What is meant by Strong Donor Hair?

[darkhorse0510]

Hello everybody.. This is my first post. Although my hair loss has bothered me for quite some time, I'm finally ready to do something about it. So, I'm reading lots of post and researching everything that I can to educate myself.

 

I keep reading alot of references to whether or not someone might be a candiate for HT based whether or not they have "Strong Donor Hair". Can someone explain, in a little more detail, what this means exactly?

 

Does it have to do with the quanity, density, quality, location? What exactly? What would exclude someone from getting a procedure? And does this apply to FUT as well as FUE?

 

Personally, I feel that I have very "fine" hair. I'm sure a personal consultation would give me a definitive answer as to whether or not I would be a HT candidate, but I'm just trying to get a general idea of what is acceptable.

[TommyLucchese]

I think it means the density and quality of the hair at the back of your head that would be taken and placed in the balding/thinning areas.

 

I have fine hair too but that didn't mean my donor wasn't good enough. My doctor was very complimentary on the quality of my donor hair.

 

I did have concerns about this though. I was worried if my donor would be fine, if I had the laxity of my scalp etc but all these worries were put to rest when I had an in person consultation. This is definitely the way to do it, the doctors are the experts so you should try and meet as many in person as you can. Though online consultations can help too if you take quality photos of your hair.

 

If you haven't read this already, it's advised to be on medication like propecia/minoxidil for a year to try and stabilise your hair loss before you consider surgery.

[Dr. Glenn Charles]

I agree. Good donor quality usually refers to the number of follicular units per sq. cm.(density) and several other hair characteristics including hair shaft diameter (courseness), curly/wavy vs straight, and color. Just because a person has fine hair does not necessarily mean they are not a candidate for HT surgery. I do on line consultations all the time but the one thing we cannot determine from photographs is donor density.

[Dr. William Lindsey]

TommyLucchese hits on some good characteristics of "strong" donor hair: Thickness and density. There is one other characteristic that you can't tell until the surgery is underway, unfortunately, and that is scalp tissue thickness.

 

I haven't seen any articles on this topic, and honestly, Wendy my assistant and I have been trying to figure out a scientific way of evaluating this.

 

First you can indeed get a good idea of donor quality looking at the physical findings of how thick and coarse the donor hair is. The thicker and curlier the better. As I've posted a number of times, a wirey hair-ed middle eastern or Indian patient is really the ideal candidate...and a thin straight haired northern chinese patient is possibly the worst. Its simply a matter of the bulk of the transplanted hair covering underlying scalp(remember, we're not curing baldness, we're covering bald skin) and the color match of the hair and underlying skin.

 

Next you can get a decent guess as to your yield looking at the density of the donor region. High density in thick hair is best, but high density in thinner, straighter, hair can overcome the straightness factor simply by putting more hair in the recipient area.

 

Its very similar to all of the tree analogies that I give. If you want to cover an acre of land, its far easier with 10 willow trees than with 100 skinny pine (arbor vitae) trees. With the skinny trees, you'll cover the land but not as satisfyingly as with willow trees(thick wirey hair). This should all be discussed at the initial consultation so that patients can have proper expectations and the doctor can do his/her best to meet them.

 

Lastly though, scalp skin thickness "seems" to play a role in the result as well. It may be only anecdotal, but of the patients that I see back that have what I'd consider weaker results---when I look back at my notes and strip pictures, a common finding is the scalp is just thinner. And I've seen this in a number of 2nd cases done to increase density that have come from other highly regarded surgeons recommended on various forums. I don't think they did a bad job in those cases, I find that I think the patient has really thin scalp tissue and then I always worry that my result on that second case may not be enough.

 

I just haven't figured out a way to study this. Once you inject the scalp with local anesthesia, and everyone needs a different amount..., you really can't take measurements that would allow good comparisons.

 

BUT I do strongly believe that the weakest results are more commonly seen in people who have really thin scalp tissue in their donor region regardless of the density of the donor hair.

 

I hope this helps with the question above.

 

Dr. Lindsey McLean VA

[Dr. Glenn Charles]

Great response Dr. Lindsey. I also feel that skin thickness plays a very important role in the overall results of a hair transplant including hair growth and donor scar.

[TommyLucchese]

Great replies Dr. Charles and Dr. Lindsey, very informative!

[waitforanagen]

Just curious, what is "good" density? i.e. 80 FU/CM 70 FU/CM etc.... just wondering what the ranking would be....

[Davis91]

Dr. Lindsey,

 

So after a big or couple of procedures (FUT) which stretch the scalp but leaves enough for a final surgery, would the scalp thickness be compromised even further and affect that final surgery outcome?

[darkhorse0510]

Thank you gentlemen for the very thorough responses..

 

So short of a one-on-one consultation (which I definitely plan to do at some point in the future), I guess I need to take some pictures. This way, I could at least get a preliminary opinion.

 

Which brings me to a couple of other questions.. I'm actually in need of haircut right now. I was thinking of getting it buzzed/cut short.. for the purpose of taking some pics.

 

This was actually a recommendation in one of the threads I think. I've never actually done this before.. mainly because of something I remember my dad saying when I was young..

 

He basically said something to the effect of, "... and once I got it cut short, it never grew back again." I don't know how much of this is truth vs bs.. but I never forgot it. And I don't know enough about hair growth cycles either. He is pretty much bald on top, with only hair on the sides and very back of his head. Also, I have not yet started a treatment regimen (but planning on Nizoral, Minox, Finasteride).

 

Would taking pictures with my hair buzzed be the best way to judge my Norwood level and guage (as much as possible with pictures) if I might be a good candidate for HT?

 

This might be a weird question, but would taking a close up pic with, say, a ruler as a reference point give any indication of density??

 

Last thing.. there was a reference to hair color as well. I started going gray very early.. and have used over-the-counter hair coloring. Does this make me a less-likely candidate for HT? Would it be better to take my initial pictures with my hair colored (dark brown) or natural?

 

Sorry if this seems off topic.. I guess the whole "taking pictures", "haircut", and "haircolor" items could be other threads entirely.. chalk it up to me being a newb. But, I thought they were all related to determining what constitutes "good donor hair".

 

Thanks.

[TommyLucchese]

I don't have much time right now so sorry for the rushed reply

 

I have seen where clinics/representatives ask for pics with the hair grown out, as a buzzed hair cut is not ideal for displaying density - making it harder to give a possible estimation of grafts you'd need. Maybe it's best to take some of your hair grown out, then when buzzed if that's how you want it styled.

 

Again, though, just emailing and getting in touch with some recommended doctors is your first step - they'll be able to give you clearer info of what you need to do.

 

But yes, as someone who had an in person consultation, you should definitely try to get at least one done because it was incredibly beneficial. I'm sure online is a great alternative for those who can't meet face to face, but it will make things much clearer to you in person.

[darkhorse0510]

Thanks Tommy..

 

I'm appreciative of any reply (rushed or not).. I'll take what I can get..

 

My first step is to get on the Big 3 as soon as possible so I can try to preserve what I have left.. which may or may not be quite as bad as I think it is..

 

But thinking ahead, you bring up an interesting point..

 

Perhaps having pics of my hair grown out would be a good way to gauge density. However, I think taking pics of my hair really short would be a good way to get opinions on what my NW level actually is, and how many grafts I'd probably need.

 

I don't really WANT to cut my hair short, or even style it that way.. but as a temporary measure I think it would serve a couple of beneficial purposes. For one, I think it would be informative for the reasons stated above.. and for another (and this may sound a little hokey) but from a psychological standpoint, although I've accepted the fact that I've been losing my hair, I believe I would gain a new perspective (literally) and better appreciation for the severity of the problem.

Edited November 7, 2012 by darkhorse0510

[Cant decide]

I can tell you from experience that going in for a consultation with very short hair is not a good idea. I went to the same doc twice for consultations over a span of 8 months. Once with very long hair and once with it basically buzzed. He gave two totally different recommendations (He forgot that he had already seen me before). I ended up not going to him but went to Dr. Rahal who basically recommended the same as the other doc did when my hair was long.

 

Plus, most docs preop instructions say to come in the day of surgery after your hair has been allowed to grow out for about 6 weeks. This is so they can see how your hair lays, immediately see the weak areas, what is miniaturized, etc and determined donor density much better.

[Dr. William Lindsey]

Davis91

 

I don't think so. After a bunch of strips, yes the scalp density gets lower..but the inherent thickness of the scalp stays pretty much the same I "guess". What I'm talking about is when you excise a strip and the scalp just isn't nice and beefy....it seems like the results are often a little less impressive.

 

Dr. Lindsey

[Raphael84]

Totally agree with Cant Decide here. To be able to assess your donor hair quality, I have heard many Doctors recommend keeping the hair longer, as when a patients hair is buzzed, it tells a different story. A less accurate one at that. So I would recommend keeping your hair longer, especially if this would be your preference anyway. But DarkHorse, you are correct also. Depending on the length and style of your hair, it can "hide" your actual genuine pattern. My hair for example, was never long but lets say 1.5-2.5 inches. I knew that I was thinning in the crown, but then when I buzzed down, I was very surprised to see that I actually had the makings of that horse shoe pattern of a late NW pattern. I would never have thought this to be the case when my hair was longer.

Whilst an in person consultation is undoubtedly better than any other type of consult (phone/internet), the fact that you can begin the process with whichever and however many Doctors you see as good options for you, by the way of online consultations, with just photographs, is an amazing opportunity to get educated and begin building bridges with some of the worlds best Doctors.

Thanks Dr Lindsey and Dr Charles for getting involved and educating us further. It is much appreciated!

[chrisdav]

Great response by Dr Charles & Dr Lindsey.

 

I like the example of the trees.

[MoeyK]

hey mate,

 

It would be in your best interest to keep your hair at a longer length. Ill give you an example, your backyard has grass, parts of that grass are visibly thinner then the other parts when the grass is long. When you cut the grass to a very short length, nobody can tell where the thin part is (unless its you looking). Most people "buzz" their hair so they can conceal the hair loss in some way!

 

Your father is right in the sense that once you buzz your hair, generally if you let it grow for a week or 2, because the side hair grows much quicker then the top, it becomes so much more obvious you are balding, that you just keep buzzing to avoid that confrontation. So if you are going to buzz, you ain't turning back haha!

 

Goodluck with it all though. Best suggestion is to take finas + nizoral asap! and just forget that you are taking them. The more you think about it and think about time, means more stress which is potentially more damage to your hair!

 

That day when the cure comes out for baldness, we can both grow afro's and walk around the street lol.

[darkhorse0510]

I just saw that my original post was shared on regrowhair.com.. a Q&A blog.. sweet. haha.

 

Let's say someone is a diffused thinner.. does this necessarily affect donor quality?

Edited November 15, 2012 by darkhorse0510