HAIR TRANSPLANT FORUM

Dear Dr Cole

I am new to hair transplant world - but now that I have seen a few photos on-line, I am desperate to jump in. I am trying my best to hold off however until I do some more research.

I have been in contact with one surgeon so far who has told me that I need 2,600 grafts in zone 1. He says that this will be ultra-dense packed to around 80-100 grafts per cm2. His photographs of this on his website are very, very impressive. More impressive than the photographs on other surgeons websites if I am honest.

However, I do realise if his results were always so good then all the other surgeons would be copying him by now... but I gather they are not. I am just wondering what density you would recommend for re-creating a hairline therefore? I am looking to lower my hairline by 1-2cm as well as fill in my temple angles. I would be very greatful for your opinions.

Thanks

O B-J.

Density is a double edge sword. if you attempt a higher density, you will be very happy if it all grows. You will be very dissappointed and you will loose some hair for life if it all does not grow. there have been very few good studies looking at yields from higher density sessions. All the stuides say the same thing. if you exceed 30 grafts per square cm, the yield will drop from 90% to 73%. With this information at hand, you can be the judge of whether you want a high density or a low density.

i've had the occassion to inspect many patients who were told they got 80 grafts per square cm. only 40 to 60 per sq. cm are growing. achieving 80 per sq cm or higher is technically very challenging. therefore, i always wonder whether they indeed did get 80 per sq. cm.

don't be too fooled by photos. you have to know the individual very well. many will resort to adobe photoshop tricks to make their results look better. there is one very well known group that of physicians who do not even own their own practice. the practice is owned by a wig salesman. if you've ever had to deal with a wig salesman, let me tell you that they are far less honest than a used car salesman. the more you get to know this field, the more you will see that it is a very sleezy industry. you are very wise to do your home work first and make your decision slowly.

hairline location is an individual option. if you are young, i would highly discourage you from building a hairline that is too low. you can get into trouoble later in life because you wind up with a hairline that is too low for the degree of hair loss behind it. it can make you look silly. you simply do not have enough hair in your donor area to fully restore a class 4 or higher degree of hair loss. a class 5 has 150 to 180 sq cm of loss. imagine that a donor area has about 12,500 grafts available. the original density on the top is 80 to 100 per sq. cm. even if you totally stripped the back and sides of all the hair, you will not match your original density.

i do not know what zone one is, but usually in the frontal area we can hit total graft counts of 2000 to 2500 and this will be a density of about 40 to 50 per sq cm. of course, there is always a risk that these higher densities will not give you a full yield.

i feel your expectations may be a little high. you are not going to restore the density you started with with a single pass and frankly this is seldom necessary. your expectations may be a little high right now. therefore, you really do need to proceed with a degree of caution at this point.