Dense Packing

[Julius]

What stage on the norwood scale is it acceptable to dense pack at say 50 grafts per cm? And would such packing compromise graft survival?

[Julius]

What stage on the norwood scale is it acceptable to dense pack at say 50 grafts per cm? And would such packing compromise graft survival?

[Bill - Seemiller]

Julius,

 

This is a difficult question to answer generally speaking, but I'll give it a shot.

 

Transplanted hair isn't usually placed uniform. Thus, transplanted hair density isn't consistent throughout the scalp. Packing more hair in the front and gradually tapering off further back is usually the best approach since people are viewed head on more than from the back or top of the scalp.

 

Other things to consider are the available donor supply and the risk of future hair loss.

 

Consider a Norwood 6 level patient has approximately 300 cm2 of baldness to cover. In order to achieve 50 FU/cm2 uniformly over a 300 cm2 bald area, you'd need approximately 15,000 follicular units. To cover 200 cm2 of bald area at 50 FU/cm2 uniformly which is a patient somewhere between a level 4 and 5 on the Norwood scale, you'd need approximately 10,000 grafts.

 

Most leading hair restoration physicians can densely pack 50 FU/cm2 and even higher in some cases without compromising vascularity or hair growth yield. The actual number will depend on the number of hairs per follicular unit, the patient's hair characteristics (thin, fine, coarse, etc.), and the actual density a patient requires to achieve the illusion of density. Remember, just because a certain hair density can be achieved doesn't mean it's appropriate for each patient.

 

I hope this helps.

 

Bill

[Dr. Glenn Charles]

It has been shown that 50 follicular units per sq. cm. is an acceptable density that can have a high percentage of successful graft growth. More importantly is how much remaining hair is in the potential transplant recipient area and what are the doctors techniques and capabilities. If performed properly there should be no compromise in graft survival.

[Julius]

Thank you for your reply doctor, but when you say 'more important is how much remaining hair is in the potential transplant recipient area' is this because of a greater likelihood of shock loss when dense packing?