ISHRS Conference: Acceptable Density in Transplants

ISHRS Conference:  Acceptable Density in Transplants
May 15 05:28 2016 Print This Article

Presentation at this month’s ISHRS Conference discussing what should be considered acceptible density for transplanted hair. An analysis of the hair density in comparison to tendency to rate the density visually as “acceptable” is covered.

Density is the Only Issue
(abstract modified for easier reading, originally was in translated form)

Authors: Minotakis, Papdopoulos


The objective of hair transplantation in the modern era cannot continue to just be the regrowth of hair in the balding areas of the head. The naturalness of cosmetic results with smaller size grafts is taken for granted. The patient’s main worry is the density of the transplanted hair, and the satisfaction with the results is evaluated from this point of view. Lack of density also is their usual cause of complaints.


In this study we examine the factors that determine attaining acceptable density, and estimate the aesthetically acceptable density that should be the target of any hair transplantation technique.

Materials and Methods

69 patients, Norwood V-VI, had their first operation in our hair clinic with the DHI-No-Touch technique (follicular unit hair transplantation using stereomicroscopes, separated needle sticks, and Choi implanters as the placing techique) during a 2-month period from January to February 2000. These patients were evaluated 12 months postoperatively. It was a randomized group. By the aid of digital macro photography we recorded the average density achieved in the frontal hair zone and compared actual density to the result of an expert evaluation of density.


Density ranging from 20-35 Fus/cm2 was evaluated always within the acceptable range (good, very good or excellent). Any density below that level made the final result unacceptable (not bad, bad) even though there was a full coverage of the bald area.


In our practice only 25% of the patients proceed to a second operation in a 5 year period. This creates the necessity to have the best cosmetically acceptable density obtained from the first operation (the one-session philosophy). Due to the limitations of the donor supply, aesthetically acceptable density should be attempted only in the frontal area through a weighted distribution of the implants. Any technique, regardless of the number of sessions, should not be considered complete unless it has attained this aesthetically acceptable density. This will satisfy the patient and it should be the main goal for successful implementation of hair density.