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How your doctor should think - budgeting hair in hair transplant

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  • Senior Member

So I had a chance to pick my doc's brain a little about how he decides how far apart to place the hairs that he transplants into a recipient region. I think that for some of you, it may be enlightening to learn how a HT surgeon thinks, in order to optimize the placement of grafts. Of course, there is an art to it, as well as a science. I'm sharing Mohebi's thoughts because I think he did a miraculous job on me and his response to how budgeting is done fascinates me.


by Dr Mohebi:

When I examine every new patient hair microscopically, I try to determine two main facts:

1. The final stage of hair loss or the total surface area that needs to be covered

2. The total value of their permanent hair

Recipient factors

It is important to know what the final stage of hair loss will be for a particular patient. Microscopic evaluation of hair can determine where you are heading in most cases even in early stages of hair loss. Family history of male patterned baldness can also help me make a better determination. For example, if you are heading for a class VI of hair loss (losing the entire hair from front and top), that means you will need adequate volume of hair to cover this large area.

Donor factors

Total value of permanent hair has to do with the qualities of donor hair described as follows:

1. Density: The more hair per square millimeter you have in the permanent zone, the more reserve of permanent hair you have for transplantation.

2. Thickness of donor hair: Thicker hair produces more volume after a hair transplant procedure. The important index to consider is the cross section of hair. If your hair diameter is twice as much as someone with fine hair, your final volume for the same number of hair will be four times more. So you can see that hair thickness is a crucial factor in the final result of a hair transplant.

3. Waviness: Wavy or curly hair produces the appearance of more fullness.

4. Color: The contrast of Hair color with skin tone is also important. Considering everything else is the same, transplanted hair in someone with only 20% hair density with blond hair on white skin will look a lot fuller than someone with black hair with white skin.

Other factors to consider

Besides donor and recipient factors, we have to take into consideration other factors that play an important role in the process of planning for hair restoration such as:

Patient styling preferences: People who always comb from front to back require a denser front that can help the back areas too. People who comb from left to right require more coverage and maximum number of hair on the left side as opposed to the right

Patient height: top coverage becomes more important for shorter patients while frontal hairline and back of the crown become more crucial for very tall people

Patient job: Sedentary jobs makes top coverage more important

Aging and other individual factors

A good hair transplant surgeon plans the hair transplantation with consideration of the future pattern of hair loss. Focusing on restoring a juvenile hairline in a very young patient could result in a fake hairline when the person’s hair loss is matured in the future.

So as you can see, planning for hair restoration is not always simple and should be done after a thorough examination of all the factors that play a role for each patient. Since the distribution of hair in transplanted areas is almost never even, the hair transplant surgeon should implant the hair grafts strategically to create the appearance of maximum fullness.


To answer your question about whether you need more transplantation to fill the very front of the scalp; it depends on whether you have adequate donor hair that can address your future hair loss in the top and crown areas. Obviously, our priorities might change due to factors such as height, job, and personal styling preferences.

Paulygon is a former patient of Dr. Parsa Mohebi


My regimen includes:

HT #1 2710 grafts at Parsa Mohebi Hair Restoration in Los Angeles in 2012

Rogaine foam 2x daily, since 2012 (stopped ~10/2015)

Finasteride 1.25mg daily, since 2012 (stopped ~12/2015)


HT #2 3238 grafts at Parsa Mohebi Hair Restoration in Los Angeles in Jun. 2016

Started Rogaine and Propecia in July. 2016 after being off of them for about a year.

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