HAIR TRANSPLANT FORUM

We had a patient come in recently who was schedule for a 1200 graft strip. Before the surgery, we measured his donor densities. His overall naturally occurring density is and average of 1.8 hairs per follicular unit. With strip harvesting, this is the calculated density that would be harvested. A calculated density of 1.8 for 1200 grafts would yield 2160 hairs transplanted via strip method (assuming no fractionation). Remember, the cost is per graft.

Dr. Cole decided that this patient would get much more hairs per graft if he switched to FIT. With FIT, he can choose to only harvest the two and three hair grafts, leaving the one hair grafts behind. Because this patient wanted to thicken the crown, one hair grafts were not as valuable to him. With FIT, Dr. Cole was able to harvest a calculated density average of 2.62 hairs per graft. With the same amount of grafts, 1200, this patient increased his hairs transplanted to 3144. That is nearly 1000 hairs extra!

Not only did this patient get 1000 hairs better value for his money by switching to FIT, he also has no more concerns about the strip scar in the donor area.

Here is a look at his donor area. Which hairs would you want to transplant for your crown? Isn't it nice to be able to choose?

Key:
Red=1 hair units
Blue=2 hair units
purple=3 hair units
green=4 hair units
Black circles indicate areas of estimated 10mm squared surface area

Note: This area is above the ear. The donor densities vary as you move laterally from the center of the head. Densities above the ear are typically lower then in the back of the head. This picture shows an average calculated density of 1.54 hairs/unit. The overall average of the entire donor area was calculated to be 1.8 hairs/unit, with averages in different spots of the donor area ranging from 1.5 to 2.1.

great job - that's WAAAYYYY interesting...

Thanks Wassup.

I feel that is important for people considering their transplant options to know the differences between FIT and strip. All too often I hear that people choose strip because it is $5 per graft rather than the $8 per graft for FIT (these prices are probably wrong, but generally speaking...). I wanted to point out that you typically end up getting more hairs per graft with FIT. And this is without even addressing the strip scar issue.

FIT yields more hair per graft than strip.

This aspect is well illustrated in cases where the donor has low density, such as the example above. In the cases of average density, about 2.3 hairs per graft, FIT can still increase the amount of hairs you get to 2.6 or higher, depending on the patient's groupings. For example, on a 1500 graft session where the average donor density is 2.3, strip will give you 3450 hairs (again assuming no fractionation). FIT will give you 3900 hairs. That is 450 extra hairs! To put this into perspective, a typical hairline will require 300-350 single hairs for the front line.

GT - in regards to the new example (another awesome illustration), for someone like myself, say when I visit in Sept I end up getting 1500 grafts, will my averages decrease since my donor has been harvested so much or will the averages remain constant since grafts will be extracted from new areas? many thanks for your time, knowledge and info.

Let's see...

I'm at home, so I don't have all of your details.
Do you remember what your density was like before you began HT?
You have had 3 strips and one session of FIT, correct?
Have you had your densities measured after any of the procedures?
Do you know your current donor density?
If not, no big deal. We can get some measurements when you come in.
Also, good donor preservation and management depends on different types of densities such as follicular density (hairs in an area) and calculated density (hairs per follicular unit). Here's some general, but related information:

After surgery, your follicular density (how many units are in an area) changes because:
1. follicular units are missing
2. surface area has changed

Typically, the donor goes through density changes after surgeries. When a strip is cut out, you lose that amount of follicular units available in the donor. But, you also lose surface area because a lot of tissue is removed, much more than is removed with FIT. When the wound is closed, it pulls the rest of the scalp closed. Because the surface area has changed, your follicular density goes down per square centimeter. Imagine if you have a polka dot shirt made of stretchy material (bad, girly example, but bear with me). If you stretch the material, the dots spread apart. The density is less. Such is the effect after a strip. The extent of the change depends on healing, size of strip, etc.

Not only is the follicular density less after strip, but it doesn't have a consistant effect over the whole donor. Some areas will stretch more than others. Usually, the area below the strip will have lower density than the area above the strip. Example: http://www.forhair.com/hairtransplant/viewtopic.php?t=378&highlight=shaved+head . Sometimes direction of hair growth can also change, effecting donor coverage, but that's a different topic all together.

With FIT, there is no stretching and far less surface area removed. The density is still spread evenly and naturally throughout the donor. There is less follicular density because units were removed. Typically, less than 25% of the units are removed in a given area therefore there is not a noticeable difference in density with short to medium length hair. Example: http://www.forhair.com/hairtransplant/viewtopic.php?p=3806#3806 .

Dr. Cole is THE expert for donor preservation. When you come in, he will take measurements and plan out the best surgical route for you. He has techniques to overcome almost all obstacles. If you want more hairs per unit, he has FIT methods and techniques. If you want to minimize the change in follicular density, he has FIT farming. If you want to graft your scars, revise your scars, take hair only from the most dense areas, pick out the finest hairs for the hairline and temple points, etc. He has the methods to do so.

Every patient gets an individualized surgery from Dr. Cole. In the first 10 minutes of extraction he makes at least a dozen adjustments to customize the surgery to your hair, goals, scalp, hair characteristics, future hair loss, etc. As he is extracting grafts, the surgery team is busy at the microscopes, compiling statistical reports for your head. The punches he invented (which I'm not supposed to talk about yet, so don't ask) have several adjustable variables built in so he can customize each surgery for top results.

GT - thanks so much for the in-depth details. I don't recall what my density was before my first HT - it may have just been average or slightly above average.

I would love to know what my density is in both the donor and recipients areas - that would be cool if that could be measured when I come in.

For the procedure I'm hoping to have my scars filled in more (especially left-side, the back appears fine and I wouldn't mind another sprinkle on the right-side scar as well), lower the temple portions of my hairline so they are not so angled (I don't want the center hairline lowered any and I don't want my hairline to run straight across either - have previous templaes and hairline in these areas re-filled to increase thickness - right now the thickness is very anguler if I pull my hair back) - keep that same softness for new hairline, etc.. and then just do a general fill-in on top... I tried to mockup some picts to show Dr. Cole when I come in (he has seen a previous earlier variation):

http://s9.photobucket.com/albums/a64/wa ... /?start=13

I really like David Beckhams hairline - I think mine could be close to this with some tweaking but right now is too angular in the temple areas. below are some picts: