Surface area of bald men

[TC17]

Does anyone have an idea as to what the average surface area is for Norwood 7's, 6's, 5's, etc. I was measuring my scalp and found that even if I progress to a NW 7 I will only have about 175 cm2 of bald area. That would only take 7,000 grafts to fill in the entire area with 40cm2, a density that I believe is more than adequate to give an illusion of fullness. I realize there are variables such as color, hair shaft diameter, texture, etc. that come into play, but shouldn't any physician that transplants 1,000 grafts per NW level fill in the entire area with good density?

[TC17]

Does anyone have an idea as to what the average surface area is for Norwood 7's, 6's, 5's, etc. I was measuring my scalp and found that even if I progress to a NW 7 I will only have about 175 cm2 of bald area. That would only take 7,000 grafts to fill in the entire area with 40cm2, a density that I believe is more than adequate to give an illusion of fullness. I realize there are variables such as color, hair shaft diameter, texture, etc. that come into play, but shouldn't any physician that transplants 1,000 grafts per NW level fill in the entire area with good density?

[roscopeeco]

good question but unfortunately all heads are different...in my case my head is huge so obviously i will have more surface to cover.

 

i have also noticed that a nw 6 on one person is not the same as on another person...people don't lose their hair in the exact same way...if you do an online consult with a doctor, take a picture of the area that needs to be covered...draw a hairline that you want and hold a ruler up to your scalp...with that information in a picture a doctor can easily tell approximately the surface area in cm squared.

[imissthebarber]

even if I progress to a NW 7 I will only have about 175 cm2 of bald area

 

You should recheck your calculations because I'm sure that you have it wrong. I believe the average surface area of hair on a man who has not suffered any hair loss is around 500cm2. A NW7 could lose around 75% (or maybe even more) of that, leaving let's say 125cm2 of hair and 375cm2 of bald area. It is highly likely that the surgeon would not want to cover the whole bald area and would go for a conservative hairline but even so the total area to cover would be vastly more than you calculate. The crown alone can be 175cm2.

[TC17]

I sent in my photos to a number of physicians in addition to some photos of my dad and my maternal uncle because they are by far the baldest men in my family. Each physician said that at most, my uncle is a NW 6 and that my dad is a NW 6.5. I measured each of their heads from where an appropriate hairline would be back to the lowest bald area in the back of the head (which dipped in the middle back like an upside bell curve), and across at the widest point near the lateral humps. Keep in mind I did NOT factor in temple recession points, so this math will actually be more bald area than is necessary. I will use my dad as the example here because he is 62 and balder than my uncle. From front to back he has roughly 9.5 inches and from the side it is about 7 inches for a total of 66.5 INCHES. When you multiply that by 2.54, (2.54 centimeters equals 1 inch) you come out to 168.91 cm2 of bald area. If you fill in an area of 168.91 cm2 with 40 grafts per cm2, it comes out to 6,756.4 total grafts.

 

While I recognize that all men have different size heads, one would think that the the area of baldness would be proportional to the size of the head, so even if you wear a size 8 hat and have 220cm2 of bald area, all other things being equal you should still have a greater number of grafts available. Again, these are not as exact as a physician would do, but keep in mind I measured from the baldest areas at their widest, and longest points. So, that means I didn't take into consideration the temple points receding (which would decrease the graft requirements) nor did I factor in the total area of the bald crown because I just measured to its lowest point, so again less grafts would be required to fill in that point.

 

As far as 500cm2, I just measured my head from tip of the ear to tip of the ear, and from hairline (which is not yet receded, but mature) to neck hair and only got a total of 444.5cm2. Another example is the palm of my hand, which in inches is 22.5 or 57.15cm2. Measure your hand and place a couple of those on your head and see how many it takes to fill in an entire area if you don't believe me.

[TC17]

If my math is wrong, PLEASE someone correct me! I will be the first to admit that my math skills are atrocious, but do your own experiments on your head as well and see what you come up with.

 

Final point, is if you look at the result that Janna posted from Dr. Ron Shapiro a few days ago, she said that he estimated that he placed between 25-35 grafts per cm2, and I think it looks nice and full. In my (possibly faulty) calculations, I am giving 40 grafts per cm2 and still coming up shy of 7,000 grafts.

[roscopeeco]

when you were measuring your head you did your calculations of area for a square or a rectangle..Length times width...doing that actually increases the surface area because the actually balding area is more like an egg shape with the hairline representing the top of the egg...i would say from your calculations there should be slightly less area to cover considering how your arrived at the total bald area.

 

your math was excellent my friend!

[imissthebarber]

TC17

 

Your relatives sounds like they have been really accomodating letting you measure them!

 

OK, I can buy the measurements you gave 9.5 inches x 7 inches. To put that in to cm it is 24cm x 18cm (to closest cm) which equals 432cm2. Now as you said the 9.5 inches is at the longest point, at the shortest point it might be a lot less. If you want more slightly more accurate calcs I would suggest you divide the scalp into different regions which are easier to calculate and measure each one. e.g. a circle in the crown, a rectangle on the top, rectangles on the lateral hump, triangles in the temples.

 

In your calcs you multiplied by 2.54 but you need to multiply by 2.54^2 to do the calcs that way. All the best dude, I hope you get a good result.

[Stimpson]

Alas, I am sorry to imform you that your math *is* wrong.

 

If you do the calculation as you described, i.e. 9.5 inches X 7 inches, and THEN convert to centimeters, you do not just multiply by 2.54, but you multiply by 2.54 SQUARED. If you only multiply by 2.54 once, you are not converting BOTH sides to centimeters. The actual calculation is 9.5 inches X 7 inches X 2.54 X 2.54 = 429.03 CM2.

 

To check this, lets convert FIRST before we do the area:

 

9.5 inches = 9.5 X 2.54 cm = 24.13 cm.

 

7 inches X 2.54 = 17.78 cm.

 

Now, we just calculate the area as 24.13 cm X 17.78 cm = 429.03 cm2.

 

Sorry to be the bearer of bad news...

 

Best regards - Stimpson

[Stimpson]

Oh...

 

Imissthebarber beat me to it...

 

Damn!! I felt so smart!!!

 

Oh well...

 

Best regards - Stimpson

[imissthebarber]

It isn't all bad news. This is just the supply and demand issue of HT's. You need to work out what you would be happy with.

 

Also the real figure will be less than 430 because the shape is not as regular as a rectangle. I still say 375 is a ball-park for a guy with an average sized head gone to a NW7. You then need to work out which zones to target with what density and what zones to leave. Also meds may well help once you have understood possible side effects and are comfortable with them. To state the obvious your plan should suit you know and take into account ageing and potential further hair loss.

[Stimpson]

To state the obvious your plan should suit you know and take into account ageing and potential further hair loss.

 

It's obvious but it cannot be said often or loud enough!!

 

I remember when I got my first procedure at Bosley at the age of 21 (or maybe 22, I forget). In retrospect, ALL I was concerned about was fixing my IMMEDIATE situation. Although the Bosley work was pretty attrocious, as Bosley usually is,thank GOD they had the sense to place the minis well behind the hairline, and at least angle them more or less correctly. This at least allowed the mini's to be camoflauged pretty easily later by a good surgeon (Dr. Parsley in Louisville).

 

I was so desperate when I went to Bosley I literally do not remember having one single thought beyond the immediate future. I even remember them trying to instill into me that this was a commitment to a lifetime process and that I would never have a 16YO hairline (even the evil Bosley has their moments I guess). I was just like "yeah yeah...", and I STILL had it in my head that I would walk out of there with my baldness problem cured for life after receiving my 132 mini's. Of course those minis became a real problem for me when my hair continued to recede.

 

If I could go back in time and visit myself, I would TOTALLY kick my ass. I was SO stupid. It's not that I'm a stupid person, I just could not see beyond my immediate desperation. This site was not here, as the internet was not what it is today back in the early 90's.

 

Caution and careful planning for the future are a MUST. Also expectations MUST be kept realistic. Avoid looking at things with rose colored glasses. Personally, I am believer in a nice looking receded hairline. Like a 3V. This way you do not look bald, and since you are not filling in a low hairline, you have less area to cover and more grafts to play with. It's win win. Of course a 3V looks great on me with my facial/hair characteristics. I guess everybody is a little different in this regard. Boy I just cringe sometimes though when I see young patients taking aggressive approaches. I am afraid they are like I was at that age, only concerned about the IMMEDIATE future.

 

Oh my, some of the trials a lot of these Armani type patients are going to face later in life are going to truly test their inner strength in ways they cannot yet even imagine.

 

There is another category on this forum, called something like "support for hairloss issues" or something like that. I don't know if most people check in there, but posts like this one by dalew should be required reading:

 

http://hair-restoration-info.c...41047973/m/461102761

 

Caution, people. Caution...

 

Best Regards to all, Stimpson

[Dr. Paul Shapiro]

TC17

In my experience the average patient head can be divided into two areas.

The frontal 2/3 of the scalp on average measures 100 sq.cm. On average the crown loss is 80 to 100 sq.cm. The area of the crown will vary by how low and wide the crown loss is. On average I would say that to cover the total bald area in most men who are type 6 or 7, I cover an area of 200 sq. cm. But there are men with very large scalps in which the area is more like 250 to 300 sq.cm and men with smaller areas. A total area of 170sq.cm.is in the realm of a normal area to cover.

 

Since the area of scalp I am transplanting is not a box, it is hard to get a measurement by measuring just the length and width of the balding area. So your measurements may not accurately estimate the area balding in your scalp. The way I measure the recipient area is as follows. I went to Kinko's and had them copy some one sq.cm. graph paper onto clear plastic overhead sheets. To measure the recipient site area I place this clear plastic sheet on the scalp and draw the recipient site with wax pencil. Then I count the number of intersections inside this drawing on the sq.cm. grid. The number of intersections counted should closely approximate the area inside the tracing. This method is mentioned in some of the textbooks on hair transplant surgery. Try this method and see what area you get for your recipient area.

I hope this is helpful

Dr. Paul

[TC17]

Dr. Paul and all other people who have responded,

 

Thank you all for your help and for correcting my math. It's pretty embarrassing that I struggle with 4th grade math, but I suppose that's why I'm in law school and not in any field that requires math skills that would exceed that of the average 3rd grader.

 

I ended up going to a sporting goods store and buying a white swimming cap that I put on and then drew a hairline. After breaking everything down into different sections, I eventually ended up with 195cm2 of bald area IF I were to ever progress to full blown NW7 status. A lot more work than Dr. Paul's suggestion, but I was already home and finished by the time I read his post lol. D

 

I must say though, I am very happy to learn that the average man who is a 6 or 7 "only" has 200 sq cm to cover, as you could put 40 in the hairline, 30 in the mid scalp and transition to 20 in the crown for what I would consider a fairly decent amount of coverage with only 6,000 grafts.

 

Many thanks again to all of you guys and to Dr. Paul who I am sure is very busy. It's always appreciated when a world class physician answers our questions. Anyone want to follow Dr. Paul's manner of measurement and post the sizes?

[biscuit]

You can cut up some 10 sq cm pieces of paper and see how many it takes to cover the bald area.

[dakota3]

My brain hurts. LOL!

[Zup]

To add a bit more detail on this topic.

 

At SMG we assess patients with where their hair loss is when we see them, but because we are dealing with a limited source and moving field and unknowns we always educate them on the worse case scenario and what is achievable if they progress and go bald.

 

We base this on what the average patient has opposed to what an above average patient has.

Average patient has approximately 4000-8000FUs in their donor....moderate being approximately 6000FUs, average Male Pattern Area is approx 200sqcm. Assume, an average patient progresses and goes bald. One takes 6000FUs and distributes them over a 200sqcm area, it yields 30FUs/sqcm, what is 30FU/sqcm, depending on the characteristics of ones hair 30 can be the low end where things have a fuller appearance. Not bad for someone who would otherwise be bald. Now how most people would distribute it would be, rather then treating everything equal most would rather have the front 100sqcm fuller, close to the appearance of normal density and the crown just enough hair to hide the scalp. Now to get a bit more precise with selective distribution, rather then 40FUs evenly through the front, we would establish a strong and natural hairline at a density of approximately 35 and the core approx 45. Many build and create more density at the hairline and fade back. Well normally heads of hair are like bodies of water, along the lake shore the water is shallow and as you move in the water gets deeper. By establishing the hairline with good substance, but not a wall, and then building density in the core this will make the hairline itself appear much thicker. Similar to a forest, if there are 20 rows of thick trees and an open prairie behind it you will see light through the trees. By having a thick core behind the hairline it blocks the light making the hairline appear thick.

 

In the crown rather then 20FU/sqcm uniformly through out, we treat the crown as if it is made up of thirds; top, mid and bottom and because it sit on a slope we establish a higher density in the top third approx 30FUs, 20 FUs in the mid third and 10Fus in the bottom third, in that everything up high will shingle downward over the areas below. Another issue with the crown is one needs to be a bit careful with the bottom border because that is the area that will potentially recede further in time.

 

So overall summary, 30FUs through out or 40FUs front half and 20FUs in the crown....further break down of distribution in the front 100sqcm, 35FUs hairline 45FUs frontal core and in the crown (the back 100sqcm) a 30, 20, 10 distribution.

 

Now this is all based on average patient that progresses and goes bald or may go bald. If one does not go bald or has above average donor more can be achieved.

[Take a chance]

Great post Zup. I just wanted to add my 2 cents. I was an NW6 before my first procedure. Out of the entire 209 square cm of measured bald area, the plan was to transplant 4000 grafts in 114 sq cm approximately.

I got 4337 grafts and had an average density of 38%. Good density to the front as well as forelock close to 45%, and then tapered it as we moved further back. I was not able to get a low and square hair line, instead taking a more conservative approach to plan for any future loss.

I'm sure if most people make a good plan with their HT Docs they can achieve a great result. The hardest part is now waiting for it to grow in...