For years I've seen patients of various clinics post their immediate post-operative photos to document their experience. This is obviously a good thing as many others can learn from this documentation.
Usually, when one posts an image of their recipient sites, fresh after surgery, there will be at least one or two comments about how "dense" the placement looks even if the recipient area is relatively large and a modest amount of graft work was performed. Fast forward several months and the patient or others that have been tracking the progress of the patient come back only to say that the result is not as dense as hoped so obviously some of the grafts didn't take.
One possible reason for this phenomena is something I have recognized for years but I didn't have the right tools to describe my observations. I propose and firmly believe that the recipient site redness and scabbing creates an illusion to the observer. The contrast between recipient scalp and the subsequent scabs that form immediately post-op creates a misrepresentation of the actual density that was achieved.
Observe the photo I put together shown below. It is actually two copies of the same photo. I used CS5 to remove most of the redness in the scalp which means that most of the scabs were removed as well. This exercise shows just how much the density, or the perceived density, declines once the contrast ratio is equalized.
This is a NW6 patient with just over 4000 grafts. Looks rather dense.

Doesn't look quite as dense now, does it?
What one sees and what gives the impression of greater density is the fact that each scab that forms is roughly 500% larger (or more) in diameter than the hair that has been placed into the recipient scalp. Combine that with a higher contrast between scabs and scalp and you have a very powerful illusion.
Usually, when one posts an image of their recipient sites, fresh after surgery, there will be at least one or two comments about how "dense" the placement looks even if the recipient area is relatively large and a modest amount of graft work was performed. Fast forward several months and the patient or others that have been tracking the progress of the patient come back only to say that the result is not as dense as hoped so obviously some of the grafts didn't take.
One possible reason for this phenomena is something I have recognized for years but I didn't have the right tools to describe my observations. I propose and firmly believe that the recipient site redness and scabbing creates an illusion to the observer. The contrast between recipient scalp and the subsequent scabs that form immediately post-op creates a misrepresentation of the actual density that was achieved.
Observe the photo I put together shown below. It is actually two copies of the same photo. I used CS5 to remove most of the redness in the scalp which means that most of the scabs were removed as well. This exercise shows just how much the density, or the perceived density, declines once the contrast ratio is equalized.
This is a NW6 patient with just over 4000 grafts. Looks rather dense.

Doesn't look quite as dense now, does it?
What one sees and what gives the impression of greater density is the fact that each scab that forms is roughly 500% larger (or more) in diameter than the hair that has been placed into the recipient scalp. Combine that with a higher contrast between scabs and scalp and you have a very powerful illusion.
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