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Density Question


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If an HT surgeon packs a high density of hairs, say 60-70 Fu/cm squared in the frontal zones and hairline, would the transplant in the front still have a "see thru" look when dry in harsh light? Of course this is assuming minimal shock loss and high yield? I know it is unrealistic to expect thick hair when gelled or wet, but is it too much too expect non-see thru hair when dry also???

 

I'm asking this because i've heard ppl. say that all transplants give you a see thru thinning look. If this is true then a transplant is worthless to me as that is what I currently have. No totally bald spots yet.

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Well, I haven't had my HT yet, so I'm only able to repeat what I've read and heard on this site, which is that typical density is somewhere around 90 FU's, but that baldness doesn't reach a level that is noticeable until the density falls below half of that.

 

That was true for me, baldness really sneaked up on me.

 

Now my HT is supposed to average about 40-45 or half normal density, and my expectations have been set to expect a normal look when it reaches maturity in about a year.

 

I did know a guy some years back who'd had a transplant that looks the way you describe. He had the doll plug look. It was obvious it was a transplant. I altogether don't expect that to be the case for me because the technology and technique has advance so much, and I've chosen one of the top doctors.

 

I wil add however, that even though this fellows transplant was obvious, he still looked better than he would have bald..in my opinion.

mark h

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If an HT surgeon packs a high density of hairs, say 60-70 Fu/cm squared......

IMO-- if you achieve 60-70 cm2 density in the frontal zone and hairline, you would not be see through dry or in harsh light. Of course, if one has very fine hair or some type of unusual scalp/hair contrast, but those are exceptions, rather than the rule.

 

H-Town--- a couple of things to consider: Attaining that type of density will use available donor quickly. Say if you transplant the frontal 110 cm2 zone to 65fu's per, you will have used 6500+ grafts, more than likely MOST of your available donor (there are exceptions) leaving you with some of the mid-scalp and all of the crown without any chance for a decent coverage. In addition, transplanting that density into weak native hair will most assuredly result in some shockloss in surrounding areas as well. In looking around, I think optimal density is 50 to 60, which represents a density slightly greater than half of normal density (90fu cm/2). Using a theoretical case similar to my own, someone with 200cm of bald area to cover, would typically have 18 to 20,000 fu's missing from his head. It is impossible to restore hair to that density, as donor cannot meet that demand. Half of that density 45fu cm2 would require 9000 fu's transplanted, a number that very few can reach (donor, scalp, etc...) So what has to be done is proper distribution and planning--- in your case you need to either minimize shockloss (smaller sesions) OR target areas of need and perhaps sacrifice coverage in other areas (frontal zone--- leaving crown). In your case I would try to meet others with density's of 30, 40, 50, and 60 to see what it looks like in the light, in person, wet or dry. I know I have densitys of 25 to 40 and I would like to double the areas where I have 25 and then do 10 to 15 in the areas I have 35 to 40, giving me an average of 50 to 60 fu's in the frontal 120cm2 of my balding pattern. I figure I will need another 2500 fu's over the top of my first HT to acheive this, a very realistic goal that will give me 5500 grafts from hairline to the top of the crown. If I get 4000 grafts on my next turn, I will sprinkle 1500 grafts throughout the crown region, about 15fu cm2. Of course I have extreme baldness, but I think it helps to point out just what can be done, and try to keep realistic goals of coverage and densitys. Keep in mind---- (this is so important)--your density numbers may differ from others----- Should you see 45fu cm2 in one region, you might be happy with that, but you would never know this if you planted 75 fu cm2 the first time. Just keep that in mind as you think your way through the process. I certainly hope this helps you out a bit. Chin Up, and lots of reading!!!!

Go Cubs!

 

6721 transplanted grafts

13,906 hairs

Performed by Dr. Ron Shapiro

 

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

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  • 2 years later...
  • Senior Member

B spot,

 

I like your explanation of this question. Layering various density levels through the various parts of the scalp. The downside though is multiple surgeries and more down time. In the end though, if this an option and clearly conveyed to the patient, it should be carefully considered...

 

B, in the hairline area, how far back would the doc need to plant to greatly reduce the see through look with natural results? In addition, in my opinion, it seems natural to see some scalp, when you see guys with very thick hairlines that are not age appropraate- it is a dead give away that an HT was performed. Not to mention what happens 10 years from now to that persons hair.

 

You brough up some great points about the number of FU's needed to give the density level of 45fu cm2, could FUE be used to suppliment a strip? If we are talking about the average man needing say 9000 Fu's to achieve good density,and assuming a complete bald scalp of 200cm and the normal available donor is roughly 6500 fu's could FUE make up the difference?

 

Also, in terms of schock loss, if someone had a previous HT, how would that affect their existing HT hairs?

 

Thanks,

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i have had two procedures to the same area about 13 months apart,all in the front.and yes i did suffer from shock loss to the previously transplanted hair. it was ahorrible feeling.but ive been told that these hairs will return at around 4-5mos.thats where iam now and it does appear that is happening

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great topic guys. i asked question like this before but didnt get much of response. My idea is to use meds and get transplant. hopefully meds will help but maybe in a few years stop meds and leave the crown go. I would like to get a strong enough hairline to frame my face so that I can shave it to a one blade like say zinedine zidane.What FU per cm would require to look proper shaved that tight? I dont plan to try get my original hairline back but just to have a better angle than what i have.

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  • Senior Member
Originally posted by M1A1:

 

B, in the hairline area, how far back would the doc need to plant to greatly reduce the see through look with natural results? In addition, in my opinion, it seems natural to see some scalp, when you see guys with very thick hairlines that are not age appropraate- it is a dead give away that an HT was performed. Not to mention what happens 10 years from now to that persons hair.

 

You brough up some great points about the number of FU's needed to give the density level of 45fu cm2, could FUE be used to suppliment a strip? If we are talking about the average man needing say 9000 Fu's to achieve good density,and assuming a complete bald scalp of 200cm and the normal available donor is roughly 6500 fu's could FUE make up the difference?

 

Also, in terms of schock loss, if someone had a previous HT, how would that affect their existing HT hairs?

 

Thanks,

 

Hey M1----Dr. Shapiro pioneered the "transition zone" where a hairline would mimic nature and start from fine lower density and graduate to a higher density behind it, thus reducing the "see through" effect. At the same time, this gradient approach removed the wall of hair or abrupt hairline that made HT's so noticeable.

 

Matt Zupan our patient educator likes to say that when you enter a forest it is always less dense on the edges, but once you take a couple of steps in, it gets more dense.

 

Ideally, you would want to start using some 2 and 3 hair grafts about a half cm behind the actual hairline itself which is made up of 500-600 1 hair grafts. I can tell you if you have hair characteristics like mine, thin + slight wave, a density of 55 is more optimal.

 

I think strip + FUE used in tandem will likely yield the greatest results for those in need of higher graft totals. Myself personally, I have had 8000+ grafts via strip and FUE, and I still have a bald spot in the crown a bit smaller than a baseball---reason is, it takes so much more of my hair to make a difference due to my characteristics. Others could get much more mileage out of their hair, like Bill, who have thicker individual hair follicles.

 

If a guy can get 6500 strip grafts, it stands to reason he should have another 2K via FUE, maybe more. Obviously factors like scar width and donor density come into play, but if a patient has enough density to yield 6500 strip grafts, the should be able to get 2K taking from the entire donor area.

 

Previously transplanted hair is tough--- most of the time it is not shocked out, when transplanted by a top clinic, if it does happen, it will grow back in a few months.

 

Forehead---it really depends on your characteristics, but a sold hairline of 30-35 followed by using 25-30 all the way back. Transplanting the frontal 100-120cm would take around 3000-3500 grafts, which MOST people should be able to take, without noticeable scarring or thinning in the donor. I think you should be able to use a 1 guard, but plan on using a 2 guard as a better approach... as there are no guarantees you can buzz to a #1.

 

Take Care,

Jason

Go Cubs!

 

6721 transplanted grafts

13,906 hairs

Performed by Dr. Ron Shapiro

 

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

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  • Regular Member

Don't forget that multiple factors are important, not just a number/density. Equally critical is hair shaft caliber. (for example each of the last 2 fridays we have had 2500 graft crown cases. 2 fridays ago the guy had the second thinnest hairs that I have ever worked with, and last friday was much more of a normal "generic european decent american" thickness. both were military guys in their 50s but one will get way better coverage)

 

Also important is patient expectation. Its important preop that the doc point out what each patient brings to the table and what they can reasonably expect in most cases. In the instance of what I described above, I told the first guy he'd have some coverage but not nearly enough that he'd no longer have to worry about sun exposure on his scalp; and the second I think will get excellent coverage with thicker coarser hairs.

 

Lastly color difference between hair and scalp can vastly increase or decrease apparent density.

 

So as you are contemplating different approaches, factor all of these things in to your decision.

 

Dr. Lindsey McLean VA

William H. Lindsey, MD, FACS

McLean, VA

 

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

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