Singles in hairline

[Upshall]

In General how far deep in the hairline should there only be singles? 1 inch? half an inch??

 

[txtransplant]

depends on the patient. I think the first .5 cm is about good. But in some patients with thick, thin or curly hair it could be anything,  I had barely any singles when they extracted. So wasn't much choice. But still looks natural as I think my doctor chose thinner hairs for the front to compensate. So much depends on patients. A patient with a very soft gentile hairline looks really odd with a really abrupt line front and center. I think for 2 patient types it really matters. Those with a naturally gentle and soft hairline, and for those guys with unusually thick and dark hair.  On a middle aged patient, at hairline that goes from bald head to a will of thick almost black hair looks pretty abrupt and not natural. But they guys who get them usually seem to love their helmet look.  

    Though no as good as singles, even doubles spaced a bit far apart for the first 3-4mm will give a softer and more natural look. Unless they have really thick hair. In that case might be better to have a abrupt hairline. 

Edited February 23, 2019 by txtransplant

[Spaceman]

The first few rows of hair should be singles. Refined surgeons will excise enough singles (or split multis) to create a natural looking hairline. 

Edited February 24, 2019 by Spaceman
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[txtransplant]

I will add that some surgeons consider it bad practice and an unnecessary risk to split multi hair grafts. Ever patient is unique. But we all agree, the Dr. has an important and pretty straight forward job to create a natural looking hairline. That means the front edge is softer and slightly irregular. Simple thing and often see it overlooked. So much depends on individual doctors ideas of what looks natural. It's important for a patient to advocate for what they want. 

[Sean]

First row should be loaded with singles to make a natural looking hairline.  If they add singles in and out and behind the first row if will start making it look weak or Pluggy with lacking densities.  Multies in the hairline are a disaster and can turn into ant leg type look.  

Oh and when a doctor assures you they do lateral slit placement of grafts then they better do lateral slit.  Otherwise, you are screwed with hair forcing themselves in different angles and a very failed illusion.  fML FML FML

 

 

[Markee]

How does 5x Carl Zeiss loupes compares to microscopes for singling out grafts ?

Anyone care to comment ?

[Spaceman]

2 hours ago, Sean said:

If they add singles in and out and behind the first row if will start making it look weak or Pluggy with lacking densities.  

Don’t you think that depends upon the ability of the surgeon to dense pack the hairline area and the patient’s hair characteristics? I say that because in my case, the first few rows are all singles and it does not look weak or pluggy. I’m sure with less density it would.

[Spaceman]

1 hour ago, Markee said:

How does 5x Carl Zeiss loupes compares to microscopes for singling out grafts ?

Anyone care to comment ?

Loupes are used to select FU for excision in FUE and for graft placement. Stereo microscopes (~10x) are used for examining/dissecting grafts post FUE excision or from a strip. Many FUE clinics don’t use microscopes but most of the best ones do.

[Markee]

35 minutes ago, Spaceman said:

Loupes are used to select FU for excision in FUE and for graft placement. Stereo microscopes (~10x) are used for examining/dissecting grafts post FUE excision or from a strip. Many FUE clinics don’t use microscopes but most of the best ones do.

The reason I ask is I was discussing with the Eugenix rep Nelson about there (DHT) Direct Hair Transplant Technique  and how they single out there frontal hairs. I asked if use microscopes hes said they use 5x Carl Zeiss loupes and the doctor also goes on to say the same thing in this below shared thread. I don't have the best eye for spotting doubles in hairlines but to me looking at the before and after photo's on Eugenix  they look pretty good what do you think?

https://www.eugenix.in/

https://www.hairrestorationnetwork.com/topic/53241-dr-bansal-dr-sethi-grade-6-5615-grafts-scalpbeard-8-months-post-op/?do=findComment&comment=494373

https://youtu.be/8AUlHgvlXhM

[Spaceman]

I think it’s standard to use such loupes during extraction and implantation. I don’t know if they examine grafts under microscope with DHT. It’s more about minimizing out of body time. Even so they can probably ensure that most grafts are singles just with loupes. You may miss a few multis with follicles in telogen. As you probably know the Eugenix doctors are active here so you may want to PM them about it.

Edited February 25, 2019 by Spaceman

[Sean]

3 hours ago, Spaceman said:

Don’t you think that depends upon the ability of the surgeon to dense pack the hairline area and the patient’s hair characteristics? I say that because in my case, the first few rows are all singles and it does not look weak or pluggy. I’m sure with less density it would.

That is a big factor.  Dense packing and doing it wrecklessly can kill all those precious 1 hair grafts and cause scar tissue that is detrimental for future repair or repairs if the surgeon failed more than once.  Then the surgeon can act like they did you a big favor by trying to assist when they fully didn’t inform and screwed you over ethically.  No amount can take away the years of pain caused and tge worst part is trying to get things rectified.

Another factor is hair texture and caliber.  Some people have thicker hairs some not so.  The thinner hairs  may not survive harsher extraction methods via fue if motorized or suction.  Thats why manual extraction is less risky for most other hair types.

multiple factors play a role though and I agree with what you wrote