What is the maximum density?

[Rafael Manelli]

It's often said that a transplant can never match native density, and it would be unwise to attempt it because you don't need to go that high to get the impression of density/opacity of the scalp.

But it's still an interesting topic and may be worth considering for those with minimal loss and good donor or straight, fine hair who require more density to get the appearance of thickness.

Density is said to be limited also by the amount of hair you can implant in one go. Try to put too many grafts too close together and you run into the problem of competing for blood supply or simply not having enough physical space to actually insert them all. 

So my questions are 

1. What is the maximum density implantable in one operation? 

2. What is the maximum density achievable with multiple ops? 

I imagine with subsequent surgeries, you can implant between existing transplanted hairs, and there may theoretically be no limit. But I wonder how great the risk is of transecting previously implanted hairs when you put in new ones, especially if they're telogen.

Would be great to hear from surgeons on this. 

[HappyMan2021]

28 minutes ago, Rafael Manelli said:

What is the maximum density implantable in one operation? 

I personally have seen 100cm/2 growth from a patient from one procedure alone. 

28 minutes ago, Rafael Manelli said:

What is the maximum density achievable with multiple ops? 

I would informally say the sky is the limit. I imagine at some point (200cm, 250cm) the grafts may not have enough physical space to exist side by side. Don't quote me on the specific density #, but I imagine there is a ceiling # of density where the grafts run out of physical space.

But in general....as long as a patient has a generous donor and is willing to go through as many surgeries as needed, there is no reason patient can't have a super strong density. 

I would say 70-80cm would be the dream spot, getting more density than this is unnecessary for the illusion of density. Having a 80cm density transplant would be enough for even the most hair greedy patients, perhaps too much even. 

Goes without saying there is the obligatory statement that you need to look at the holistic/aesthetic big picture, don't focus on the density #, most patients would have zero complaints with 50cm/2, even 40cm/2 may cut it for some people. 

Edited February 2, 2023 by HappyMan2021

[Rahal Hair Transplant]

@Rafael Manelli,

it would be incorrect to suggest that natural density cannot be matched if it’s appropriate however, there are very few cases where matching natural density is something that’s needed to be done. For example, Hair Transplant Surgery is a matter of supply and demand. And since hair loss is progressive, one can’t predict with any degree of certainty just how much demand there will be over a persons lifetime. One can predict how much supply one will have and that supply is limited.

So while today’s skilled and experienced hair transplant surgeons can transplant hair so close together that it matches natural density, it is not usually a good idea. And it’s also not often if ever necessary.  

Frankly, transplanting hair at 50 to 60% density of one’s natural, true density is often sufficient to create an adequate illusion of density under most lighting conditions, even some of the toughest and hardest lighting.  Transplanting at a reduced density preserves precious donor  hair for the possibility of necessary subsequent procedures.

I hope this helps.

Rahal Hair Transplant

[Rafael Manelli]

It would be great if people posted examples of hyper density here. Could be an interesting thread. 

[Rafael Manelli]

1 minute ago, Rahal Hair Transplant said:

@Rafael Manelli,

it would be incorrect to suggest that natural density cannot be matched if it’s appropriate however, there are very few cases where matching natural density is something that’s needed to be done. For example, Hair Transplant Surgery is a matter of supply and demand. And since hair loss is progressive, one can’t predict with any degree of certainty just how much demand there will be over a persons lifetime. One can predict how much supply one will have and that supply is limited.

So while today’s skilled and experienced hair transplant surgeons can transplant hair so close together that it matches natural density, it is not usually a good idea. And it’s also not often if ever necessary.  

Frankly, transplanting hair at 50 to 60% density of one’s natural, true density is often sufficient to create an adequate illusion of density under most lighting conditions, even some of the toughest and hardest lighting.  Transplanting at a reduced density preserves precious donor  hair for the possibility of necessary subsequent procedures.

I hope this helps.

Rahal Hair Transplant

What's the highest density Dr Rahal has done?

And how do you pronounce Rahal? If you don't mind me asking! 

[Fue3361]

Max density is very high these days.  I know Thiago Bianco says he is able to go over 100fu/cm2 in rare cases where it is warranted.  In my case, he did over 80 with no issues and great survivability.

Here's mine:  

I've seen a case from Konior going for 100ish as well.

Edited February 2, 2023 by Fue3361

[NegativeNorwood]

Very good questions, followed to read more answers.

1 hour ago, Fue3361 said:

Max density is very high these days.  I know Thiago Bianco says he is able to go over 100fu/cm2 in rare cases where it is warranted.  In my case, he did over 80 with no issues and great survivability.

Here's mine:  

I've seen a case from Konior going for 100ish as well.

Can you please post that Konior case? Tried to search it but couldn't find it.

[NegativeNorwood]

This are very interesting posts from @Dr. Michael Beehner made in 2009:

"The 60 FU per cm2 is certainly not the practice of the majority of hair transplant doctors. In our ISHRS Journal (the Forum) 2 issues ago, a doctor from Europe showed a high survival rate of 100 FU's in a cm2, but the grafts were put in absolutely perpendicular, which is about the only way you can accomplish that - but the aesthetic result of grafts placed in an upright angle is horrendous and very abnormal."

This is extremely interesting, don't know how much has changed in the last 14 years tbh, would be nice to get some updated insight on that.

 

[bear56]

everyone wants density and is understandable but we all are different. some of us have high or low density hair, i mean everywhere, not just where you lost your hair. if you go after ultra high density. a density that is higher than your normal hair it might look out of place, if for example the density on top of your head is higher than the sides and back of your head it would be a sure way for people to tell. this would be more suitable for people that have a high density but still when the density is too high the hair will be more difficult to style with the rest of the hair. i think its best to stick to your own density (50-60% of it). its more important that your hair line design is spot with correct use of singles, doubles , triples and direction of hair. i know some of you think about for example of couto's patients where the density looks like a lot but most of those cases that have a very good outcome are people that have thick hair and it looks like they have extreme high density but it is an illusion. its the hairline that presents a challenge in those cases because of the thick hair. that's where the doctor's artistry comes in.

[Rafael Manelli]

33 minutes ago, bear56 said:

everyone wants density and is understandable but we all are different. some of us have high or low density hair, i mean everywhere, not just where you lost your hair. if you go after ultra high density. a density that is higher than your normal hair it might look out of place, if for example the density on top of your head is higher than the sides and back of your head it would be a sure way for people to tell. this would be more suitable for people that have a high density but still when the density is too high the hair will be more difficult to style with the rest of the hair. i think its best to stick to your own density (50-60% of it). its more important that your hair line design is spot with correct use of singles, doubles , triples and direction of hair. i know some of you think about for example of couto's patients where the density looks like a lot but most of those cases that have a very good outcome are people that have thick hair and it looks like they have extreme high density but it is an illusion. its the hairline that presents a challenge in those cases because of the thick hair. that's where the doctor's artistry comes in.

Actually Couto’s videos feature men with coarse, medium and fine hair. What they all tend to have in common is a high hair:graft ratio.

[shadowcast]

8 hours ago, Fue3361 said:

Max density is very high these days.  I know Thiago Bianco says he is able to go over 100fu/cm2 in rare cases where it is warranted.  In my case, he did over 80 with no issues and great survivability.

Here's mine:  

I've seen a case from Konior going for 100ish as well.

How many months of hair growth without cutting is this? Just curious as I'm currently growing my hair out post op.