distance between hairs

[goldbondmafia]

Probably a dumb question but what is the distance between each hair follicle on the average head. Do HTs place follicles the same distance as others so it looks even on the scalp?

[baldymcgee]

There are about 90 - 100 follicilar units per square cm in your donor area, so about 1mm separates each FU.

When you get a transplant then say you have 250 square cms to transplant to and 6000 grafts over your lifetime. This means you'll have about 24% of original density.

Your doctor, however, will generally give you higher density at the hairline and very much lower density towards the crown/back.

Also, keep in mind, that this means that 62.5 square-centimeters (or 10 square inches) of scalp will have to be removed from your donor area if you use FUT. That's quite a bit.

In summary, expect about 24% density (one fourth), or even lower if you have a larger bald area or if you lose many grafts to transection or other losses by choosing a bad surgical team.

Hope this helps.

Edit: Oh, 1/4th the density only means *double* this distance between FUs. So you have 1mm of separation in your donor, but you'd have 2mm of separation in your recipient. Double the separation -> quarter the density.

Or so I think Others can check my math.

[goldbondmafia]

There are about 90 - 100 follicilar units per square cm in your donor area, so about 1mm separates each FU.

When you get a transplant then say you have 250 square cms to transplant to and 6000 grafts over your lifetime. This means you'll have about 24% of original density.

Your doctor, however, will generally give you higher density at the hairline and very much lower density towards the crown/back.

Also, keep in mind, that this means that 62.5 square-centimeters (or 10 square inches) of scalp will have to be removed from your donor area if you use FUT. That's quite a bit.

In summary, expect about 24% density (one fourth), or even lower if you have a larger bald area or if you lose many grafts to transection or other losses by choosing a bad surgical team.

Hope this helps.

Edit: Oh, 1/4th the density only means *double* this distance between FUs. So you have 1mm of separation in your donor, but you'd have 2mm of separation in your recipient. Double the separation -> quarter the density.

Or so I think Others can check my math.

I see. Are those the numbers for a standard procedure or someone getting more grafts? Say for example someone needs 1000 grafts to fill their hairline. Is it possible to use 2000 instead and bring them closer together which will create 75-80%> density?

[baldymcgee]

I see. Are those the numbers for a standard procedure or someone getting more grafts? Say for example someone needs 1000 grafts to fill their hairline. Is it possible to use 2000 instead and bring them closer together which will create 75-80%> density?

Depends on the doctor (talk to yours) and the patient. Some docs will only do up to 35 FUs per square cm in a procedure as this maximizes graft health and survival in their experience.

I can't really see doing too many more than this ... making 75 holes in a one-square-cm area of scalp *then* expecting all the planted FUs to survive and thrive seems unlikely. Though, as I said, there are docs who do this and patients on whom this works. I have no idea how likely such successes are though.

So, once again, talk to your doctor and decide if you trust him/her.

Me, I'd max at 35/sq-cm and then get a second procedure if that wasn't dense enough in certain areas.

[35YrsAfter]

Probably a dumb question but what is the distance between each hair follicle on the average head. Do HTs place follicles the same distance as others so it looks even on the scalp?

I have seen the mistake of attempting to cover too large of a bald area with an evenly placed, low density. It doesn't look natural. In the upper Norwood classes, a patient must have the attitude, some hair is better than the slick look. A high hairline placed with a good bit of recession will always look better on an upper Norwood class man. Proper variations of density will always look more natural and improper use of even two and three hair FUs can stand out as unnatural on severely bald men with a lot of area to cover.

Supply and demand is currently one of the greatest challenges for competent hair restoration surgeons. The potential size of the crown alone can create a near insatiable demand for donor hair.

Considering the math of this and other regions:
The frontal area, from the hairline back to a line drawn across between the two temporal angles, measures an area of roughly 50cm2. The top of the head, from behind the frontal area to the front border of the crown, may be approx. 150cm2. The crown, can vary widely in size, but in a Class VI or VII patient it can be as large as 175cm2: a huge area to cover! Doing the calculations, we see that, even if we transplant a minimal density (for example 15 FU's or about 35 hairs per cm2) to a fully bald crown (about 175cm2), we have used up roughly 2600 follicular unit grafts. If we go for a higher density, for example, 40 FU, we have then used 7000 grafts, more than the average person even has available in their scalp donor area. Again, this is addressing only the crown and leaves the frontal area and hairline with essentially no donor hair for transplantation.

Careful use of beard hair is improving the outlook for men in the higher Norwood territory. Follicle regeneration is also improving the outlook. The current challenge with ACell is improving the regeneration rate.

35YrsAfter also posts as CITNews and works at Dr. Cole's office
Cole Hair Transplant
1045 Powers Place
Alpharetta, Georgia 30009
Phone 678-566-1011
Please feel free to call or email me with any questions.

[baldymcgee]

I have seen the mistake of attempting to cover too large of a bald area with an evenly placed, low density. It doesn't look natural. In the upper Norwood classes, a patient must have the attitude, some hair is better than the slick look. A high hairline placed with a good bit of recession will always look better on an upper Norwood class man. Proper variations of density will always look more natural and improper use of even two and three hair FUs can stand out as unnatural on severely bald men with a lot of area to cover.

Supply and demand is currently one of the greatest challenges for competent hair restoration surgeons. The potential size of the crown alone can create a near insatiable demand for donor hair.

Considering the math of this and other regions:
The frontal area, from the hairline back to a line drawn across between the two temporal angles, measures an area of roughly 50cm2. The top of the head, from behind the frontal area to the front border of the crown, may be approx. 150cm2. The crown, can vary widely in size, but in a Class VI or VII patient it can be as large as 175cm2: a huge area to cover! Doing the calculations, we see that, even if we transplant a minimal density (for example 15 FU's or about 35 hairs per cm2) to a fully bald crown (about 175cm2), we have used up roughly 2600 follicular unit grafts. If we go for a higher density, for example, 40 FU, we have then used 7000 grafts, more than the average person even has available in their scalp donor area. Again, this is addressing only the crown and leaves the frontal area and hairline with essentially no donor hair for transplantation.

Careful use of beard hair is improving the outlook for men in the higher Norwood territory. Follicle regeneration is also improving the outlook. The current challenge with ACell is improving the regeneration rate.

35YrsAfter also posts as CITNews and works at Dr. Cole's office
Cole Hair Transplant
1045 Powers Place
Alpharetta, Georgia 30009
Phone 678-566-1011
Please feel free to call or email me with any questions.

Thanks for the great insight. Speaking of "higher norwoods", is it realistic for a norwood 6 to call into Dr. Cole's office with the expectation of getting something like the "Steve Jobs" look?

http://a57.foxnews.com/www.foxnews.com/images/538239/350/450/3_23_jobs_steve_thin_close.jpg

So a small amount of hair at the front, a bridge in the middle, and a bit of coverage in the sides/back?

Or are the characteristics of transplanted hair that would prevent something like this from looking "natural"?

[35YrsAfter]

Thanks for the great insight. Speaking of "higher norwoods", is it realistic for a norwood 6 to call into Dr. Cole's office with the expectation of getting something like the "Steve Jobs" look?

http://a57.foxnews.com/www.foxnews.com/images/538239/350/450/3_23_jobs_steve_thin_close.jpg

So a small amount of hair at the front, a bridge in the middle, and a bit of coverage in the sides/back?

Or are the characteristics of transplanted hair that would prevent something like this from looking "natural"?

We had a patient a while back who came to us as a smooth Norwood 6. Dr. Cole gave him a conservative high hairline with recession. His hair looks thin when viewed directly from the top and back, but received a great overall cosmetic improvement by framing his face.

The chances of decent result on a Norwood 6 are greatly improved when a man has excellent donor hair characteristics.

Video

[baldymcgee]

We had a patient a while back who came to us as a smooth Norwood 6. Dr. Cole gave him a conservative high hairline with recession. His hair looks thin when viewed directly from the top and back, but received a great overall cosmetic improvement by framing his face.

The chances of decent result on a Norwood 6 are greatly improved when a man has excellent donor hair characteristics.

Video

35YrsAfter also posts as CITNews and works at Dr. Cole's office

I hate to come off as belligerent, because I'm really not, but I interpret your response as: Dr. Cole will not perform a procedure if the desired outcome is a "Jason Statham" or "Steve Jobs" look.

Now, I completely understand and respect each physician's techniques and (of course) their freedom to offer their own approach to treatment.

Speaking *only* for myself, I'd rather have a "Steve Jobs" look than the relatively thin look shown in this video. But that's just me and this patient (and most people) should be very pleased with those results. They are quite impressive given the area needing coverage!

[35YrsAfter]

I hate to come off as belligerent, because I'm really not, but I interpret your response as: Dr. Cole will not perform a procedure if the desired outcome is a "Jason Statham" or "Steve Jobs" look.

Now, I completely understand and respect each physician's techniques and (of course) their freedom to offer their own approach to treatment.

Speaking *only* for myself, I'd rather have a "Steve Jobs" look than the relatively thin look shown in this video. But that's just me and this patient (and most people) should be very pleased with those results. They are quite impressive given the area needing coverage!

baldymcgee:
Steve Jobs and Jason Stratham look natural in the photos I have seen in a Google Image search. I can't see that there would be a problem simulating a similar Jobs or Stratham look. Creating the look of miniaturized hair on top could present a challenge, particularly if a patient has dark coarse hair and light skin tone. Possibly finer caliber chest or stomach hair could work. That requires a small test session. Could you post a photo? What color is your hair?

35YrsAfter also posts as CITNews and works at Dr. Cole's office

[baldymcgee]

That's a very good point about creating the "miniaturized look" of hair in certain areas.

If it's all the same then I will send photos directly to your office rather than post them here.