Illusions of Density?

[Middleson]

This question is for the folks who are at least 12 months past a HT.

 

Having reached the 5 month post-op milestone, I'm starting to see some growth as expected. Even though I know there's much more to come, I'm still pretty thrilled with the process at this point. Recently I'm starting to notice that in indirect lighting my crown almost looks filled in, and in direct lighting, while it looks much improved, it looks not quite so filled in. I suspect having dark, somewhat coarse hair is giving me this illusion of density in lower lighting(?).

 

I recall reading many references in discussions on this board about the "illusion of density", and also recall (think it was Bill?) someone saying something like "some lighting is friendly, other lighting is not so friendly" in terms of being satisfied with the results of your HT process or end result(?). And, of course, we've all heard about greed.

 

After my HT, my doctor provided me with this density data:

 

Transplanted Area: 60cm2

Recipient density: 40-60 grafts/cm2 (average~50/cm2)

 

Question: In general, what can you tell me about your level of satisfaction with the results of your HT (in terms of density) with respect to the actual approximate density obtained from your HT?

[Middleson]

This question is for the folks who are at least 12 months past a HT.

 

Having reached the 5 month post-op milestone, I'm starting to see some growth as expected. Even though I know there's much more to come, I'm still pretty thrilled with the process at this point. Recently I'm starting to notice that in indirect lighting my crown almost looks filled in, and in direct lighting, while it looks much improved, it looks not quite so filled in. I suspect having dark, somewhat coarse hair is giving me this illusion of density in lower lighting(?).

 

I recall reading many references in discussions on this board about the "illusion of density", and also recall (think it was Bill?) someone saying something like "some lighting is friendly, other lighting is not so friendly" in terms of being satisfied with the results of your HT process or end result(?). And, of course, we've all heard about greed.

 

After my HT, my doctor provided me with this density data:

 

Transplanted Area: 60cm2

Recipient density: 40-60 grafts/cm2 (average~50/cm2)

 

Question: In general, what can you tell me about your level of satisfaction with the results of your HT (in terms of density) with respect to the actual approximate density obtained from your HT?

[Bill - Seemiller]

Middleson,

 

Great topic for discussion. This answer is clearly subjective, but let me try to help give you my perspective.

 

You are correct...some lighting is more friendly than others. I have found that it depends on several factors:

 

1. Illumination of the light

 

Brightness will clearly influence how dense our hair looks. The brighter the light, the more detail is exposed. A quality hair transplant will stand up in all lighting conditions - in that it will look natural, however, clearly, the appearance of density will lessen as the light brightens

 

2. Color of the light

 

Lighter colored lights such as florescent ones lessens the appearance of density whereas normal or colored lights increase the appearance of density.

 

3. Direction of the light

 

I have found specifically that direct sunlight hitting my hairline makes my hair appear super dense, whereas the sun coming from behind makes my hair look much thinner from the front. Straight overhead (around noon), I'd say my hairline looks somewhere in between these two extremes.

 

But do not be deceived. Lighting affects even those with a full head of non-balding native hair (especially when their hair is kept shorter). It just isn't as obvious. Remember, we ARE dealing with less density than one with a full head of native hair.

 

One question that tends to come from this discussion is: So which lighting exposes the truth? There are varying answer, but here's mine: They all do IMO, with the exception of photos taken with a flash (more on that in a link posted below).

 

The bottom line is at varying points of one's day and/or life, we will be seen in all types of lighting. At the same time, though, one has to consider where they will be seen the most. I admit, there have been times where I am talking to someone outside and end up noticing that the sun is behind me. So I'll strategically angle myself so the sun is more flattering to my hairline. Some might consider that a worry they don't want to have to deal with, but for me, I am not all that concerned...but I know where I look the best...so I try to face that way.

 

To answer your question specifically about my overall satisfaction, I'd say it's very high! Because I have realized that even in the worst lighting conditions, I still look 1000 times better than I would without hair transplantation. And the truth is...I don't feel that even in worst lighting that it looks bad.

 

Below is a link to a related topic posted by Joe Tillman (JoTronic) regarding flash photography.

 

http://hair-restoration-info.com/eve/forums/a/tpc/f/346...141012852#5141012852

 

Cheers,

 

Bill

[Middleson]

I always appreciate your thoughtful and detailed responses to peoples questions Bill, thank you.

 

A follow up question(s):

 

I've read about people getting "hair greed" after their first HT. And I've also read about people getting a HT to increase their density on a specific area of the scalp. To your knowledge, has this ever been a matter of increasing density in a HT recipient area where the patient didn't get enough density in the first place (for whatever reason)?

 

In general, is there an optimum amount of density per cm2 for different hair types? Is there a minimum density below which you would say "why even bother with a HT", and is there a maximum density beyond which it is simply not technically possibly assuming the most ideal candidate with nearly unlimited hair & resources & a top notch surgeon?

[rjvw]

Middleson, Great topic.

In indoor lighting I strut around like a proud peacock. My hair looks thick and filled in but in reality it's not. I find myself staying away from indoor spot lights. They are ego killers. In other types of lights I find myself thinking "Damn Bro, you look good". Being past 4 1/2 months post op I know I have a ways to go but having the right lighting sure does help. As for the hair greed, I never thought I would fall into that but slowly it does creep back into my mind that maybe on more HT might do the trick. But only time will tell.

[the B spot]

A follow up question(s):

 

I've read about people getting "hair greed" after their first HT. And I've also read about people getting a HT to increase their density on a specific area of the scalp. To your knowledge, has this ever been a matter of increasing density in a HT recipient area where the patient didn't get enough density in the first place (for whatever reason)?

 

In general, is there an optimum amount of density per cm2 for different hair types? Is there a minimum density below which you would say "why even bother with a HT", and is there a maximum density beyond which it is simply not technically possibly assuming the most ideal candidate with nearly unlimited hair & resources & a top notch surgeon?

 

Your question is a good one.

 

The ACCEPTED standard where the "illusion of density" is reached is often referred to 50% of natural density.

In the case of caucasion males, who ON AVERAGE possess 85-90 fu's cm/2, a transplanted density of 45-50 fu's cm/2 would achieve this look.

This is factoring average curl/kink and hair diameter.

Basically the "average" white HT patient.

 

Obviously, if hair characteristics differ (straight/fine--- thick/curly) the numbers will be skewed to some degree, but you can use densities of 45-50 to work from.

 

Of course, this leads into the "actual density" question--- 50 1 hair grafts NOT the same as 50 2-3 hair grafts, etc..

 

I have seen 50-70 fu's cm/2 in the hairline being performed more these days, and I have recently seen a pic of a patient Dr. Hasson transplanted at 90 fu's cm/2, so I will say that 80-90 is the true "mark" of REAL density, but ONLY in the hairline.

Armani claims densities of 100-120, but I have never seen this--- seeing mostly 65-80 from him.

 

Going back to native or original density, 85-90 fu's as they exist in nature will contain many bundled grafts 1,2,3,4 and even 5-6 hair grafts, so the hair density is much greater as it exists in nature, vs transplanted areas of the scalp.

 

I guess what it comes down to is graft survival and physician skill when asking for density above 55 in one session.

 

This leads into asking WHY transplant above 55-60 in one pass?

 

Until the patient has a chance to view this density and say "I would like a little more" IMO it is a waste of donor.

 

Of course, there are patients who possess the "perfect" candidacy for a dense pack hairline-- upwards of 65+, but I believe they represent a very small percentage of us baldies, unlike some are being led to believe.

 

Think NW5-6 when your planning your future and you will probably be OK, regardless of the philosophy of the doc you choose.

 

I hope this answers some of your questions!

J

[hairbank]

Great thread, Middleson.....I'll add my $.02-

 

I think initially 45 cm2 was considered optimal for the "illusion of density". The last few years, I think you would increase that to 55 cm2, more in the hairline, maybe a little less in the crown.

 

You're like I was before my 2nd HT with respect to the crown. Dr. Wong estimated he was transplanting my crown at around 40 cm2...............if I comb my hair back, it's pretty much covered but still slightly see-through in spots..........see my blog for reference. If I comb my hair forward or part to the side, the crown looks even thinner......part of the reason I'm going back for another HT. Very plainly, the crown takes up many, many grafts for an appearance of density.

 

Now............one IMPORTANT thing I'll mention to you. I grew pretty fast considering I had grafts in teh crown.......see my 4mo 22 days pics in my blog. So, compare yourself to those pics. I can tell you, I was still a little disappointed by month 6 that I didn't have better coverage. By month 9, I was a pretty happy camper. The crown takes longer to fill in so try and be patient. If you had an average of 50 cm2 I believe you'll be very pleased with the end result.

 

Hang in there!

[the B spot]

Hairbank---- why do you have to come and start bragging...."I got 40 fu's cm/2 in my crown etc..blah blah blah???"

 

Do you ever think some of us might be a little sensitive to that type of information!!!!!

 

HUH??

 

 

J/K --- your going to be a hairy mofo in the future-- you and Bill both....... I think I am going to have to kill both of you and steal your hair!!!!!!!!

 

 

MMMWWAAHHHHAAAHAAAHAAAHHAAA.........hahaha....ah

 

[Aquarius]

Great post. Once again I will make it short and sweet. Is it "Hair Greed" or false expectations ? Because of "unrealistic expectations" this is "bull$hit". If the A -hole Dr. that cut you and turns this around on you after promising you the world? He is IMHO a criminal.

[hairbank]

Originally posted by the B spot:

Hairbank---- why do you have to come and start bragging...."I got 40 fu's cm/2 in my crown etc..blah blah blah???"

 

Do you ever think some of us might be a little sensitive to that type of information!!!!!

 

HUH??

 

 

J/K --- your going to be a hairy mofo in the future-- you and Bill both....... I think I am going to have to kill both of you and steal your hair!!!!!!!!

 

 

MMMWWAAHHHHAAAHAAAHAAAHHAAA.........hahaha....ah

 

 

Hey, you hairy stud..............you have more grafts than I do !!!!

 

So when's #3 big guy????

 

I can't speak for Bill but I'm okay with you wanting to kill me....................just don't go crazy and shave my head or anything

 

Aquarius makes a nice point.............expectations. I remember my consult with my Doc for HT #1, I was getting 1200 grafts which I thought "wow, that's a ton"..........and I was told by him to have realistic expectations. This is true, but REALISTICALLY, I would have loved to know that I could have gone somewhere and gotten probably 5000 grafts in one pass.

 

I believe Hair Greed is Hair Greed............for me it is anyway. My results from the first two HT's have actually surpassed the results I thought I'd achieve..............but I figure if I have the donor and it's safe, I CHOOSE to have more hair.

[Bill - Seemiller]

I can't speak for Bill but I'm okay with you wanting to kill me....................just don't go crazy and shave my head or anything

 

LOL...that's right. I don't care if you kill me...just don't shave my head and take my hair

 

Funny stuff...and great discussion.

 

I don't really have much more to add. B Spot hit the nail on the head with Middleson's follow up question, so I truly am speechless for once. In other words, my response is "what he said" .

 

Bill

[the B spot]

LMAO!!!!

 

Anyway, I am not sure Bank--- my scalp was pretty tight for HT #2, so I think I might do one more little strip session and then possibly do an fue session to top everything off.

 

I really think that I have 2500 or so grafts left via strip/fue so I would like to use them!!!!!

 

The sooner the better, but I think I will have to wait a bit and see what #2 looks like first--- I got a lot of grafts so I want to make sure that I really plan my next move out right, ya know?

 

I will say this---- any fue I have done will most likely be done by Dr. Rose---- the man just knows his way around the donor, eh?

 

Hey, how cool would this be...... a strip/fue combo session with both Dr. Shapiro AND Dr. Rose at the same time?????

 

How cool would that be!!!!!!!

 

Now THAT would be an interesting day in the chair.

 

[bayscholar]

Bspot

 

What's new great point about the differences in perceived densities and real densities....real i.e...Terminal density includes hair counts makes a huge difference for comparison purposes (apples to apples...shoot I sound like Pat). I don't think the issue is as much hair greed as it is reality....60+ in the front looks amazing even if they are all 1's in zone 1.

 

Sucks but in truth "it is what it is"...60-65+ hairline is the magic number if you see it in person you will know. Hbank 40 in the crown I am beyond jealous round 3!!!!....do us proud hit 8k.

 

Bay

[hairbank]

Bay-

 

I'm tellin' Master Wong to swing for the fence so who knows the total yield! I'm stretchin' that scalp like a madman via Joe's scalp exercises.

 

B spot-

 

Hey........come to think of it......where are the updates for HT #2, bro? Shapiro & Rose...........what a one-two punch to knockout any remaining MPB, my friend.

[the B spot]

Nothing to really show right now---- a bit behind the schedule of #1, so I think I will post some 6 month pics (first week of July) to show everyone what's up.

 

Not sure the Shapiro Rose thing is even possible, just came to me while I was posting!!!!!

 

J

[NervousNelly]

With the illusion of density it is very interesting the choice of photos that they always put on doctors websites.

 

You never see photos with the light bright and coming from behind. That is why it is importand to see HT in person.

 

NN

[hairbank]

Originally posted by NervousNelly:

With the illusion of density it is very interesting the choice of photos that they always put on doctors websites.

 

You never see photos with the light bright and coming from behind. That is why it is importand to see HT in person.

 

NN

 

Good point....as usual, NN .

 

Also brings to mind something I keep mentioning as of late............I hope more posters and bloggers will start posting outdoor and indoor pics of similar angles to show what things look like in bright sunlight. It's really the best way to show everyone the "true" appearance of HT hair.