4103 FUT

1 Hair 691            691
2 Hair 2108       4216
3 Hair 1025       3075
4 Hair 279          1116
Total: 4103       9098

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Hair Density and Demand

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

Achieving The Density & Coverage Required

When placing grafts a measurement is made as to how many FU´s per cm² are required, this is largely determined by the hair characteristics to ensure light is blocked from reflecting off the scalp and to give the look of fullness

As the head is not a flat surface it is harder to calculate the surface area, it is not as simple as measuring the width and length of the area. The surface area to cover will dictate the number of grafts required, taking into consideration the natural hair characteristics

It is important to understand that everyone is different and different hair characteristics will give different results from person to person

As the recipient area expands it is important aspects such as the hair line design and placement combined with the quality of the donor can sustain a natural balanced coverage over the scalp

The frontal and mid sections can measure around 100 cm², and the crown or vertex also on average 80 to 100 sq.cm. The crown surface area though can open further if the loss spreads to the sides and back, an example of a high Norwood, 6 or 7; larger heads or very aggressive hair loss the area of hair loss can reach closer to 300 cm²

The highest density placed will always be the hair line as single hair follicular units are required; the density can then drop slightly behind as 2, 3, and 4 hair groupings can be distributed to give the illusion of a natural density

On higher Norwood stages the surface area is easier to calculate as hair loss has progressed and unlikely to increase dramatically further

An easy measurement can be made at home to calculate the surface area;

Place a transparent wrap over the scalp and mark out the area of hair loss, then place over the grid sheet to count the number of cm² boxes to give you the surface area; from this it is possible to calculate how many follicular units are required by taking an average density placed multiplied by the surface area total

For example, after judging the hair characteristics an average density required over the area is 35 FU cm²

Surface area 150 cm² x 35 density = 5250 Follicular Units or Grafts

Decision Time For A Hair Transplant

Deciding when to commence surgical hair restoration can impact of how successful over time the result achieved will be and the individual’s long term happiness; starting too early when hair loss is minimal can result in long term consequences

As not all individuals will suffer from advanced hair loss some will require less restoration than others, but it is important that the donor supply, which is finite is not totally depleted to ensure restoration in the future can be carried out

If total restoration cannot be achieved in a single procedure then it is important there is no demarcation line between the native hair and the transplanted area; as this will leave an unnatural pattern of hair growth

When initially planning to restore an area of hair loss the surrounding areas also need to be assessed, weak, miniaturised hair that may still be giving coverage will recede in the future; placing into miniaturised areas will help to ensure the first hair transplant achieves a solid result

Restoring relatively small area of hair loss can result in chasing hair loss on a constant basis, requiring small touch-up sessions to camouflage small thinning areas; this can deplete the door area and long term reduce the total number of grafts available

Planning is vital from the first procedure, understanding hair loss for the majority of men is progressive; a genetic hair loss pattern can be a guide but not the rule and it is a gamble to just rely on this information

For the vast majority of men hair loss is progressive, only a small % of men will only recede to have a mature hair line; male pattern baldness follows stages of progressiveness, frontal third hair loss to total loss of hair over the top of the scalp

Only a very small % of men can ever achieve total restoration of a high NW scale hair loss pattern in a single operation; and normally the crown even if covered will have a lower density of hair placed

Planning to cover the largest area possible gives the advantage of restoration in a single procedure and maintains the donor safe zone in the best quality if future procedures are required

For many this approach is considered the best, even with a lower crown density as they achieve full coverage from hair line to crown and a natural looking pattern of hair growth. If further density is desired it is still possible to achieve this with a another hair transplant in the future

The age of an individual and hair loss pattern will play a large part when a hair transplant doctor assesses how to approach surgical hair restoration; an ethical clinic will have the individual´s long term well-being in mind and make known any concerns they may have if they feel the goals are ill-advised

Best Time For Surgical Hair Restoration

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.

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Coordinating A Hair Transplant Procedure

There are many aspects to be considered when performing surgical hair restoration, and it is important that the medical team are well versed, work efficiently and as a team for the well-being of the patient

A hair transplant is a team effort, with the Doctor controlling their team to ensure the day runs smoothly as each individual in the team has specific roles during the day

The doctors are skilled to perform all aspects of a hair transplant. Principle duties are design and planning, anaesthesia, FUE punching, strip removal and suturing and slit making in the recipient with custom-made blades

The Tech team are medically certified and trained in-house to perform the cutting and slithering as well as graft placement, with a professional but caring manner

Preparation Of Follicular Units Under Magnification

Preparation Of Follicular Units Under Magnification

The doctor needs to extract the grafts from the donor area, be it with FUE or FUT technique; this is the first phase of the procedure. Dependent on the technique this may be performed over the day, with FUE for example; whereas FUT the harvesting is performed in one pass

Time management is important to ensure the grafts remain out of the skin for the minimal time possible; this ensures greater medical care and for the well-being of the patient. The grafts then need to be separated into their follicular unit size and cleaned, a job undertaken by the technicians and checked by the doctor

The slithering and cleaning of the grafts should always be performed under magnification; this ensures a high survival rate, reduces transection and allows for cleaner grafts to be placed

Whilst the techs are cleaning and dividing the follicular units in to the different size groupings the doctor will be making the recipient sites for the grafts to be placed into; this takes time in large sessions

The placement of the grafts is generally performed by the technicians, overseen by the doctors to ensure no slit are overlooked and the grafts placed in specific recipient sites; it is common that the technicians rest and swap over to maintain efficiency, also that more than one tech will place at the same time

Although the doctor cannot be personally hands on in every aspect on the procedure it is important that they are present and checking throughout the day and of course importantly when the procedure is finished.

It is important the patient understands who does what and is not surprised; so prior to the operation confirm with the doctor the roles of themselves and their team

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What Graft Count Is Required?

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

NW5 Diffused Hair Loss Pattern Treated with 3994 FUT. Hattingen Hair Transplantation

NW5 Diffused Hair Loss Pattern Treated with 3994 FUT. Hattingen Hair Transplantation

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


Hair Transplant Education   Hair Transplant Patient Results

Free Hattingen Hair Consultation

Hair Loss & Treatment

Hair Transplant & Prices

Procedure & Results

Support & Guidance