Optimal Density achieved for Transplant

[newhair46]

I am new to this. I have spoken with several doctors and I have a dilemma. Both doctors state that they would do between 2,100 and 2,500 grafts in one sitting for my transplant. However doctor A says with a density of 20 FU/cm I could cover say 90% of what I want while doctor B says he would achieve a density of 40 FU/cm and cover the same or more. Doctor A says that many doctors claim higher density but that their survival rate is much lower than his thereby achieving even a lesser result that doctor A's 20 FU/cm.

 

Both doctors belong to all the "right" medical associations and have been mentioned in these forums with good comments. Doctor A has over 30 years experience while doctor B has 20 plus years. I like them both but, of course, I want higher density.

 

So who or what should I believe or how should I interpret this info?

[chrisdav]

Do you have any pictures you can post?

[newhair46]

Do you have any pictures you can post?

 

what kind of pictures do you want?

[chrisdav]

Well other forum members will be able to give their own constructive comments.

 

Whatever the area is that you wanted transplanted into.

[newhair46]

I'm just trying to understand what density is the usual density after a hair transplant using 2,100 to 2,500 grafts. Is it as little as 20 FU/cm or is 40 FU/cm reasonable?

[chrisdav]

It depends on other factors but the main one would be the size of the area being covered.

[1978matt]

Photos would definately help.

 

Are you looking to have a Strip method or FUE transplant?

 

These docs probably took a tape measure and did a few rough approximations which may partly explain the differences in what they are saying.

[Thehairupthere]

Density varies depending on the area you work on typically on average it's about 40 or slightly more grafts per square centimeter. If you were to have 40 and get less than 20 per square centimeter than something is wrong; that kind of survival rate is very rare from the recommended doctors on this forum.

[strypp]

I am new to this. I have spoken with several doctors and I have a dilemma. Both doctors state that they would do between 2,100 and 2,500 grafts in one sitting for my transplant. However doctor A says with a density of 20 FU/cm I could cover say 90% of what I want while doctor B says he would achieve a density of 40 FU/cm and cover the same or more. Doctor A says that many doctors claim higher density but that their survival rate is much lower than his thereby achieving even a lesser result that doctor A's 20 FU/cm.

 

Both doctors belong to all the "right" medical associations and have been mentioned in these forums with good comments. Doctor A has over 30 years experience while doctor B has 20 plus years. I like them both but, of course, I want higher density.

 

So who or what should I believe or how should I interpret this info?

 

i asked the same question on another forum and got the same non answer (but for the true and dorin answer)

 

one doc says anything over 40grafts/cm2 per session will compromise blood supply and graft survival....

another says he could do up to 65grafts/cm2 per session but if you want more density you can do so in another procedure

 

this is an "in general" question and is practice specific not patient specific

so pics are not needed

 

just like one doctor recommending 1000 grafts for a specific area

and another recommending 2000

 

it seems to be a straight forward question, at least true and dorin answered it directly, at least for their practice

[newhair46]

Thanks Strypp! Hopefully I'll get some addl feedback to add some other perspectives.

[Spanker]

It depends on the doc. Dr Rahal is planting at very high densities and getting close to a hundred percent. Some docs can and some can't. Also, some won't.

[Davis91]

Also, you are talking specifics and to a specific area that we can't see. If you post pics it will help. The reason is that you should think of a general overall game plan. If you are an NW2-3 and 50 years old with stable hair loss and a good donor supply, you could probably go more aggressive on the density. If you are 25 with NW6, then you may need to get with a conservative, long-term thinking doc. You may want to seek a third or fourth opinion.

[England]

The reality, in my opinion, is that the doctor who is claiming doctors can't achieve 40 grafts per sq cm is proven wrong by thousands of cases which are posted on here, all at a density of 40 / sq cm or above. It is not true that 20 grafts per sq cm by this doctor will result in the same or better appearance as the 40 grafts / sq cm by a top doctor due to yield issues.

 

In fact, 20 grafts per sq cm is typically not sufficient to achieve an illusion of density at all. I would be very surprised to see any recommended doctor on this site claim what you stated.

 

There are some possible reasons why a doctor could recommend going less density, such as there being a large area to cover, limited donor supply, big risk of future loss. The other important factor is how much native hair you already have in the area, if you have a lot (say 40-50 grafts per sq cm) then it's possible 20 could be enough whereas 40 could put you more at risk of shock loss.

 

However, the reason that you state the doctor gave is not one of these possible reasons so I personally would avoid, assuming that your question paints an accurate picture.

[newhair46]

Also, you are talking specifics and to a specific area that we can't see. If you post pics it will help. The reason is that you should think of a general overall game plan. If you are an NW2-3 and 50 years old with stable hair loss and a good donor supply, you could probably go more aggressive on the density. If you are 25 with NW6, then you may need to get with a conservative, long-term thinking doc. You may want to seek a third or fourth opinion.

 

Thanks for your comments! I am more of a NW4 -5 however about 55 with stable hair loss and a donor supply of about 6,000 total. So do you believe that 40 grafts per sq cm is a reasonable expectation for an initial total graft of between 2,100 and 2,500?

[newhair46]

The reality, in my opinion, is that the doctor who is claiming doctors can't achieve 40 grafts per sq cm is proven wrong by thousands of cases which are posted on here, all at a density of 40 / sq cm or above. It is not true that 20 grafts per sq cm by this doctor will result in the same or better appearance as the 40 grafts / sq cm by a top doctor due to yield issues.

 

In fact, 20 grafts per sq cm is typically not sufficient to achieve an illusion of density at all. I would be very surprised to see any recommended doctor on this site claim what you stated.

 

There are some possible reasons why a doctor could recommend going less density, such as there being a large area to cover, limited donor supply, big risk of future loss. The other important factor is how much native hair you already have in the area, if you have a lot (say 40-50 grafts per sq cm) then it's possible 20 could be enough whereas 40 could put you more at risk of shock loss.

 

However, the reason that you state the doctor gave is not one of these possible reasons so I personally would avoid, assuming that your question paints an accurate picture.

 

Thanks for your comments! As I just mentioned with the last post I am more of a NW4 -5 however about 55 with stable hair loss and a donor supply of about 6,000 total. So do you believe that 40 grafts per sq cm is a reasonable expectation for an initial total graft of between 2,100 and 2,500? If not, what density do you think is reasonable?

[RCWest]

The average non balding person has roughly 600-650 follicular units per square inch. To achieve 20 percent density, that would be transplanting about 120 follicular units per square inch, so 2500 grafts would cover about 20 square inches. The problem is 20 percent original density is still kind of thin unless you have coarse hair.

[Bill - Seemiller]

newhair46,

 

For most patients, transplanting 50% of their original hair density will provide them with adequate density for the illusion of fullness. Since the average natural hair density is approximately 80 to 100 FU/cm2, optimal transplanted density is between 40 and 50 FU/cm2.

 

But providing you with numbers really isn't enough. It's important to understand the process, what the numbers mean and to develop the best approach to meet your hair restoration goals.

 

Typically, physicians will transplant higher densities in the front and taper off towards the back since donor supply is limited and demand for some patients is often great due to large areas of baldness. Physicians typically take this approach in order to provide their patients with greater densities in crucial areas that promote a greater illusion of fullness. If you follow the link to my patient website and photos in my signature, you'll see that my hair in the front is denser than in the back.

 

Thus, while physicians may transplant 40 to 50 FU/cm2 in the frontal area (assuming you have the donor hair supply for it), if you require transplanting in the crown/vertex area, physicians may only transplant 20 to 30 FU/cm2 depending on supply versus demand, costs, etc.

 

If you are willing to post photos showing the balding areas of your scalp, the veteran members of this community may be able to provide you with some better feedback. But hopefully some of this will help you with your research.

 

Best wishes,

 

Bill