23 Oct

Cross-Sectional Trichometry: Understanding the Math of a FUE & PRP Treatment

Description: 57-year-old white male received hair transplant (HT) treatment for receding hairline and excessive thinning hair. He elected to receive the FUE shaved hair procedure along with PRP treatment based on verbal discussion with Dr. Cole.

Background: 2 strip surgeries to correct hair loss. Medical doctor, Director of research residency “enjoys teaching, making rounds and telling residents what to do.”

Sample: A sample of his hair was taken at the beginning of the procedure to assess the density. The sample of TAB 8 yielded an Cross-Sectional Trichometry (CST) of 15, producing an average of 63% hair loss based on a CST in his donor area of 15. His CST above the scarring is 4, a 90% hair loss, while the CST below the scar is 22. He has an average hair diameter of 53. 9 μm (human average is 69 μm). His “safer” donor area contains only 13,496, follicular units (Average is 15,300). A surface area of the frontal scalp was calculated at, S=90.98 cm2 while the surface area of the crown was recorded at S=50.11cm2. The surface of the top of the patient’s scalp is approximately 50cm2. Thus he has a total surface of loss approximating 190 cm2.

Patients Goals: “Would like to fill in what he sees in the mirror;” the front of his scalp.

Patient Notes: The patient’s hair diameter and cross-sectional trichometry are below average. His follicular unit density is well below average, as well. He has a significant degree of hair loss. He does not have enough hair to obtain a full head of hair. Fortunately, his goals are to focus solely on the front.

It is imperative to fully evaluate a patient prior to a procedure. One may only formulate a treatment plan specifically designed for each individual patient when we have a complete set of data reflecting the hair characteristics of the patient.

Other notes: cross-sectional trichometry (CST) is a measure of the number of follicles and the diameter of hair follicles. Average CST is 69μm. When the patient has over 120 cm2 of hair loss, they cannot expect full coverage unless the CST is well above average. In this case, the patient is wise to focus on the front. One can obtain the appearance of coverage in the front without matching their original CST in the front because hairs shingle over themselves and add to one another. In the crown, one must often exceed 50% of the original CST to appear full because hairs are following the natural diverging growth angles of the spiral. Those with a greater hair diameter may obtain a full appearance with fewer grafts, while those with finer hair require more grafts.

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