1 Hair 397 397
2 Hair 2329 4658
3 Hair 1654 4962
4 Hair 683 2732
Donor management is vital to the long term result a candidate can achieve; if too much hair is removed to treat a relatively small area as hair loss progresses the demand surpass what the donor can supply
A hair transplant relies on being able to meet the demand for hair by the recipient surface area to cover; the hair that can be removed safely to ensure the donor area is kept in good condition and not depleted to the extent no further work can be carried out
If the starting donor hair density is too low surgical hair restoration may not be a viable option; it may be able to treat minor hair loss but as hair loss progresses the demand for hair will out way what the donor can provide
The donor hair density will alter dependent on the area of the scalp, around the back a higher density of follicular units compared to the sides; also the average number of hairs per FU will drop around the sides compared to the back
The density can be easily assessed at a hair consultation under magnification; it can make an estimate of the density per square cm, the approximate average of hairs per grouping and any miniaturisation present; from this a Master Plan can be made how, when and where to start the restoration
The density of hair is measured per follicular unit; each follicular unit can range in size from on average 1 to 4 hairs per grouping, with an average of around 2.2 hairs per follicular unit and the calculation measured per cm²
The FUT technique relies on removing a hair bearing strip from around the sides and back; although the hair has been removed the overall density is hardly changed; FUE relies on the removal of follicular units from the surface area, so the density of FU´s will actually decrease
With planning it is possible even with high Norwood scale hair loss sufferers to give close or total restoration from hair line to crown, may be requiring a lower crown density being placed, but achieving a natural coverage
The density of hair in the donor area is a crucial aspect as to how good a hair transplant candidate actually is; the donor area covers the back and each side of the head and ranges in size dependent on the technique utilised, FUT or FUE
Regardless of the technique used, FUT or FUT donor hair density is an important factor; FUE is more reliant on donor hair density because the FU´s are removed over a wide surface area, lowering the donor area density
The donor hair density coupled with the average number of hairs per follicular unit (FU´s) can make you a good or bad hair transplant candidate. The approximate average hair density is 75 FUcm², but this can vary dependent on ethnicity and hair characteristics
Almost whatever stage your hair loss is at the time of a hair transplant it should be assumed that has loss will progress and this needs to be taken into account
When treating a low Norwood Scale candidate if the donor hair density is low and hair loss progresses there maybe not enough hair to treat the area or give a balanced coverage, especially if a low hair line is fixed
Donor hair density is one of the most important aspects of hair transplantation; the hair density around the sides and back (donor area) must be able to cope with the demands of the surface area (recipient area)
When planning your hair restoration it is important to have your donor hair density measured prior to making a decision. The density is calculated per cm², with the highest density found around the back of the head; occipital bone area
Treating a high Norwood candidate the density needs to be calculated and then the hair transplant design planned to ensure a balanced coverage can be achieved
Donor hair density is a vital element that needs to be calculated when planning a hair transplant, coupled with the average number of hairs per follicular unit. Whenever you have a personal consultation with a Doctor ensure this is measured.
It is important as we age and lose more hair an age appropriate hair line is designed and a natural coverage and density can be achieved; a balanced coverage is created across the top of the head
From a medical perspective there are very few conditions that may prevent an individual from undergoing a hair transplant procedure, but a hair transplant relies on more factors to determine a suitable candidate
Age combined with hair loss pattern often determine the suitability of a candidate; this is not to dismiss the emotional trauma hair loss can create, but a hair transplant should not necessarily be the first choice
Treating a receding hair line at an early stage of hair loss and especially at a relatively young age will fix a low hair line forever; if hair loss progresses the donor must be able to deal with the need to cover the surface area
A hair transplant is not a cure for hair loss, a hair transplant is simply the movement of hair from one area of the scalp (donor area) to another area (recipient area); the donor is a finite resource and will run out
The pattern of hair loss, the surface area to cover is a large consideration, especially if hair loss is minor and has the potential to progressively advance over time. Higher hair loss patterns make it easier to ascertain the graft numbers required
The amount and quality of the donor hair is a crucial aspect to making an individual a good hair transplant candidate; donor hair density and hair characteristics will determine the quality of a result
If the donor hair is poor quality, low density a hair transplant may not be advisable, especially if and when hair loss progresses from a lower Norwood to advanced hair loss.
In many cases hair retention medications can be a better first option to stabilise hair loss and even improve the quality of the native hair, results will vary from person to person, and time must be given to assess how effective they work.
Goals and objectives must be discussed with the doctor to assess whether they can be met short and long term. This is a vital aspect of a good hair transplant and the happiness of the patient
Before deciding on a hair transplant it is important to understand the limitations of the procedure, for example how much hair have you lost and how much hair can be safely removed from your donor area
There is no simple answer to when it is best to have a hair transplant procedure. Losing one’s hair can be emotive for many and can provoke an immediate reaction to deal with it straight away
A hair transplant is not a miracle cure for hair loss, it is simply the movement of hair from one area of the head to another; it will not prevent further hair loss from continuing so planning is vital as a hair transplant is not a procedure that can be reversed
Treating minimal hair loss, especially in younger men can make it hard to measure long term hair loss and donor management, therefore it is vital to be cautious and not “pull the trigger” too early
There are many aspects to consider, for example, your age, your hair loss pattern today, the potential for future hair loss, family history for hair loss both paternal and maternal sides to name a few.
It is important to have a long term plan in mind to try and ensure that your decision is correct as you become older, that the initial planning, hair line placement/design still looks natural in the future
It is sometimes better in the early stages of hair loss to use hair loss prevention medications and try to stabilise the hair loss; this can prolong the time before looking at a hair transplant, and possibly see a pattern to the hair loss
Fixing a low hair line will mean if hair loss progresses aggressively the surface area to treat becomes larger and the donor may not be able to provide enough hair to effectively treat the area with a natural looking coverage
This does not mean it is impossible but correct donor management is required; prior to any decision the donor hair checked for density and characteristics to ensure a sustained and natural coverage can be achieved
Try to ensure your decision is based on logic and not just emotion, as the decision you take today will affect you in the future and your long term happiness.
An important concept to surgical hair restoration is to use the minimum amount of follicular units or grafts to treat the surface area, whilst maintain a natural coverage and density; this ensures good donor management and good for the patient´s pocket
Hair is placed into the recipient area in natural bunches of hair, follicular units, also known as grafts. The scalp can be divided in to the 3 main areas, hair line and frontal third, mid-section and crown.
Total restoration from hair line to crown can require around 7-10,000 grafts, it is not always possibly to safely extract this from all candidates. It is important that prior to your first surgery a long term plan is made and take into consideration aspects such as age, donor supply and progressive hair loss.
The number of grafts required to treat an area depends on a number of factors, hair characteristics and the size of the surface area to cover. Hair characteristics play an important role in how many grafts are required, the better the characteristics will reduce the number needed
Curly or wavy hair, low hair to skin colour contrast, coarse hair will all allow for more coverage per hair, more shadow created over the scalp and reduce the total number of follicular units required
Follicular units are divided into sizes, normally 1 to 4 hairs per FU, averaging out to around 2.2 hairs per follicular unit on a larger hair transplant procedure; much below this will hamper the result and the coverage that can be achieved
The hair line needs to be made of single hair follicular units, 1 hair grafts; the number of single hair units will differ dependent on the density needed to be placed and the hair line design, behind the hair line 2,3 and 4 hair units are placed in the frontal third
The mid-section is the area between the frontal third and the crown, the surface area will vary dependent on factors such as how broad the head is and whether the lateral humps are showing signs of miniaturisation
The crown or vertex can have an insatiable appetite for hair as it can open on both sides and drop down the back of the scalp, from a classic NW5 to NW7.
If the crown expands aggressively the surface area can reach the same as the frontal and mid combined, making total restoration impossible in some cases and in others a reduced density may have to be placed. It is common even with a smaller crown that a lower density needs to be placed to give total coverage.
The distribution of grafts is a vital component to hair transplantation and being able to treat high Norwood scale hair loss sufferers. Especially when starting to treat minor hair loss and it is not possible to assess the future pattern of hair loss
Prior to undergoing surgical hair restoration it is important to understand a hair transplant is not a miracle cure; as positive it can be on the right candidate it does have limitations that cannot be overcome
As tempting as it maybe to jump into hair restoration it is always better to take a step back and rethink your goals long term. A hair transplant is not something that can be reversed if you do not like the result
Understanding the limitations and accepting them it is then possible to set your goals accordingly; this will go a long way to ensuring your long term happiness and well-being, and not being another “repair case” statistic.
The goals of the individual have been met but what happens as hair loss progresses over the years and the balance of hair to bald area becomes disproportionate and unnatural with a hair line fixed in a low position
Of course it is possible to have multiple hair transplant procedures but the donor hair is a finite resource and needs to be managed well to ensure the maximum number of follicular units can be safely removed as hair loss advances
As the donor hair is key to the long term result, especially as hair loss is progressive over our lifetime, it is essential to have a clear plan in the worst case scenario what the donor resources can give
Have the donor hair density measured, calculated the approximate average hair to FU count, good, bad or fair hair characteristics, skin healing and laxity, donor safe zone size, the best techniques to use now and in the future
How realistic your goals are in relation to your hair characteristics and potential for advanced hair loss. A man in his early/mid 20´s with minor hair line recession wanting to rebuild the hair line to its original position; can this be achieved? Yes of course, with a relatively minor number of grafts the hair line can be rebuilt, 1000-1500 FU´s needed.
A common response is “I will shave if I do not like the result or cannot have more procedures”; shaving is rarely an option as there will always be some signs a surgical procedure has been performed. This is not a good plan to enter into surgical restoration with.
Create a plan based on these qualities and then review your goals to ascertain whether at your stage of hair loss now your goals can be sustained over the longer term as the hair loss advances. Be aware that to rely solely on family “hair history”, especially at a younger age is ill-advised as hair loss does not always follow the genetic pattern of our paternal, maternal or siblings; it is a guide only.
In the early stages of hair loss important factors such as potential for future loss, recipient surface area, the size of the donor safe zone are impossibly to determine accurately. In more stages of hair loss compromises may be required on hair line placement.
It is important to be realistic and objective, if your goals cannot be met and the reasons are explained logically it is sensible to come to terms with this and either not undergo a hair transplant or revaluate your goals to fit with what is possible with the hair resources available.