Question/Answer: Will I be able to gain a full head of hair from a hair transplant?

[Bill - Seemiller]

I've posted similar information in another thread, but have decided to add more information and post it in this thread since it's a great topic of discussion. Please feel free to add your thoughts.

 

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Many people ask if they will be able to obtain a full head of hair. What people typically mean when they ask this question is "Will I be able to restore my hair to look like the good old high school days (or maybe Junior High for some)?" For some, this may be more possible than others, depending on the level of hair loss one is experiencing, however, before we answer this question, let's take a look at more specifics regarding this topic.

 

One has a finite supply of donor tissue that can be removed for hair transplantation during strip surgery (regardless of number of sessions). Additionally, there are only so many hairs that can be extracted using the Follicular Unit Extraction (FUE) or the Follicular Isolation Technique (FIT) without the donor area looking moth-eaten. Because there is a limitation of how many donor hairs can be taken, clearly these grafts/hairs should be used wisely, taking into consideration factors like density verses coverage. Clearly those with lesser amounts of hair loss can use their grafts to dense up existing balding areas (assuming their hair loss is under control), whereas those with greater amounts of hair loss has to sacrifice one or the other, density or coverage. One can choose to dense up the frontal part of their scalp for example and leave the crown bald, or choose to cover the whole area whereas density will be sacrificed.

 

The phrase "illusion of density" is common when discussing hair transplantation. Because donor supply is limited, there is simply no way to restore a "full head of hair", BUT, with proper use of the limited donor grafts/hairs, physician and clinics can strategically place the grafts over the balding region to create an "illusion of density". This means that for the most part one might appear to have a full head of hair, even though it's much thinner than it used to be in their glory hair days.

 

How then is the illusion of density different than having a full head of hair?

 

I think the best way to answer this question is to discuss lighting. Being a hair transplant patient, I've gone from a Norwood 6 to having a pretty decent head of hair after 7550 grafts. I have also found, that some lighting is much more flattering than others.

 

I believe the appearance or illusion of density related to lighting depends on several factors:

 

1. Illumination

 

Brightness will clearly influence how dense our hair looks. The brighter the light, the more detail is exposed. A quality hair transplant will stand up in all lighting conditions - in that it will look natural, however, clearly, the appearance of density will lessen as the light brightens

 

2. Color:

 

Lighter colored lights such as florescent ones lessen the appearance of density whereas normal or colored lights increase the appearance of density.

 

3. Direction/Angling

 

I have found specifically that direct sunlight hitting my hairline makes my hair appear super dense, whereas the sun coming from behind makes my hair look much thinner from the front. Straight overhead (around noon), I'd say my hairline looks somewhere in between these two extremes.

 

But do not be deceived. Lighting affects even those with a full head of non-balding native hair (especially when their hair is kept shorter). It just isn't as obvious. Remember, we ARE dealing with less density than one with a full head of native hair, hence the illusion of density.

 

One question that tends to come from this discussion is: So which lighting exposes the truth? There are varying answers, but here's mine: They all do. The only exception to this, I'd suggest are photos taken with flash photography. To see more on this topic specifically, see the following thread posted by Joe Tillman, a patient, fellow member of our community, and employee of Hasson and Wong: http://hair-restoration-info.com/eve/forums/a/tpc/f/346...141012852#5141012852

 

The bottom line is at varying points of one's day and/or life, we will be seen in all types of lighting. At the same time, though, one has to consider where they will be seen the most. I admit there have been times where I am talking to someone outside and end up noticing that the sun is behind me. So I'll strategically angle myself so the sun is more flattering to my hairline. Some might consider that a worry they don't want to have to deal with, but for me, I am not all that concerned. But I do know where I look the best...so sometimes I remember and try to face that way. This would be the same concept as those who are into body building. Certain lights and mirrors are more flattering than others, therefore, they prefer to flex in front of those mirrors, in that lighting.

 

As a hair transplant patient three times around, I'd say, however, that my level of satisfaction is very high! I have realized that even in the worst lighting conditions, I still look 1000 times better than I would without hair transplantation. And the truth is...I don't feel that even in worst lighting that it looks bad.

 

I hope this gives you even more of an understanding of how hair transplantation works and what to expect from your hair transplant.

 

---------

 

Bill

[Bill - Seemiller]

I've posted similar information in another thread, but have decided to add more information and post it in this thread since it's a great topic of discussion. Please feel free to add your thoughts.

 

---------

 

Many people ask if they will be able to obtain a full head of hair. What people typically mean when they ask this question is "Will I be able to restore my hair to look like the good old high school days (or maybe Junior High for some)?" For some, this may be more possible than others, depending on the level of hair loss one is experiencing, however, before we answer this question, let's take a look at more specifics regarding this topic.

 

One has a finite supply of donor tissue that can be removed for hair transplantation during strip surgery (regardless of number of sessions). Additionally, there are only so many hairs that can be extracted using the Follicular Unit Extraction (FUE) or the Follicular Isolation Technique (FIT) without the donor area looking moth-eaten. Because there is a limitation of how many donor hairs can be taken, clearly these grafts/hairs should be used wisely, taking into consideration factors like density verses coverage. Clearly those with lesser amounts of hair loss can use their grafts to dense up existing balding areas (assuming their hair loss is under control), whereas those with greater amounts of hair loss has to sacrifice one or the other, density or coverage. One can choose to dense up the frontal part of their scalp for example and leave the crown bald, or choose to cover the whole area whereas density will be sacrificed.

 

The phrase "illusion of density" is common when discussing hair transplantation. Because donor supply is limited, there is simply no way to restore a "full head of hair", BUT, with proper use of the limited donor grafts/hairs, physician and clinics can strategically place the grafts over the balding region to create an "illusion of density". This means that for the most part one might appear to have a full head of hair, even though it's much thinner than it used to be in their glory hair days.

 

How then is the illusion of density different than having a full head of hair?

 

I think the best way to answer this question is to discuss lighting. Being a hair transplant patient, I've gone from a Norwood 6 to having a pretty decent head of hair after 7550 grafts. I have also found, that some lighting is much more flattering than others.

 

I believe the appearance or illusion of density related to lighting depends on several factors:

 

1. Illumination

 

Brightness will clearly influence how dense our hair looks. The brighter the light, the more detail is exposed. A quality hair transplant will stand up in all lighting conditions - in that it will look natural, however, clearly, the appearance of density will lessen as the light brightens

 

2. Color:

 

Lighter colored lights such as florescent ones lessen the appearance of density whereas normal or colored lights increase the appearance of density.

 

3. Direction/Angling

 

I have found specifically that direct sunlight hitting my hairline makes my hair appear super dense, whereas the sun coming from behind makes my hair look much thinner from the front. Straight overhead (around noon), I'd say my hairline looks somewhere in between these two extremes.

 

But do not be deceived. Lighting affects even those with a full head of non-balding native hair (especially when their hair is kept shorter). It just isn't as obvious. Remember, we ARE dealing with less density than one with a full head of native hair, hence the illusion of density.

 

One question that tends to come from this discussion is: So which lighting exposes the truth? There are varying answers, but here's mine: They all do. The only exception to this, I'd suggest are photos taken with flash photography. To see more on this topic specifically, see the following thread posted by Joe Tillman, a patient, fellow member of our community, and employee of Hasson and Wong: http://hair-restoration-info.com/eve/forums/a/tpc/f/346...141012852#5141012852

 

The bottom line is at varying points of one's day and/or life, we will be seen in all types of lighting. At the same time, though, one has to consider where they will be seen the most. I admit there have been times where I am talking to someone outside and end up noticing that the sun is behind me. So I'll strategically angle myself so the sun is more flattering to my hairline. Some might consider that a worry they don't want to have to deal with, but for me, I am not all that concerned. But I do know where I look the best...so sometimes I remember and try to face that way. This would be the same concept as those who are into body building. Certain lights and mirrors are more flattering than others, therefore, they prefer to flex in front of those mirrors, in that lighting.

 

As a hair transplant patient three times around, I'd say, however, that my level of satisfaction is very high! I have realized that even in the worst lighting conditions, I still look 1000 times better than I would without hair transplantation. And the truth is...I don't feel that even in worst lighting that it looks bad.

 

I hope this gives you even more of an understanding of how hair transplantation works and what to expect from your hair transplant.

 

---------

 

Bill

[Here I Grow Again]

Great info Bill, good points to consider when getting a transplant and for afterwards. It helps to keep expectations in check. I was at the beach last weekend and took some photos. When they were developed I could clearly see where my transplant was growing in but the areas where I am still bald were REALLY bald and highlighted from the sun. Nothing was hidden. You are right, when one is outside in direct sunlight even folks with a full head of hair seem to have less density. Its all in the angles

[hairbank]

HIGA-

 

Thanks for sharing your personal experience............that's what counts .

 

This is a good post to review...........IMO, every poster should show indoor and outdoor pics (in bright sunlight) of their HT. What better way to depict "real-life" results??

[balody]

as higa said its all about expectations and really keeping your feet on the ground.i was a bald man now i am happy to be a balding man,when i get my crown done i will happy to be a man who is receeding.i know i will never have excellent density but like you say its all about the illusion of having hair with only a percentage of the scalp space being used.farjo made this very clear to me at my consultation so ive never been under any false pretences about strong lighting effects etc.

[Aquarius]

bolody ; I'm your hucklberry. The answer is NO.

I hate semantics.

Did Farjo give you the pith helmet or did a friend?

[hairbank]

Originally posted by Aquarius:

I'm your hucklberry

 

Tombstone.....right, Aq?? One of my favorites! Along with: "Why Johnny Ringo.....you look like someone just walked over your grave"!

 

Okay......back to hair. I do believe we are going after the illusion/appearance of density, however, I believe with more than 7500 strategically placed grafts for a NW 5 or maybe even 6 that it can "appear" pretty darn dense.

 

Hairstyles also play a role. At present, I'm guessing I have 40 cm2 in most places except maybe a little of the crown. Combing my hair back, as in my lastest pics on my blog, my crown covers pretty good. However, styling it forward with a little side part I have very little see-through even in the sunlight. My point being, with many now having in excess of 7000 grafts due to the mega-mega sessions, the full look is becoming more and more of a reality.

[balody]

eh?

[the B spot]

Why Johnny Tyler...... madcap..... (Kilmer)

 

Doc... that you? (Billy Bob)

 

 

Also just as good...

 

Blood? That's my game. (Kilmer)

 

Tombstone is a GREAT Western-- often overlooked.

 

Bank, you and I could probably spend a month yakking about hair and watching Westerns in between!!!!

 

J

[hairbank]

LOL! Sounds like it...my friend.

 

Yes........Tombstone is one of my all-time fav's for westerns.

 

Wyatt (to Johnny Tyler): Are you gonna do somethin' or just stand there and bleed??

 

or

 

Cowboy: Why...you're the piano player, your so drunk you're probably seein' double.

 

Doc: I've got two guns.........one for each of ya!

 

BTW......I was in Walmart tonight with my wife and almost picked up "Once upon a Time in the West". Remember it.........Bronson, Fonda, Robards.....all at their best. Great lines with a very unique story line.

 

Western movie trivia for you........did you know that the spaghetti westerns role of the man w/ no name was initially offered to Bronson before Eastwood?? (maybe I've mentioned this before??) Crazy!

 

Anyway............I can always get away with mentioning Eastwood on HTN 'cause he had great hair........specially back in the Rawhide days!

[NervousNelly]

Hairbank,

 

Did you know that Eastwood had a HT?? I read that in a gossip journal so not certain but he has kind of had the same hairline for awhile.

 

NN

[hairbank]

Hey NN,

 

No.......I did not know that. Stands to reason though..........he was really receding during the 70's though his hair was still thick. Seems like he's held on the last 10-15 years maye a little too much to be natural !

[the B spot]

Yeah--- for some odd reason Bronson turned that role down

 

Those movies made Clint a star.

 

I had heard he had a hair transplant, but I wonder how they did it?

 

His hair is only slightly less resistant to damage than Supermans'

 

Anyway, couple more of my favorite quotes:

 

I know Ike..... Let's have a spelling contest.

 

or

 

You know Fredrick Fu@#$@) Chopin?

 

Love it!

J

[hairbank]

Originally posted by the B spot:

 

I know Ike..... Let's have a spelling contest.

 

or

 

You know Fredrick Fu@#$@) Chopin?

 

Love it!

J

 

Forgot the first one...............one of my fav's and I chuckled as I read it. I loned by Tombstone DVD out to my best friend and have yet to see it returned over a year later......wait a minute, maybe he's not my best friend after all !!

 

 

One last quote and I'll quit:

 

Curly Bill (after shooting the mexian police): "We're the cowboys........next time we come to town, y'all had better step aside........I ain't kiddin', neither!"

[Aquarius]

You guys are too much. Next week .A Clockwork Orange . That is if you have any yarbles.

I am still laughing from your quotes.

[Bill_the_bald]

I have a somewhat related question with regard to this "illusion of density." It seems to be generally agreed on this forum that you only need slightly more than half of the original density to achieve the illusion of fullness. So consider the scenario where we have this hypothetical patient with 100 fu/cm2 density on his native hair. He hairline has now receded to the midscap with a completely shiny forehead but a full crown with original density. He goes in for a HT and completely fills in the bald area, but with 70 fu/cm2 on his left front, and 130 fu/cm2 on the right front. So now with full coverage but three regions of different density, each over half of the original density, how would he look to the eyes of someone who doesn't know he had a HT. Would his hair appear "uniformly dense", or "some areas fuller than others"?

[Bill - Seemiller]

Bill,

 

I might suggest based on what I wrote above that it would depend on lighting. I think approximate uniform density, however, is important. Dense packing one side significantly more than the other could certainly leave an imbalanced look especially in certain lights.

 

Bill

[finnari]

I just want my hair to look good.

 

Dont you guys think this over analysis can be a bit neurotic?

[Aquarius]

Finnari-

Do you want to become neurotic after?

Have a smoke, tell a joke.. Get in the chair. You want to circumvent the knowledge at your feet.

Don't come back teary eyed.

Since you are in AZ. A visit to Dr. Keene might prevent you from doing anything stupid.

[hairbank]

Actually, I think Bill has a valid point not to be dismissed. Not sure I understand in the example however why this person received 70 cm2 on one side then 130 cm2 on the other??

 

IF you have someone with 100 cm2 of native hair in the crown that's still dense as ever, but their midscalp and frontal third are bald, you may take the strategy of going with 60-70 cm2 on the first pass to see how they blend. You can always go back and add more later, AND, I think you'll hear arguments on the negative side of graft survival if you start dense packing more than 60-70 cm2 in one pass.

[Bill_the_bald]

Hairbank,

 

The reason I used these numbers is to test the claim "you can achieve the illusion of full look with slightly over half the original density." In this hypothetical example, since we are dealing with the same person, hair characteistics that may affect the appearance of density are identical, so the only factor remaining is density.

 

Therefore, under ideal conditions (dry hair, lighting not working against you, etc), once the density has exceeded this "threshold" so to speak, will the eyes be able to tell the difference between "illusion of fullness" (70 fu/cm2), "original fullness" (100 fu/cm2), and "above original fullness" (130 fu/cm2)?

[the B spot]

The simple issue is to have a gradient approach where the hair begins in a lower density and gradually increases to try and match the more dense existing native hair.

 

One thing to keep in mind--- it is almost impossible to achieve natural density, even if you are transplanted at 100 fu's c/2.

 

Natural follicular units as they exist on the head are grouped in 1,2,3,4,5-7 units, thus when we say "original density" and our original density was 100, the hair density is 200-230 hairs a sq cm, vs 100 singles, 50 doubles, etc...

 

Again make sure you understand how density works as a graft to hair count divided by the area of coverage needed.

 

100 single fu's cm/2 is equal to 50 2 hair grafts.

 

Take Care,

J

[hairbank]

I'm not sure you're creating a realistic scenario here?? Under what conditions would this ever happen? I don't think native density is going to vary that much.......i.e. not matter how far my hairline or sides recede, the density I run into will likely be within 10 cm2 at each point of contact for native hair and HT donor hair.

 

For instance, take a look at guys like London Lad, NicNitro or others who have insane donor density at 130 cm2............look at their HT's........they appear natural, correct? I just don't think you're going to run into a situation where you'll be matching HT hair to 2 highly variable sets of donor density, make sense?

[Bill - Seemiller]

This is an interesting conversation and certainly worth discussing.

 

Of course, the problem is, regardless of whatever answers we give, one can only work with what is possible to achieve. As B Spot said, achieving natural density with transplantation may be next to impossible, yet at the same time, I think the gradient approach to a hair transplant is clearly the best approach. Of course, those with a thick crown and missing the frontal third might need to take a different approach. But those with less hair loss (if the other requirements are right, like age) are more optimal candidates for mega dense packed sessions. Though maybe matching native density may not be possible, going a few passes at the frontal third with much of the available donor could achieve some amazing results.

 

Bill