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Why is a HT "the illusion of density"

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just want to know what the school of thought on this concept is.  I've seen many HTs on here that looking at it, i'm like thats a perceptively dense hair transplant, so why is it considered an illusion, and what are we comparing it to? just curious

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it plays to the fact that you’ll never have your original teenage year density. Essentially saying we’re gonna use 50grafts/cm2 and get as close as we can compared to your native density of ~100grafts/cm2. 

 

Its supposed to look like you have a full head of hair/full density with essentially as little or as many grafts as possible. It looks like you have a full head of hair, but when you pull back the curtains it’s really not.

 

Its open to each persons opionion on what “density” equates to

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^^ agreed, which is why I laugh when some people part their transplanted hair and complian about it, never gonna look like someone who’s been blessed by the hair gods

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If you're a NW6 you likely have say 300cm2 bald area.  Prior to balding you might have had 200 hairs/cm2, so 60,000 hairs have disappeared.

To get you back to square one would take 60,000 / 2.2 ~ 30,000 grafts assuming 2.2 hairs per graft.  But as we know, most people can only spare 6-8,000 from their donors.

Judicious placement of grafts will therefore be needed.

40 grafts /cm2 is recognised as good density of 40 x 2.2 = 88 hairs/cm2, which is roughly half (50%) your original density.

But to cover 300cm2 like this would require 300 x 40 = 12,000 grafts.

So you have to mix your densities to make best use of those 6-8,000 available.  For example maybe 50 in the hairline, 30 mid scalp and only 15 to 20 in the crown.

Edited by 1978matt
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4,312 FUT grafts (7,676 hairs) with Ray Konior, MD - August 2013

1,145 FUE grafts (3,152 hairs) with Ray Konior, MD - August 2018

My HT results thread from 1st procedure.

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19 minutes ago, hairlossPA said:

it plays to the fact that you’ll never have your original teenage year density. Essentially saying we’re gonna use 50grafts/cm2 and get as close as we can compared to your native density of ~100grafts/cm2. 

 

Its supposed to look like you have a full head of hair/full density with essentially as little or as many grafts as possible. It looks like you have a full head of hair, but when you pull back the curtains it’s really not.

 

Its open to each persons opionion on what “density” equates to

fantastic answer. thank you

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Unless you get or got screwed, the illusion should not draw eyes to your hairline or any fuken comments

 

Illusion should be done in a way where it flows and looks natural

 

natural enough so you can live in peace and not waste close to 10 years or more waiting for a successful illusion

 

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You've hit on one of the most basic concepts in hair restoration and one that is truly not explained at length during a consultation.  It is rather complicated, particularly when you are trying to guide a young patient during a consultation.  Most believe a donor area will have 3000 - 7000 grafts in their lifetime, (some more, some less).  Consider that when you are born you are starting out with about 100,000 hairs. By the time you are a teenager you've lost half but still don't realize that you've lost any native hair.  So, if 50,000 is full density, you are asking 3000-7000 grafts to do the job of 50,000 hairs.  It is truly an illusion and speaks volumes about the doctors in the hair restoration industry and their artistry.  

What provides density is the shingling effect, hair on top of hair.  This is the reason why many consultants, depending on the pattern, will suggest to patients that they comb the hair from side to side.  This allows for all the hairs to work together and give the illusion of density.

Where this gets really complicated is when you are consulting with a young patient.  This patient will typically reminisce about the teenage hairline they used to have and also want to address the crown.  What do you do?  In my view, and the responsible thing to do is for the Doctor and consultant to educate the patient and start with some kind of medical regimen to help him retain/slow down the loss.  Give a plan short term to address the patient's concerns and a long term plan that takes into account donor availability and effect of medical therapy.  If the meds work, awesome.  If not,   the patient will still enjoy a very natural result.

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A very simple basic answer is that the illusion of density can be attained on most individuals at 50% of original density.  The reverse is also true.  Once you lose over 50% of original density, it becomes visually noticeable.

In addition, terminal hair harvested from the donor zone is basically DHT resistant so that terminal hair has optimal characteristics in terms of caliber, color, etc.  It provides better visual coverage as compared to thin diffused hair that is DHT receptive.


Gillenator

Independent Patient Advocate

I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice, but are my own views which you read at your own risk.

Supporting Physicians:  Dr. Robert True & Dr. Robert Dorin, New York, NY

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I know others have already offered their feedback but allow me to offer my input on this as well. Hair transplant surgery is referred to as the illusion of density because there is simply not enough donor hair available to re-create true density in most cases. Hair transplant surgery is about supply and demand. The overall scalp with a full head of hair possesses approximately 100,000 hair follicles or 50,000 follicular unit grafts.   Approximately 25,000 grafts make up  true density on the entire top of the scalp. But nobody has that many grafts available in their donor area for transplanting.  If you are really lucky and one of the fortunate, you might have close to 10,000 or 12,000 grafts available.  That means if you placed all you’re available donor hair on top of the scalp in an evenly distributed fashion, you would have approximately 40 to 45% true density.   However, most hair transplant surgeons will place more follicular units in the front than in the back in order to make it appear more natural. 

Now regarding the illusion of density, most hair loss suffering men and women don’t even notice any visible signs of hair loss until they’ve lost about 50% of their original density.   That means, a surgeon doesn’t have to re-create true density for an individual to appear like they have a full head of hair. They only need to re-create about 50%. This is referred to as the illusion of density because it looks and appears as dense as if it were true density. 

Now where the illusion begins to fail is when you begin taking photos under harsh lighting or even standing under harsh lighting such as a bathroom or other fluorescent lights such as an office, etc.  Your hair will also appear a bit thinner when it’s wet if you only have re-created 50% or less density.  

Since nobody has enough donor hair to restore hair to a completely bald head, surgeons re-create what’s referred to as an illusion of density by restoring 50% of an individual’s original density or true density to the most vital areas and a bit less density to areas that aren’t as vital such as the crown.  

Does this make sense? 

Best wishes,

Bill

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