How hard is it to achieve uniform density after a HT?

[DriveByShooter]

I've noticed that people with afro textured hair especially tend to grow out their hair after getting a HT. This is done to give the illusion of density, because at lower level cuts, the difference in density in certain parts is clearly visible. 

I believe the same might be true for those with Caucasian hair texture. When you get a buzzcut, do you have regions that look much thinner? 

SO, how hard is it to achieve this uniform density? 

[Big Rome]

As far as I can make out it doesn’t matter what ethnicity you are, the density isn’t going to be the same as native hair… maybe closer after a second transplant 

[Melvin- Admin]

It’s all simple math. If your native hair is 90 follicular units per cm2. There’s no way even a dense HT will compare. A dense HT can produce 50-60 grafts per cm2. So it will take multiple procedures in the same area to get close to the same density.

[general-etwan]

^ but taking grafts from native donor decreases that density, so you hypothetically have bald area increasing in density and native area decreasing in density until the two meet. All depends on the math of the transplant though and how many grafts are being moved. 

[AB2000]

4 hours ago, DriveByShooter said:

SO, how hard is it to achieve this uniform density? 

If you are looking to style your hair short and want the appearance of more density that you have, then skin micro pigmentation might be a good option at that point.

SMP along on a bald area forces someone to always keep their hair short of have a very strange appearance, but if you mix it in with your transplant result it should maximize the illusion of even density.

[John1991]

7 hours ago, Melvin- Moderator said:

It’s all simple math. If your native hair is 90 follicular units per cm2. There’s no way even a dense HT will compare. A dense HT can produce 50-60 grafts per cm2. So it will take multiple procedures in the same area to get close to the same density.

Does the average male without hair loss have a hairline that is the density of 90 follicular units per cm2, though?  It seems this question is constantly getting jumbled up.  The relevant question isn't whether you can achieve the same density as your donor in whatever other area of the scalp you're transplanting to, but how close to whatever density pre-hair loss you can achieve.  Or, perhaps more relevant, how dense the area of loss currently is - as ultimately improvement is the first goal of hair transplantation, perfection is just a hope.  Or, perhaps most relevant, what % of density in the area is actually necessary to achieve enough density that the transplanted area looks dense enough to the naked eye to not be noticeably worse?  I doubt 50% actually does the trick.  FUE3361 claims his native hairline was 90 fu/cm^2, which means he achieved 75-85% of his native density and his result is as good as is possible.  Perhaps his result would've been similarly good if he achieved merely 2/3 density at around 60 fu/cm^2, but I'm guessing 45 fu/cm^2 (which would've been 50%) wouldn't have made the grade visually even to the naked eye. 

[shiba1985]

1 hour ago, John1991 said:

Does the average male without hair loss have a hairline that is the density of 90 follicular units per cm2, though?  It seems this question is constantly getting jumbled up.  The relevant question isn't whether you can achieve the same density as your donor in whatever other area of the scalp you're transplanting to, but how close to whatever density pre-hair loss you can achieve.  Or, perhaps more relevant, how dense the area of loss currently is - as ultimately improvement is the first goal of hair transplantation, perfection is just a hope.  Or, perhaps most relevant, what % of density in the area is actually necessary to achieve enough density that the transplanted area looks dense enough to the naked eye to not be noticeably worse?  I doubt 50% actually does the trick.  FUE3361 claims his native hairline was 90 fu/cm^2, which means he achieved 75-85% of his native density and his result is as good as is possible.  Perhaps his result would've been similarly good if he achieved merely 2/3 density at around 60 fu/cm^2, but I'm guessing 45 fu/cm^2 (which would've been 50%) wouldn't have made the grade visually even to the naked eye. 

Most ppl don’t even have a donor area of 90fu/cm2 much less hairline. 

[John1991]

15 minutes ago, shiba1985 said:

Most ppl don’t even have a donor area of 90fu/cm2 much less hairline. 

Right, that's my point.  

[general-etwan]

14 hours ago, AB2000 said:

If you are looking to style your hair short and want the appearance of more density that you have, then skin micro pigmentation might be a good option at that point.

SMP along on a bald area forces someone to always keep their hair short of have a very strange appearance, but if you mix it in with your transplant result it should maximize the illusion of even density.

Hypothetically I think I would rather use SMP on donor area after extraction if the area becomes too thin for the liking. In my opinion SMP never really looks good on top of the scalp which is what most humans naturally focus on. It would seem to me that transplants should be more aggressive taking from the donor area if the patient cares less about the back and sides and then if that area needs a little “buffing up” later, do SMP there. Not like botched donor area, but, you know, thinned out just too much for the liking. 

[asterix0]

4 hours ago, general-etwan said:

Hypothetically I think I would rather use SMP on donor area after extraction if the area becomes too thin for the liking. In my opinion SMP never really looks good on top of the scalp which is what most humans naturally focus on. It would seem to me that transplants should be more aggressive taking from the donor area if the patient cares less about the back and sides and then if that area needs a little “buffing up” later, do SMP there. Not like botched donor area, but, you know, thinned out just too much for the liking. 

Yes, and with a good surgeon that does homogenous extraction, small punch size, minimal scarring, you can definitely over harvest the donor this way and kind of mask it with SMP if you keep a short hair cut on the sides.

[Fue3361]

I doubt my result would be as good if it was 60fu/cm2.  But what I got is not something most people should consider.  Grafts are limited.  You don't get more of them (unless science has a breakthrough).  If you're balding, you need to be careful how many you use, as you may need more in the future. 

My case is different from most people, as I don't think I'll ever need more grafts, so my surgeon was able to go all in on density.

[John1991]

13 minutes ago, Fue3361 said:

I doubt my result would be as good if it was 60fu/cm2.  But what I got is not something most people should consider.  Grafts are limited.  You don't get more of them (unless science has a breakthrough).  If you're balding, you need to be careful how many you use, as you may need more in the future. 

My case is different from most people, as I don't think I'll ever need more grafts, so my surgeon was able to go all in on density.

It wouldn’t be as good, but it might still pass the test as “good”. And you apparently have a far denser than average hairline to begin with if it actually was 90 fu/cm^2. That’s way denser than the average hairline.  And I don’t think it would’ve looked good enough at 45 fu/cm^2, which would’ve been half as dense as your hairline supposedly was to begin with. Thus going against the 50% of native density being good enough notion we hear so much. 

Edited August 25, 2022 by John1991

[Fue3361]

24 minutes ago, John1991 said:

It wouldn’t be as good, but it might still pass the test as “good”. And you apparently have a far denser than average hairline to begin with if it actually was 90 fu/cm^2. That’s way denser than the average hairline.  And I don’t think it would’ve looked good enough at 45 fu/cm^2, which would’ve been half as dense as your hairline supposedly was to begin with. Thus going against the 50% of native density being good enough notion we hear so much. 

Don’t know if it helps, but here’s 9 days post transplant; with scabs gone.  Very minor shedding, so mostly all grafts still in place.  Compare density with native hairline right above it:

 

 

Also a good photo to show how he used some very small caliber hairs at edge of hairline.

Edited August 25, 2022 by Fue3361

[John1991]

Ok then, so we can safely say that 80%+ of native density yields exceptional results.  I would guess that around 65% would yield good results, while 50% wouldn't really make the grade.  It's good that you had yours packed extra dense, as your native hair was exceptionally dense.  Do you have SE Asian or Amerindian ancestry?  Based off the density and color of your hair, I'd guess that (though could be wrong).  My guess is for the average white dude with standard "good" hair, around 50 fu/cm^2 would probably do the job.  Not so for you.

[Gatsby]

The best approach I feel is to style your hair (whatever it's characteristics) in a way that gives your hair the greatest illusion of density. That may mean growing your hair long, short, with fibres added, etc. All the best!

[Rahal Hair Transplant]

Drivebyshooter,

Are you suggesting that the transplanted hair density is far reduced compared to natural hair density or are you saying that transplanted hair density in one area is reduced compared to the the transplanted hair density of another?

Assuming you are talking about the former, one needs to keep in mind three principles of hair transplant surgery. These include the illusion of density, supply and demand and donor dominance.  In this case we’re talking more about the illusion of density and supply and demand.  

Simply put, there’s not enough donor to re-create natural hair density unless you’re one of the lucky and privileged few with highly minimal hair loss and an abundant donor supply.  Many men however, possess larger amounts of scalp to cover and a limited donor hair supply.  

As a result, at best surgeons may densely pack some areas up to 50% of one’s natural hair density but not all areas will be transplanted at the same FU/cm2   This addresses the latter of the two issues above.

Typically a surgeon will provide more density in the frontal region of the scalp and then gradually fade into the crown with reduced density for the purposes of naturalness and full coverage.  As a result, patients may need to wear their hair a little longer so that the overlapping affect makes the hair look thicker.

At the end the day, a hair transplant rarely restores a full head of hair but it can look full depending on how you wear your hair and of course, making sure you’ve selected an outstanding surgeon with a proven track record of producing dense and natural looking results. 

I hope this helps

Rahal Hair Transplant