Poor Yield Or Just Low Density Placement

When choosing a hair transplant specialist it is advised to ask what protocols the clinic has in place in case a poor yield or lower density than expected occurs. Poor density can also be due to poor graft management during the procedure, and impaired skin, scar tissue, pitting and ridging from a previous hair transplant procedure

Graft management, not to place transected or damaged follicular units as there is a high potential they will not survive the procedure resulting in a poor yield, and also post-operative care by the patient can impact on how dense the result can become

The density required over the recipient area is largely determined by the hair characteristics of the individual, hair calibre, colour, number of hairs, and curl of the hair shaft

Density in the donor area will determine how many follicular units can be removed in one or over multiple procedures and how much coverage can be achieved, especially if the hair loss pattern advances to a high Norwood hair loss stage

Density is the measurement of how many follicular units are placed in a cm²; the density of FU´s is one aspect but also on average how many hairs per FU are also being placed

If a lower than required density is placed or the follicular units have a low average hair count even if a high yield is achieved the result will be of a diffused thinning appearance and not cosmetically appealing; needing a further procedure to increase the density in the same area, not ideal

It is advised to achieve the correct density in one pass, although on higher hair loss stages when it is not possible to achieve total coverage it is sensible to reduce the density as the placement finishes and not leaving a flat hard and unnatural demarcation line

Placing at high density or dense packing as it is known has pros and cons. If a high density can be placed then the area covered can be treated in one pass with a natural thickness, but too high a density can impair the regrowth and skin healing

Custom-made recipient site blades aids the creation of high density; each follicular unit is individual and varies in size, the use of different blade sizes to create custom reception slits of varying width and depth to the follicular units. The width of the blade is very small, about 0.6-1 mm

If the skin tissue is impaired, either by a previous poor hair transplant or into scar tissue this can reduce the growth rate, even when performed to a high standard. This should be explained prior to surgery to ensure the patient´s expectations are realistic

The depth of the incisions will need to vary dependent on the scar tissue thickness; thick and or tough scar tissue can require a deeper incision to ensure an adequate blood supply is reached

Thinner, atrophic scar tissue creates other concerns, the depth of the incision in the tissue may not be enough to sustain the graft survival; in this case a good degree of anatomy is required and medical proficiency to be able to place the slit at such an angle that it increases the length of the slit but at minimal depth.

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