities in the hairline may prove to be overkill.

 

A typical approach for the hairline and frontal third reconstruction is to create a hairline using single haired follicular units and reinforce behind it with some larger follicular unit grafts using shingling to block light to the scalp. In many cases, the density directly behind the hairline is denser than the hairline itself in order to give it a "soft" and natural look. From front to back overall, density decreases to make good use of a finite donor source, especially since most people will see you from the front.

 

The relevant issue however, is what hair density is right for you given your hair characteristics, donor hair, current and future area(s) of hair loss, and hair restoration goals. Be sure to speak with all surgeons you are considering about this.

 

I hope this helps.

 

Best wishes,

 

Bill

[Chops]

thanks for a great thorough answer Bill

 

I'm a little confused though. Most would consider a NW6 approaching 7 to have approx 200cm2 of area to cover on average. This would mean an average donor yielding 7000 FUs would be able to give hairline density over the complete area (200*35), whereas many would argue its extremely difficult for an average NW7 to get full coverage at anywhere near hairline density

[Bill - Seemiller]

Chops,

 

You are certainly welcome.

 

The argument regarding natural density potentially being around 45 FU/cm2 is for the hairline only, and this has not been proven with anything but anecdotal evidence.

 

35 FU/cm2 over a 200cm2 area will appear rather thin, especially in harsh lighting.

 

For example, I've had over 7500 grafts in approximately 200cm2. My density is not uniform (which is typical) but ranges between 50 FU/cm2 to 25 FU/cm2. From the front in most lighting, my hair looks very thick. But under harsh lighting, even the front looks thin. From the top, it's obvious I'm thinner, but I have enough hair to appear like I have minimal hair loss. Not bad considering I'd be completely bald without it

 

Bill

[Chops]

thanks.

 

So what density would you typically expect in the frontal 1/3 to give a good illusion of density and not thin? 50 FU/cm?

[Chuckisduck]

Originally posted by Bill - Associate Publisher:

Dr. Keene of AZ also hypothesized and has anecdotal data that suggests that natural hairline density may not exceed 45 FU/cm2.

 

I remember Dr Keene told me about the data when we decided on density. I settled for 45 FU/cm in some areas down to about 35 FU/cm on my temples.