Before undergoing surgical hair restoration the donor resources need to be measured, hair density, average number of hairs per FU, skin laxity and general hair characteristics, hair to skin colour contrast, curl of the hair for example
These aspects will determine how good a hair transplant candidate an individual is, a good estimation how many grafts are available from the first procedure to future interventions, and how much coverage can be achieved
A balanced coverage does not necessarily mean total restoration with even density throughout, it simply means that from the hair line to the crown the placement does not leave a larger hair less surface area than treated
To achieve enough density on a higher Norwood scale candidate can require 7-9000 grafts from the hair line to the crown, a number that not every individual can achieve so it is important the hair transplant is planned
It is important to achieve a certain density of hair to create a shadow so the light is blocked from reflecting off the scalp; this is the basic principle that makes a hair transplant work and look natural
The hair line is generally the first area to be restored; the hair line frames the face and can have a great impact on how you look, but then behind is the frontal third, mid-section and then the crown or vertex
A hair line placed too high will reduce the potential surface area that needs to be treated but can appear unnaturally high, especially as the hair line will be perfect with no signs of thinning hair, that a receding hair line would have
A too low hair line can create two issues; as we age the hair line pattern does not match our age and changes in facial features; and if placed too low will fix the point of restoration permanently potentially making the recipient surface area too large to treat effectively
The better the characteristics the greater options are available, hair line placement and design can be more aggressive if desired and still maintain a balanced coverage even if hair loss advances to a high Norwood stage
If the hair characteristics are average or slightly below treating minor hair line hair loss may not be appropriate and it would be prudent to wait until a more obvious pattern of hair loss is evident; this will allow for a long term plan to be made to ensure a balanced coverage
As the hair resources are finite a master plan must be made from the first surgery to ensure in worst case scenario a balanced coverage can be achieved and the donor can sustain hair restoration
Along with graft placement, hair angles and orientation, and using natural follicular units an important aspect to a hair transplant looking natural is achieving a balanced coverage from the hair line to the crown.
Hattingen Hair Transplantation 