How Many Fu/cm2 for dense hairline?

[NOMORENORWOOD]

What is usually the goal? 40 or is it much higher?

[civic]

25 minutes ago, NOMORENORWOOD said:

What is usually the goal? 40 or is it much higher?

Depends on hair characteristics, thinner hair vs thicker, wavy, curly etc.

[NOMORENORWOOD]

1 hour ago, civic said:

Depends on hair characteristics, thinner hair vs thicker, wavy, curly etc.

Thinner

[Rahal Hair Transplant]

NomoreNorwood,

To be honest, adequate density of one’s hairline Really depends on the number of factors.  Keep in mind also that density is typically measured in FU/cm2 (follicular units per centimeters squared).

Remember also that a natural looking hairline is made up of single hairs. But FUs can range anywhere between 1 to 4 hairs.  Because of this, 40 FU/cm2 in the middle scalp region or the crown would be higher density than 40 FU/cm2 in the hairline 

Today, hair transplant surges can density pack follicular units up to 80 or even 90 FU/cm2 (using single hairs) with optimal growth. However, most patients don’t require such high density hair transplants and simply put it’s just not possible for most because 1) donor hair is limited and 2)  those with advanced balding require more grafts to cover all the areas of thinning.  

that said, individuals don’t usually notice signs of hair loss until they lose approximately 50% of their natural hair. True density is typically between 80 to 100 FU/cm2 So, to create an adequate illusion of density only half of that is required. So the average transplanted hairline may only see between 40 to 50 FU/cm2.

Whether or not more or less is your fire depends on the number of factors including:

1. Hair shaft diameter or coarseness of the hair

2. Hair color to scalp color contrast ratio

3. Placement and angulation of the hair follicles

4. A surgeon’s ability to dense pack although as long as you selected a reputable surgeon with a proven track record of producing us tanning results, this won’t be an issue.

So hopefully this helps gives you an idea of how much density you may need to create a dense and natural looking hairline.

Best wishes,

Rahal Hair Transplant 

 

[John1991]

1 hour ago, Rahal Hair Transplant said:

NomoreNorwood,

To be honest, adequate density of one’s hairline Really depends on the number of factors.  Keep in mind also that density is typically measured in FU/cm2 (follicular units per centimeters squared).

Remember also that a natural looking hairline is made up of single hairs. But FUs can range anywhere between 1 to 4 hairs.  Because of this, 40 FU/cm2 in the middle scalp region or the crown would be higher density than 40 FU/cm2 in the hairline 

Today, hair transplant surges can density pack follicular units up to 80 or even 90 FU/cm2 (using single hairs) with optimal growth. However, most patients don’t require such high density hair transplants and simply put it’s just not possible for most because 1) donor hair is limited and 2)  those with advanced balding require more grafts to cover all the areas of thinning.  

that said, individuals don’t usually notice signs of hair loss until they lose approximately 50% of their natural hair. True density is typically between 80 to 100 FU/cm2 So, to create an adequate illusion of density only half of that is required. So the average transplanted hairline may only see between 40 to 50 FU/cm2.

Whether or not more or less is your fire depends on the number of factors including:

1. Hair shaft diameter or coarseness of the hair

2. Hair color to scalp color contrast ratio

3. Placement and angulation of the hair follicles

4. A surgeon’s ability to dense pack although as long as you selected a reputable surgeon with a proven track record of producing us tanning results, this won’t be an issue.

So hopefully this helps gives you an idea of how much density you may need to create a dense and natural looking hairline.

Best wishes,

Rahal Hair Transplant 

 

According to a survey done, the average density in the frontal hairline of an adult male without signs of MPB is roughly 38-78 FU/cm^2.  Not 80-100 FU/cm^2.  The 80-100 FU/cm^2 starting point doesn't really meet the common sense test either...  In terms of what any given person can hope to achieve, it depends on the thickness of the hair and how much loss there is because with more significant loss you have to be particularly judicious with grafts.  Generally, it seems 40+ looks acceptable and around 60-70 FU/cm^2 looks excellent.   

 

https://www.ishrs-htforum.org/content/htfi/19/2/local/front-matter.pdf

Edited June 16, 2022 by John1991

[Rahal Hair Transplant]

John,

The hairline consists of a single row of single haired follicular units.  So you can’t exactly measure the density of strictly the hairline unless you’re also measuring some of the “rows” behind it.  There’s no doubt that there’s a gradual fade starting with less density in the hairline with an increase in density as you go back. 

To be honest however, 38 to 72 is a huge range and thus I’d have to question a study that suggests such a wide range for an “average” unless that was the low to high range of all participants.   Typically an average is one number or at least a much smaller range.

That said to be able to respond adequately to the study Id have to look at it in more detail.  I’m guessing they weren’t referring to strictly 1 haired grafts.  It would probably be better to discuss average hairs/cm2 rather than FU since the range of hairs per each FU is between 1 and 4.

Best,

Rahal Hair Transplant 

Edited June 16, 2022 by Rahal Hair Transplant

[Rahal Hair Transplant]

John,

I’m having memory flashbacks reading this study as I recall reporting on it years ago along with the debate amongst several ISHRS surgeons at the annual 2008 scientific meeting. I was there, took notes on the debate and reported on it.

See the Highlights of the 2008 ISHRS Scientific Meeting.

The study you referenced was reported on by Dr. Sharon Keene who I spoke with in person about this very study to garner additional input given the debate.  This was at the annual 2008 I SHRS scientific meeting which I attended.

Long story short, this study yielded a lot of debate as not every physician member of the ISHRS agreed with the study and had their own findings. I’ve pasted my report on the underlying debate below. You can also find the entire report in the link above.

———

Presentations at the ISHRS meeting of particular interest to Hair Loss Sufferers

Hairline Design and Optimal Density

Natural hairline reconstruction is probably one of the most important factors considered by prospective patients and one of the greatest challenges hair transplant surgeons face on a daily basis. Combining numbers of grafts with artistic design, a surgeon must recreate an age appropriate, natural looking hairline with suitable density to achieve an optimal cosmetic improvement.

Hairline Design

In a hairline demonstration panel discussion led by Dr. Knudsen of Australia, a few top surgeons in the field including  Dr. Ron Shapiro, Dr. Arthur Tykoconski, Dr. William Pasley, and Dr. Walter Unger presented their approach to hairline design on the same few patients for compare, contrast, and discussion. Though each hairline design was aesthetically pleasing to the eye, each hairline was uniquely and creatively crafted based on scientific principles of measurement and individual experience and artistry.

Patients needing hairline reconstruction should discuss a surgeon’s approach with those they are considering and look through hair transplant photos that demonstrate their artistry.

Hairline Density

High density hair transplants are often hyped online giving hair loss forum members the impression that surgeons who produce the greatest densities (in FU/cm2) are the best in the industry. But are higher densities always superior? What about in particular for the hairline?

In a presentation and discussion led by Coalition member Dr. Sharon Keene on maximum verses cosmetic densities, a few leading hair restoration physicians presented varying densities.

Surgeons representing the 35-45 FU/cm2 side of the debate include Coalition member Dr. Robert Bernstein, recommended physician  Dr. William Parsley, and Dr. Walter Unger. On the 50-70 FU/cm2 side of the debate, Coalition member Dr. Thomas Nakatsui  and recommended physician Dr. Melike Kulahci  were represented.

Each set of photos including those representing lower and higher densities were artistic with attention to detail. So the question remains, are higher densities necessary if lower densities can achieve the same cosmetic appearance? Where higher densities may be needed is when a patient steps under harsh lighting. Hair characteristics surprisingly were not discussed, but plays a huge role in the number of FU/cm2 needed to achieve proper hairline naturalness and hair density.

Dr. Keene believes that studying natural hairline density in non-hair loss suffering patients is the only way to conclude appropriate density needed for the hairline.  Dr. Keene suggests based on her anecdotal findings that natural hairline density in non-hair loss sufferers is only between 40-50 FU/cm2 on the average as opposed to the conjectured 80. If her findings prove accurate, surgeons may very well re-evaluate the need to densely pack greater numbers in such a small area. Before Dr. Keene  feels comfortable drawing final conclusions however, she intends on increasing her sample size to at least 50 subjects.

——-

so as you can see, while it’s been reported that hairline density is lower in one study and report, there are others that contradict it.

Best wishes,

Rahal Hair Transplant 

Edited June 17, 2022 by Rahal Hair Transplant

[Rahal Hair Transplant]

All the above to say, it would be interesting to see more current studies on this because I believe the study was considered anecdotal as I reported above. I know when I reported on Dr. Keene‘s findings, I checked with her before presenting the above article. It was pretty much decided that more studies were required to draw any real absolute conclusions   

Rahal Hair Transplant 

Edited June 17, 2022 by Rahal Hair Transplant

[deeznuts]

Kinda weird to hear that hairline density is only ~50/cm^2. I always thought native density was like 80/cm^2 or something like that.

 

[Nw7HPE]

50 would be great , although a lot of other things are at play (Hair type , thickness ...)

[mafpe]

2 hours ago, deeznuts said:

Kinda weird to hear that hairline density is only ~50/cm^2. I always thought native density was like 80/cm^2 or something like that.

for non balding person, yeah it can even be denser. for thinning people though, i see many posters here say that their density is at 60/cm2. one of the factor that highlight baldness is the fact that your side area (donor) are way thicker and fuller, while the front and top is thinning or see through. now if the donor is as thin, maybe both at 50, people would think that the person just have very thin hair but not exactly balding (still less desirable, but somehow it's percieved better). 

also if the native density is 80, you'd probably take 20/cm2, so they'll end up at 60. so like that the hair on your whole head would look way more uniform.

this tho...

15 minutes ago, Kashnw7hope said:

50 would be great , although a lot of other things are at play (Hair type , thickness ...)

i wish my hair is damn thick, thet will solve alot and means you will need less graft for a way fuller look. perhaps just 1 average HT can make it look dense in that case

[BaldReaper]

What matters isnt the grafts/cm2 

 

What matters is the grafts/cm2 * thickness of hair(in microns) * hair/graft > 5.4

[Fue3361]

Mine was done at around 75-80 fu/cm2 and I'm very happy with the density.  My natural density was measured I believe (if I recall correctly) at 96.  

I think over 55 fu/cm2 you could say as "pretty dense" as a generalization.  But to achieve real "dense" results is much more nuanced, and depends on other factors.  If it's African American hair and very curly, 55fu/cm2 will look amazing.  If it's very thin hair and straight with high contrast to skin color, it can look weak.