Is there a legitimate way to calculate post op density based on graft number for realistic expectations?

[singh]

I was talking to a clinic and I gave them my calculation based on the area of surgery and the number of grafts. I was told that there's no way of calculating post-of density with any calculation and there's no way of knowing what my hair will look like post-op. I'm really confused because how am I supposed to tune my expectations and how am I supposed to know if my surgery went right?

 

[A_4_Archan]

@singh

What do you mean by "good density" ? Do you mean a density same as someone who doesn't have any hairloss ? If your expectations are as such than you will be disappointed .. HT can give very high density in very very less % of patients where all the factors affecting the outcome of a surgery are extremely favourable..and in rest of the cases HT is an illusion of density and not the actual density...sometimes even giving too much of density proves to be disastrous....

Its not always that only GRAFT COUNT leads to density...graft count is one of the factor but not a singular factor affecting the density..there are many other factors which affects the density of a HT such as

- Hair caliber of donor hairs....this plays an important role to provide density ..even if the number of grafts implanted is less but the thickness of donor hairs is more than you can achieve decent density with less grafts comparatively...

- Hair caliber of native hairs...when there are good amount of hairs already existing in the transplanted area which are thick than the native hairs plus transplanted hairs together can provide decent density even if the amount if transplanted grafts are less

- Number of multiple grafts...average hairs per graft ratio has its role when it comes to density...higher the ratio better the density....more density can be achieved with less number of grafts if donor provides more multiple grafts

- Hair angles....for this surgical skills plays an important role and that's why good surgeons can provide good "ILLUSION" of density with using less amount of grafts comparatively....they can make hairs grow in such an angles where they provide better illusion of density..if the hairs grows in upward direction than they will provide illusion of less density and if they lay flat on the scalp than they provide better illusion of density.

- Survival factor....if a surgeon implants more grafts per sq cm but his transection rate is high than you will achieve less density and if a surgeon implants a bit less per sq cm with more than 95% survival rate will achieve better density..

- Medication..some fortunate people are very good responder to meds and they get some good regrowth as well as their native as well as transplanted hairs really gets fuller and thicker with medication and they achieve good illusion of density with less grafts..

- Hairs-Scalp color contrast...this also plays an important role which people don't consider...if the contrast is low than the illusion of density is high and if the contrast is high than the illusion of density is low.

- Size of the area to be implanted ....sometimes the baldness is extreme but the total area in terms of measurement is less so the number of grafts requirement is low comparatively while in some cases the baldness is not that extreme but the area in terms of measurements is bigger and so more number of grafts are required.

- Individual's response to a surgery....sometimes an individual respond very badly to a surgery and there is a chance that he/she might not get the desired results...

 

Now if i speak about your particular case than i would say there is a good chance that you can get near to native density because as you already mentioned in your other posts that you are not diagnosed with MPB so your surgeon has a freedom to go for a dense packing and use as many grafts as it takes to achieve high density because he/she don't need be conservative in your case....plus the area is small so it won't need too many grafts either to achieve good density...you native hairs also seems to have above average thickness which will help...so if most of the factors affecting the outcome of a surgery is favourable to you than you are likely to achieve good dense outcome..

But if you are asking that if you can get some specific assurances and some calculations about this from someone than my answer would be pretty short and straight -  NO 

i hope this helps you...

Edited August 20, 2023 by A_4_Archan

[singh]

2 hours ago, A_4_Archan said:

@singh

What do you mean by "good density" ? Do you mean a density same as someone who doesn't have any hairloss ? If your expectations are as such than you will be disappointed .. HT can give very high density in very very less % of patients where all the factors affecting the outcome of a surgery are extremely favourable..and in rest of the cases HT is an illusion of density and not the actual density...sometimes even giving too much of density proves to be disastrous....

Its not always that only GRAFT COUNT leads to density...graft count is one of the factor but not a singular factor affecting the density..there are many other factors which affects the density of a HT such as

- Hair caliber of donor hairs....this plays an important role to provide density ..even if the number of grafts implanted is less but the thickness of donor hairs is more than you can achieve decent density with less grafts comparatively...

- Hair caliber of native hairs...when there are good amount of hairs already existing in the transplanted area which are thick than the native hairs plus transplanted hairs together can provide decent density even if the amount if transplanted grafts are less

- Number of multiple grafts...average hairs per graft ratio has its role when it comes to density...higher the ratio better the density....more density can be achieved with less number of grafts if donor provides more multiple grafts

- Hair angles....for this surgical skills plays an important role and that's why good surgeons can provide good "ILLUSION" of density with using less amount of grafts comparatively....they can make hairs grow in such an angles where they provide better illusion of density..if the hairs grows in upward direction than they will provide illusion of less density and if they lay flat on the scalp than they provide better illusion of density.

- Survival factor....if a surgeon implants more grafts per sq cm but his transection rate is high than you will achieve less density and if a surgeon implants a bit less per sq cm with more than 95% survival rate will achieve better density..

- Medication..some fortunate people are very good responder to meds and they get some good regrowth as well as their native as well as transplanted hairs really gets fuller and thicker with medication and they achieve good illusion of density with less grafts..

- Hairs-Scalp color contrast...this also plays an important role which people don't consider...if the contrast is low than the illusion of density is high and if the contrast is high than the illusion of density is low.

- Size of the area to be implanted ....sometimes the baldness is extreme but the total area in terms of measurement is less so the number of grafts requirement is low comparatively while in some cases the baldness is not that extreme but the area in terms of measurements is bigger and so more number of grafts are required.

- Individual's response to a surgery....sometimes an individual respond very badly to a surgery and there is a chance that he/she might not get the desired results...

 

Now if i speak about your particular case than i would say there is a good chance that you can get near to native density because as you already mentioned in your other posts that you are not diagnosed with MPB so your surgeon has a freedom to go for a dense packing and use as many grafts as it takes to achieve high density because he/she don't need be conservative in your case....plus the area is small so it won't need too many grafts either to achieve good density...you native hairs also seems to have above average thickness which will help...so if most of the factors affecting the outcome of a surgery is favourable to you than you are likely to achieve good dense outcome..

But if you are asking that if you can get some specific assurances and some calculations about this from someone than my answer would be pretty short and straight -  NO 

i hope this helps you...

By good density I mean, not having my scalp visible when my hair is slicked back. Since I'm only getting the first centimetre of my hairline being done, I believe only singles will be used. But thank you for such a detailed general and a personalized reply. Your assurance means a lot friend!

[BackFromTheBrink]

4 hours ago, singh said:

By good density I mean, not having my scalp visible when my hair is slicked back. Since I'm only getting the first centimetre of my hairline being done, I believe only singles will be used. But thank you for such a detailed general and a personalized reply. Your assurance means a lot friend!

Generally I'd say in the region of 50 follicles per square centimetre in the hairline will give the appearance of a full head of hair.

Some surgeons go higher, especially in the hairline. There has been people who got 70-80, but that's relatively unusual and extreme. 

[singh]

59 minutes ago, BackFromTheBrink said:

Generally I'd say in the region of 50 follicles per square centimetre in the hairline will give the appearance of a full head of hair.

Some surgeons go higher, especially in the hairline. There has been people who got 70-80, but that's relatively unusual and extreme. 

I already have native hair in my hairline and since my issue was traction alopecia, the remaining hair thickness allows a illusion of perfect density when styled right. However a slickback exposes the hair loss. I'm quoted 700 grafts for 12 x 1 cm hairline area between native hair which comes out to 58 FU/per cm. I'm not sure how that will work since its a very high density

[BackFromTheBrink]

I say that's an ideal density. Its not so dense that it'll require special treatment to ensure adequate blood flow in the scalp but is high enough to give a good margin of error and ensure a good result.

Edited August 20, 2023 by BackFromTheBrink

[singh]

On 8/20/2023 at 10:39 PM, BackFromTheBrink said:

I say that's an ideal density. Its not so dense that it'll require special treatment to ensure adequate blood flow in the scalp but is high enough to give a good margin of error and ensure a good result.

Now that I told them I wanna proceed the surgeon said its 1100-1200 grafts, i dont get it how will they fit so many in such a small area?