How Many Hairs

[western_star]

I recently did a little test I found on a web site to find how many grafts you possibly need to get a full head of hair. It said I needed 19,000. Isn't that quite a lot? How do you know if you have 19,000 to give. I went to one place that we can't talk about and was told I had enough donor hair to cover everything especially being blonde. Is there a way for us, the patients to actually figure out how much donor hair we have and how much coverageit will allow us?

[western_star]

I recently did a little test I found on a web site to find how many grafts you possibly need to get a full head of hair. It said I needed 19,000. Isn't that quite a lot? How do you know if you have 19,000 to give. I went to one place that we can't talk about and was told I had enough donor hair to cover everything especially being blonde. Is there a way for us, the patients to actually figure out how much donor hair we have and how much coverageit will allow us?

[Mahair]

Well 19,000 is about right most people have 4,000 - 6,000 to donate so you have discovered the "secret" fundimental flaw. They said they could cover everything? Wow do they have a magic wand? Sounds like something a quack like "Dr." Magdalin would say.

[Robert_]

Western,

 

Have you used the graft calculator located at the Hair Restoration Network?

 

It can determine pretty accurately how many grafts you would need to fill an area at different densities. Click on the above link. You will see a blue box full of animations on the left side of the page. Near the bottom is the graft calculator.

 

I remember seeing your pictures. I hate to be the one to tell you but you are not going to get a "full head of hair" with your advanced level of loss. There are, however, a few methods that you could use to "max out" your donor area hair.

 

1) You could concentrate on the entire area with low density.

 

2) You could concentrate on the crown and work forward so you have a natural-looking receded look (which, in my personal opinion, may be the best way to go in your situation).

 

3) You could create a hairline and thin backwards so it looks like you are just bald on the crown. This can also be accomplished looking very natural-looking.

 

-Robert

[arfy]

I hate to argue with the website's "Graft Calculator" but according to that, a totally bald guy only needs 8000 grafts for "full density (whatever that's supposed to mean).

 

The fact is that OFTEN TIMES the math involved for guys who want a transplant, doesn't "add up".

 

A guy who is totally bald has lost about half of the total hair on his head. Most guys have about 100,000 hairs on their head average (some more, some less). So a Norwood 7 has about 50,000 hairs left in the "permanent zone" and is missing about 50,000 hairs. (again, that is hairs not "grafts"). We'll call that "half-density" for now, okay?

 

According to one study that everuyone seems to agree with, you can lose half of the hair in any area, and still have the visual appearance of "no hair loss". So to replace half of the missing hair, you need about 25,000 hairs.

 

The average FU graft has 2.5 hairs. To replace 25,000 hairs, you need about 10,000 FU grafts. In fact according to one chart I've seen, they estimate 10,000 to 12,000 grafts for a full restoration (not a full head of hair, but "half-density" over the entire head).

 

Okay, here's the important part: Most guys have about 5,500 FU grafts available, on average. (Some guys more... some guys less. That's what average means). In other words, 5 or 6 thousand hairs available, for a potential area that could need 10 or 12 thousand hairs.

 

As you can see, there is a major flaw in the logic of hair transplants, when it comes to supply and demand... they don't even come close to matching up, for some guys.

 

Now what if you aren't totally bald? Well then you are better off. You need less grafts for now. However, hair loss is progressive. That means it never stops! You may be able to put the brakes on it, or slow it way way down with Propecia. But pretty much every guy with hairloss will eventually become Norwood 7, "if he lives long enough" as one doctor put it so delicately. Until we find a cure for hair loss, and right now we do not have a cure.

 

All the more reason to try to halt hair loss as much as possible, before even considering surgery. The more hair you keep, the better any transplant will look. And the more hair you lose, the worse your numbers look. That doesn't mean getting a transplant sooner, is better than getting it later. In fact just the opposite. Hair transplants can accelerate hair loss via "shock loss"... surgery can cause borderline (at risk) hair to die sooner than it would have otherwise. And it's better to plan your first transplant with a full understanding of how much hair you will lose, so that you don't attempt an "unrealistic area of coverage."

[western_star]

Reply

 

 

 

The multimedia Hair Loss Learning Center Hair Restoration Research Forum Hair Restoration Questions and Answers How Many Hairs

Well according to the chart then,if I were to go 40% that equals 6,655 grafts or 16,305 hairs. The other is 14 or 15% at 2,492 grafts or 6,107 hairs. That sure doesn't seem like a lot. I know in Seattle they told me that I have a large amount of donor hair. It seems like I will still be bald

[Pat - Community Publisher]

In addition to the graft calculator that Robert pointed out, the animation that explains the illusion of density explains why patients only need to re-establish just under half their original density to achieve a full look.

 

This animation illustrates how hair loss typically is not cosmetically significant/noticable until most have already lost half their original density. Thus restoring more than 50% of the original hair density is not really needed to achieve the look of having hair.

 

Understand this principle and the math does work. I know it did for me.

[Robert_]

Arfy, I don't agree with your logic 100% on many of your points. I'll address them one-by-one:

 

 

Originally posted by arfy:

I hate to argue with the website's "Graft Calculator" but according to that, a totally bald guy only needs 8000 grafts for "full density (whatever that's supposed to mean).

 

First of all, the calculator never says "Full Density." It says "Appearance of Fullness." Splitting hairs? Hardly, as Pat explained above. The graft calculator also states very clearly:

 

"Note: This tool does not replace the need for a thorough consultation with a physician."

 

The calculator has limitations. It is to be used as a guide, not as Biblical word. It is a helpful tool for helping those researching hair transplants get an approximation of what they can and cannot achieve. Of course it is going to be different for every person out there! In spite of its' limitations, however, I feel that it is an extremely helpful quide that is supposed to be employed as just that - a guide.

The fact is that OFTEN TIMES the math involved for guys who want a transplant, doesn't "add up".

 

A guy who is totally bald has lost about half of the total hair on his head. Most guys have about 100,000 hairs on their head average (some more, some less). So a Norwood 7 has about 50,000 hairs left in the "permanent zone" and is missing about 50,000 hairs. (again, that is hairs not "grafts"). We'll call that "half-density" for now, okay?

 

Your numbers are one hypothetical case. If you want to get get down to it, when is it that this person is supposed to have 100,000 hairs? As a child? A teenager? An adult? What if the person started thinning as a teenager? What then? What period in a person's life are you using as a basis for this statement? A child's head has from 150,000 + hairs. So I am going to assume that you mean an adult. Well, adults differ greatly. What if the person started to thin as a teen as I did? What then?

 

My point is that everyone is different and that your math does not work! It much too optimistic for some and much too pessimistic for others. To generalize and cover this with a blanket statement like that is reckless, to say the least.

 

According to one study that everuyone seems to agree with, you can lose half of the hair in any area, and still have the visual appearance of "no hair loss". So to replace half of the missing hair, you need about 25,000 hairs.

 

To a degree, this is certainly true. It is the very premise behind why modern follicular-unit hair transplantation is so successful when done correctly and with skill and artistry. With the correct implementation of saggital and lateral slits, in addition to dense-packing when appropriate, a patient can achieve the look of fullness depending on many factors such as the size of the recipient area.

 

Limited donor hair is, of course, the deciding factor in addition to the size of the recipient area. This all goes back to finding a quality doctor. You know this as well as I do. If a patient goes to an ethical physician, the doctor is not just going to simply do as the patient asks. He is there as a guide; an educator. He is there to meet the patients' expectations as much as possible while still looking out for his best interest.

 

How the graft calculator pulled this entire premise into question with you is beyond me.

 

The average FU graft has 2.5 hairs. To replace 25,000 hairs, you need about 10,000 FU grafts. In fact according to one chart I've seen, they estimate 10,000 to 12,000 grafts for a full restoration (not a full head of hair, but "half-density" over the entire head).

 

This is more or less right on. Next...

 

 

Okay, here's the important part: Most guys have about 5,500 FU grafts available, on average. (Some guys more... some guys less. That's what average means). In other words, 5 or 6 thousand hairs available, for a potential area that could need 10 or 12 thousand hairs.

 

This is where your terminology is confusing and, to be truthful, just plain wrong. First of all, you say that most guys have about 5,500 FU grafts available.

 

I disagree. When you take an average, that means that half of the population will have more and half of the population will have less than that available. That number really is closer to 7,000 available.

 

However, for the sake of argument, let's assume your 5,500 follicular units is correct. You say that with 5,500 FU's available, a patient will have "5 or 6 thousand hairs available for a potential area that could need 10 or thousand hairs." Well, Arfy just two paragraphs up you were actually correct in stating that the average FU is comprised of 2.5 hairs. Now, if this person is limited to 5,500 FU's of donor, that would mean that he/she would have approximately 13,750 hairs available. Give or take a few 1's or 4's, right?

 

As you can see, there is a major flaw in the logic of hair transplants, when it comes to supply and demand... they don't even come close to matching up, for some guys.

 

Well, there is no flaw in the logic of hair transplants, by the very definition of logic. There is a pretty large unfortunate fact that available donor area will never meet the needs of a NW6 or 7 patient. This is simple math. (For a refresher course on math, please see above.) Logic has nothing to do with it. Logic is composed of rational, decisive, analytical reasoning and thought. I think you will agree that there is none of that in the pain-in-the-butt we know of as male-pattern baldness.

 

Now what if you aren't totally bald? Well then you are better off. You need less grafts for now. However, hair loss is progressive. That means it never stops! You may be able to put the brakes on it, or slow it way way down with Propecia. But pretty much every guy with hairloss will eventually become Norwood 7, "if he lives long enough" as one doctor put it so delicately. Until we find a cure for hair loss, and right now we do not have a cure.

 

OK, first of all you are preaching to the choir here. If Western_Star didn't know that hair loss is progressive, then I would say my boy hasn't looked in the mirror in a few years (nothing but love for you, Western, buddy. You know it's true.) Perhaps you didn't see Western's pictures a few months back, but I did. He is easily a NW6. There isn't MUCH progression left for him. I mean, you can tell him to wait until he has nothing, but you would just be telling him to wait for yesterday.

 

He wants to get as much coverage as possible with his limited donor area hair. Don't we all?

 

All the more reason to try to halt hair loss as much as possible, before even considering surgery. The more hair you keep, the better any transplant will look. And the more hair you lose, the worse your numbers look. That doesn't mean getting a transplant sooner, is better than getting it later. In fact just the opposite. Hair transplants can accelerate hair loss via "shock loss"... surgery can cause borderline (at risk) hair to die sooner than it would have otherwise. And it's better to plan your first transplant with a full understanding of how much hair you will lose, so that you don't attempt an "unrealistic area of coverage."

 

Again, it would probably pay to just slow down a little and ask a few questions before you put on your smock and begin reciting the basic laws of hair loss. Western IS a NW6. He HAS waited. He will NOT be recieving much shockloss.

 

I know that you are out to help others, Arfy, so I hope my tone comes off as intended (tongue-in-cheek and jokingly; not hostile), but I am serious in that I am afraid that you are issuing blanket statements without asking relevant questions. I am also concerned that you are trying to focus only on the negatives and you are not allowing the many positives to shine through.

 

Why do you think the industry is continually being propelled forward? Why do you think that the forums exist? For better results, for better communication, for better options available to the hair loss sufferer. Of course, the entire picture needs to be seen. The risks must be disclosed and must be addressed. Research is imperative.

 

However, my concern is that I think you believe you are doing people a favor by automatically attempting to dissuade them from the surgical alternative. While knowledge of the past implications of surgery and the possibilities is crucial, I think that knowledge of what is possible and what can be accomplished is just as crucial.

 

Silly me, but I don't see how you are doing someone a favor by blinding them with woe and sorrow and turning them away from what may be a very helpful procedure. To me, that is a perfect example of more harm than good.

 

Education is what is needed. A hairloss sufferer that has done his/her research thoroughly should know the implications of surgery - good or bad - before they make that appointment. They should not, however, be scared away from something that may just be a great positive in their life simply because of the misinformation and blanket statements of others. I think that this is the biggest disservice of all. Education is the key to success here, and that is what the forums and these interactive tools exist for.

 

-Robert

[gillenator]

The graft calculator is an educational tool and can provide the inquiring patient "a general idea" of what might be needed based on their individual goal. I stand to be corrected, but I do not believe it was intended to be exact science.

 

In addition, it can give the patient more insight as "what to ask the surgeon" once the consultation takes place when discussing graft ranges. The surgeon can then make those important distinctions in-person regarding total potential zone of demarkation, donor examination including density evaluation, hair characteristics, and most importantly "the patient's goal" both now and in the future.

[Gorpy]

Robert,

What was the density of your transplant?

 

Thanks,

Gorpy

[Robert_]

Originally posted by Gorpy:

Robert,

What was the density of your transplant?

 

Thanks,

Gorpy

 

Gorpy,

 

As you can see from the image below, my hairline and forelock was bolstered considerably with 2,300 grafts. I never asked (imagine that!) about the actual density, but if I had to put a number on it, I would estimate that it is around 30 to 35 grafts per sq. cm. You can see my entire photo album in my signature line for larger pictures.

 

 

(Only the right image is me. I took this picture from the Hair Restoration Network)

 

-Robert

[Dr. Michael Beehner]

From many years in transplanting, I can tell you that in my experience, when I can get 10,000-12,000 hairs moved to the top of someone's head (I am referring to the horizontal plane - the entire frontal and midscalp areas, back to the point at which the vertex starts to head downhill in back), the patient's hair starts to look relatively full on top and he is happy. If the hair caliber is fine in caliber or the color-to-skin contrast is a stark one (dark hair and pale skin), then another 2000 hairs is usually necessary. If the vertex in back or the side temple areas consume some of the transplanted hair, then, obviously, one needs to transplant additional hairs to account for this work also. The ideal patient has coarse caliber hair and has some curl to his hair, which lends much to the visual appearance of "fullness". Having 10,000-12,000 hairs give a "full" appearance also depends on the patient using a reasonable styling method that uses some "overlap". If someone wants to style his hair as a "flattop" and buzz all the hairs short or part it down the center, then a lot more hair is necessary for such a pattern to work.

Part of the fun and challenge of hair transplantation is figuring out, for each given patient, with his age, amount of donor hair, and projected eventual degree of baldness, what will work best. There almost always is a pattern that will give a patient a natural looking frame to his face, as long as the patient has realistic expectations and accepts the limitations his particular situation presents.

Mike Beehner, M.D.

[Gorpy]

Thanks Robert. There's so much talk about density these days. Dr. Keene recomended 30 per cm for me. I have the donar hair to go higher, but if 30 is going to give me that "illusion of density", I'd be happy with that.

 

BTW - your hair looks very good. Very natural.

[Robert_]

It all depends on your goals. Dr. Keene has made this determination after seeing you so she is taking various aspects into account including preservation of donor hair, natural blending with the rest of your hair, and the very real possibility of future loss.

 

-Robert

[arfy]

Robert said

Your numbers are one hypothetical case.

Your graft claculator is hypothetical too.

 

You also said my estimate of 5500 grafts being available for the average patient, was wrong. You said that 7000 was average. I think that is wrong, Robert OIf 7000 grafts were average, then that means that some guys have 5000 available while other guys have 9000 grafts availabe. I have NEVER heard of a patient who had 9000 grafts available (maybe one... Jotronic? He has exceptional scalp laxity). However I believe that having 5000 grafts (max) is common.

 

I did make a mistake though. Here's what I meant to say:

Okay, here's the important part: Most guys have about 5,500 FU grafts available, on average. (Some guys more... some guys less. That's what average means). In other words, 5 or 6 thousand GRAFTS available, for a potential area that could need 10 or 12 thousand GRAFTS.

 

 

So Robert thinks that an average guy has 7000 grafts, okay lets say that he does. So he has 7000 grafts available to address an area that potentially needs 10 or 12 thousand grafts, just to have "the appearance" of fullness (not actually a full head of hair).

 

My point is that for many guys, the numbers do not add up, especially not in the way they hoped they'd add up at the beginning of hair transplant surgery.

[Robert_]

Of course the graft calculator is hypothetical. It's used as a guide. Read the text right there on it. I quoted it for you in the above post, too. You're arguing a moot point.

 

Did you even read my post? Or did you just get all wound up and concentrate on that one moot point?

 

-Robert

[HairBeThere]

I think you guys are just splitting hairs here...

 

Ba-Bumm-Bumm....

[western_star]

If I kee[p waiting any longer hell Ithey may have to make me a NW 8 I am hoping that I do have enough donor hair to put somewhere up there to give it a little fullness> I need to look the best I can at my age when they bury me.

[SorleyBoy]

Originally posted by western_star:

I need to look the best I can at my age when they bury me.

. . . Spoken like a true Bronze Age warrior !