Jump to content
brickellmoto

Why is a HT "the illusion of density"

Recommended Posts

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

Share this post


Link to post
Share on other sites

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

Share this post


Link to post
Share on other sites

^^ 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

Share this post


Link to post
Share on other sites

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
  • Like 1

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.

Share this post


Link to post
Share on other sites
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

Share this post


Link to post
Share on other sites

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

 

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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. Jim Harris, Denver, CO - Dr. Robert True & Dr. Robert Dorin, New York, NY

Share this post


Link to post
Share on other sites

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

  • Like 1

I am the managing publisher of the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog and this Hair Loss Forum. I am also a 4 time hair transplant patient. View my patient hair loss website to view my entire hair restoration journey with photos.

Remember, true beauty radiates from within, not from the skin.

I am not a medical professional and my words should not be taken as medical advice. All opinions and views shared are my own.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Find a Pre-Screened Physician

  • Who's Online (See full list)

  • Newest Topics

  • Latest Posts

    • 4 weeks/1month. I don’t know which format is better. Weeks are more accurate while months make me feel better. My hair is getting a bit patchy on the temples and parts of my scalp. I know me sleeping on my sides doesn’t help keep the transplanted hair, but I know members advocate that after 10 days the HT is “locked in”. I’ve seen members loose most of their HT hair in the first 3 months, and I’ve already accepted this destiny. I keep my expectations low, but I do keep my spirits up – This is the best time in my personal and professional life to have this procedure done. This is what I want, from the artist I wanted. I am happier now than I was before.   Feel free to ask questions. I genuinely appreciate feedback. If there is something you recommend, or see something I can benefit from, please post it. I got 90% of my information from honest members like yourselves, including the unmentioned redditor. Someone like myself could read this and decide to start their HT journey. I want to make it easy for men to lose the stigma against cosmetic surgery by understanding what to look for in a doctor and what a GOOD or BAD procedure looks like. Thank you for your contributions. I hope the donor area is "discolored" due to the hair dye of the transplant. I will get a haircut in 2 weeks, before my next update. I will know for certain if it's my head, or if I've been thinning rapidly at the crown/top.
    • Two weeks post op. I was just finishing up a full scale molt on my head. I showed a few people, and it didn’t register with me at the time. One asked, “Yeah, I can see the HT, but what’s the white stuff on your head?” It was after I told him that I kept my hat on for shedding reasons. I realized after the fact he was referring to my scabs that float above my head HAHA! Nothing crazy to report. Just that my head was red. I know that the redness stays for months, so it is what it is. I’ve already at that point resigned to the ugly duckling phase… Even before it begins. I had since started the Fin and minoxidil. I also took photos 1 week out. 1 week post op first, then the two week ones.
    • @fespafer looking good, best of luck 👍 i look forward to seeing the results 
    • An experienced doctor can provide you with desired result of FUE with grey hair so choosing a doctor wisely is the only solution to avoid the risk of treatment. 
    • SKIP TO “*******************” FOR RESULTS   LONG BACKGROUND STORY WARNING   My journey began when I saw the reddit post: https://i.redd.it/0k9i3r8myk001.jpg . In the comments, I found the link to a poster (who I won’t link, but you could find it yourself) who mentioned that results like Elon had are not only possible, he had one. I went down the rabbit hole. I saw the results that are possible, and common. Quick background: My hairline was receding since I first noticed it at ~15. It wasn’t bad, but I never felt comfortable with my hair short. I noticed acceleration into my early 20s, but I knew it was too early to do anything about it. All of the common advice was to let it develop, and worry about it then. I researched HT when I was 22/23, and google showed me horror stories of 19-year-olds mutilating their scalp with an aggressive hairline and constantly adding more after the fact. I resigned to waiting and seeing. After a few years, the recession stabilized when I was 25/26. I had not known about this site, and so I tried to use Nioxin and minoxidil from Costco, hoping to permanently slow and possibly reverse the hairloss. It didn’t do a great deal. Minoxidil did function like a hair product that kept a shape. I was content to brush my hair to the side, and as long as my SO said I looked fine, I didn’t think much of it. I was never in denial about my hair loss, but like I said, it didn’t seem that bad. My view completely changed when I was at a tailor for a suit. Looking at an angle in that 3-pane mirror, I saw myself from the side. My hair looked like it was drawn on top of my head, rather than coming from my head. I felt vulnerable and embarrassed. I decided to seriously look into a HT. After researching FUE vs FUT, I saw the clear benefits of FUE (very similar to LASIK vs PRK in my opinion) I researched the most recommended doctors, and contacted him. Long story short is: He wanted to do a mix of FUT & FUE. I told him I only wanted FUE. He insisted but conceded. He gave me the quote for 2500 grafts. I view HT as a permanent body modification. Anyone that has ever gotten a tattoo knows that it isn’t the price you pay for a tattoo, it is the artist you get the tattoo from. No one brags about how much they spent, it’s about who the artist was. After brooding on the uneasy feeling of “convincing” an artist of my perspective HT to do an art piece he didn’t want to do, I researched more FUE-only doctors. This is the search that led me to Dr. Bhatti. Long story short again: He told me I needed ~2500 grafts as well. I was contacting both doctors in May 2018. I know that great artists are in high demand, and before I asked if he was available (NOT how much it cost). I told my SO that I was willing to pay double (my local price) for an artist whose portfolio I could see, and whose name I could trust (thanks to this site) if he had availability in Dec/Jan 2019. I was planning on using this time away from college to take a “vacation” where I could get the surgery and recover. Dr. Bhatti said he was available during early Jan, and I immediately booked an appointment with a deposit. Dr. Bhatti’s quote was less than the first quote I received. This was a bonus, not the reason I went to Darling Buds. Obviously I chose to go abroad for the procedure due to costs. I don’t want to compile “unnecessary” costs. I want to be clear that it was a choice of artist. I watched airline prices, and eventually booked my tickets. Booked Lax to Del in September for $456.31 and Del to IXC for $78.01, $534.32 USD round trip total. I am pretty good at finding deals, and am happy to write a post about it if enough ask, if it hasn’t been posted elsewhere. I’ll skip the common details most posters make about travel etc. When I arrived to Dr. Bhatti’s office, I felt that I was at a safe and clean environment. I thought it was all very professional and systematic in following the procedure of bloodwork, paperwork, etc. I really appreciated the one on one time with Dr. Bhatti in drawing my hairline and him giving me time to reflect (no pun intended) on the new hairline. I thought his hairline was ABSOLUTELY natural, and matched completely what I thought would restore my ~12 year old self’s hairline. I told Dr. Bhatti that I was considering lowering it further, (because why not?!). After years of hearing forehead and balding jokes, I think we all get a little defensive and never want to be in that same position, if we can avoid it. HT seems to be the best place to ensure it doesn’t happen again. So I told him what I though, and he said it may not look natural, but he would do it if I wanted it. He told me to consider it, and he would redraw the hairline the next day, the day of the procedure, and we would decide then. I showed my mom what I was considering and she said that I should go with the marker, Dr. Bhatti’s proposal. I arrived the next day and in full conviction, happily chose Dr. Bhatti’s recommendation. ************************************** Single: 271 Double: 1268 Triple: 1013 Front transplanted: 2193 Left temple: 186 Right temple: 173 (I am happy to have it broken down to me in that manner. Temples exposed expedited my HT journey, so it is nice to see how many went to that mission.) I always followed the post care instructions Dr. Bhatti’s office provides. The procedure didn’t hurt. When I felt uncomfortable, I told Dr. Bhatti. He then gave me more local antiesthetic. Side note, I only took a few of the pain pills for post op. My scalp was numb, and I didn’t need it. I had no issues in the 3 days post op. I flew on the 4th day. My face swelled during the air travel, not too horrifying, but pretty bad. I was worried about being questioned by US customs when I arrived in LAX. No problem. I was worried about a rental car I rented later in the day, again, no issues. I didn’t take photos. The swelling went away gradually, but was gone after 3 days, no problem (I expected this thanks to this site! I always checked on here to see if others had similar issues). Picture curation is mostly chronological (I hope). Orange Line is "generally" what I was thinking. Just a rough idea of an "aggressive approach" I ultimately did not pursue. Last photo is 72 hours post. Didn't take a post donor pic due to not trying to make myself contort as well as not making my SO look at the carnage! 
  • Member Statistics

    • Total Members
      34,516
    • Most Online
      862

    Newest Member
    Lennney
    Joined
  • Top Members

×