|
One of the most frequent questions asked by potential hair transplant
patients is: "How many grafts will I need?" The answer should:
• Take realistic expectations into consideration
• Reflect the patient's degree of hair loss, donor supply, and
hair characteristics
• Be consistent with a long-term Master Plan to address future
hair loss
• Address the number of potential procedures and time commitment
required
• Consider the short and total long-term cost for the patient
An individual's goals must be realistic. For example, if a person
has significant balding (i.e., a Norwood Class 6 or 7 pattern) and fine
hair, then he should not expect a full head of transplanted hair. If
he does, dissatisfaction will be inevitable. With at least 65-75% of
hair lost (the typical loss in Class 6 and 7 patients), a thin head
of hair is a realistic and achievable goal. Although a thin head of
hair can dramatically improve patient's appearance, if he were to attempt
to achieve his original density, he would run out of donor hair before
the process could be completed and an unnatural appearance would result.
Working within reasonable expectations, the total number of
grafts required for any one patient will depend upon hair and skin color,
donor density, scalp laxity the thickness of each hair shaft, the number
of hairs in each graft, and the character of the hair itself. The physician
must consider these factors and the expectations of the patient in order
to calculate the amount of work required. Even when these considerations
are combined with the expectations of the patient, the amount of work
required to make a person satisfied is sometimes difficult to predict.
NaivetŽ of the physician, even in those who specialize
in hair transplantation, seems to be more common than many care to admit.
The failure of the physician to establish realistic expectations often
leads to an unhappy patient. This can only be prevented by providing
a clear explanation of the hair restoration process, and specifically
defining the benefits that the patient may expect to achieve.
Hair Color and Skin Color Contrast
Hair color and its contrast to skin color is one of the most significant
factors that dictate the amount of work required for hair restoration.
The lower the contrast, the fewer grafts are required. Blonde hair against
fair skin and dark hair against dark skin are two examples of hair combinations
that produce excellent results with less work on the part of the physician
(and less cost for the patient). Dark hair against pale skin often requires
the most hair in the restoration process. Of course, a patient can simply
lighten his hair to make the restoration look more full. One of the
(few) benefits of aging is that it will accomplish reduced contrast
between hair and skin all by itself.
Hair Character
Hair character is the second most important factor in determining the
amount of hair restoration work needed. Curly or wavy hair produces
a full appearance more easily than straight hair. African American hair
in particular curls so that a single hair shaft covers more scalp with
less hair length than straight hair. Strong, naturally curly hair that
holds its shape tends to produce fuller results more easily than thin
straight hair that falls flat against the scalp.
Hair Bulk
Hair bulk, or hair shaft diameter, contributes greatly to the visual
impact of hair. Coarse hair has greater bulk and requires fewer hair
follicles per square inch than fine hair to produce the same effect.
Coarse hair usually grows naturally in smaller groups (follicular units)
than fine hair and should be transplanted that way for the most natural
results.
Hair Density
In the majority of patients who are candidates for a hair transplant,
hair density (the number of hairs per cm2) varies from about 150 hairs/cm2
to over 300 hairs/cm2, with the average of about 200 hair/cm2. However,
as previously mentioned, hair in the human scalp does not grow as single
hairs, but in groups of 1-4 hairs. Interestingly, these naturally occurring
groups (called follicular units (FU)) have a relatively constant density
in the scalp of 100 FU/cm2. This means that the average follicular unit
will contain from 2.0 hairs. Those patients who average 1.5 hairs per
follicular unit will have a naturally thin appearance and therefore
a thinner appearing transplant. Those patients who average 3.0 hairs
per follicular unit (300/hairs per cm2) will have a fuller looking transplant.
 |
Recommended
Resources |
 |
 |
- Ask questions and get information on Hair Transplants
in our Men's
Forums and Women's
Forums!
- Information provided courtesy of the New
Hair Institute, taken from "The Patient's Guide to
Hair Transplantation" William R. Rassman, MD and Robert
M. Bernstein, MD
|
|
 |
|
 |
|
