HAIR TRANSPLANT FORUM

This is a multi-faceted question.

What is dense packing? It means something different depending on whom you speak with. With Hasson it is 50 to 70. with seager is is 50 to 70. with shapiro, rose, keene it is 20 to 30 per sq. cm.

density is controlled primarily by the size of the incision and the distance between the incision. The amount of tissue around the graft, the degree of hair spaly, the number of hairs within a graft, and the diameter of the hair shafts control the size of the graft. It stands to reason that a graft that is larger will require a larger incision. Some scalps are more elastic than others. The will expand and contract more than other scalps. With these elastic scalps you can squeeze a larger graft into a smaller incision. if the scalp is tight, you will need to make a larger incision.

the square root of the density is equal to a constant (10.7) divided by the distance between the grafts. if the icision is larger, the distance between the grafts will be greater and the density will decrease. if the grafts are larger or the scalp is more rigid, the distance between the grafts increases.

to achieve a density greater than 50 per square centimeter, you must trim the grafts very tight during the hair transplant. the grafts must be very small. They might even be limited to fewer hairs. The scalps might need to be very elastic. It may not be possible to reach a density over 50 per square cm in all cases. Certainly, it is possible to reach a higher density with single hair grafts than with two or four hair grafts because the single hair grafts are smaller.

the treatment of hair loss also must be individualized. if they person has pre-existing hair, you increase the risk of shock loss when you dense pack during your hair transplant. You might take three steps forward and fall back one step or two steps. Hence, it might be better to take only one or two steps forward so you don't fall back.

The real question about dense packing is will it all grow. Certainly, it would be better to achieve a single pass result that meets all expectations - patient and physician. this is what has not been tested yet. I have seen patients who had 70 per sq. cm grafted that yeilded less than 50 per sq. cm. I perfer to maximally pack all my patients. To me this is genereally between 40 and 50 per sq. cm. 45 per sq. cm is an average. we find excellent results with this density.

the density is not the primary factor in determinging coverage when treating hair loss. the primary factor is the diamter of the hair shaft and the number of hairs per follicular group. prior to showing signs of hair loss your density in the crown is about 115 to 120 follicular units per sq. cm. the density in the frontal area is about 90 per sq. cm. when you begin to show thinning, the density is the same. in other words, you do not loose density, you loose diameter and consequently hair volume. you do not need to equal the density you had prior to hair loss to show coverage. you need only to reach the critical point where hair volume allows you to conceal the surface area of the bald scalp. this will vary from one person to another and is highly individual.

I agreed with Dr Cole.
This morning I was checking the density on top of one of our patient and he had 60 follicular unit per sq cm.This is usually what we target to have a good illusion of coverage.Unfortunately, he was thin and looks bald and he wants a hair transplant surgery .
Black African American has usually less density than Caucasian or asian(70fu vs 90 fu in Caucasian).But their hair characteristics(Curly or kinky,coarse,...) and the small contrast between their hair and skin color give them a really good coverage.
It's definitely important to assess each case individually and come out with the best plan for the patient.

a good goal in a single procedure is 40 to 50 per sq. cm. it will vary highly depending on the patient. Individual characteristics play a huge role in in the surgical treatment of hair loss.