The MOST important fact to remember!!!!

[Jotronic]

If you are bald hair restoration surgery will NEVER restore a full head of hair. For a dose of reality, check out the following image. I have used my pitiful Photoshop skills to show what a donor strip with approximately 4800 grafts would look like if it was just laid on top of a bald scalp. This is assuming a donor strip of approximately 30cm X 2cm and full density of about 80 FU per cm2. If this doesn't make the reality of this procedure clear, nothing will.

[2020]

exactly.
Wait for Histogen and Replicel to announce their results first....

[Folly]

That's actually quite a kool look !!

[StressedToTheBald]

Thats 4800 grafts ???
I mean whats the point then.. if thats 4800 grafts.. then it would take a million dollars if not much more for this guy to fix his entire bald head.

[Follicle Death Row]

Good point Joe. Nice visual representation of the problem of donor limitation. I think the scale might be a little off though. My father is a norwood 5 or 6 and from where his hairline used to be to the top of the horseshoe in the crown is around 24cm, maybe 25cm. It's also varies width wise but I'd say he has a max of 230cm2 or at tops 240cm2 to cover. I think 240 is the number to plan for.

Some guys can get long strips. I could comfortably do a 32cm strip maybe more. I have heard that some of the lucky ones can have 3.5cm width extracted over 2 or 3 procedures. At a density of 85FU/cm2 which is probably about right for the average patient, and I'm going to say an extractable area of 32x3 (96cm2) over multiple procedures you're looking at 8160 FU. Of course some can get that 3.5cm width and some have big heads so they can take longer strips so they're total available donor will be higher. Plus higher donor density. I recall that NicNitro had a pretty long strip. Was it almost 35cm Joe? Sounds a bit ridiculous.

I've been told that the average patient has 8000-9000 available over a lifetime. Seems about right when pushed to the limit. Still let's go with 8160 for now and assume the 2.3 hairs per FU and average hair caliber.

240cm2 of baldness (norwood 6 land) and a native density of 85 pre mpb means 20400 FU lost.

However, in the first 65cm2 can have 45FU/cm2, the next 65cm2 can have 40 and the crown of 110 can have 30 for a total of 8825. Some could achieve that by strips and some might need another 750 FUE or so to get there. Sure that would mean a thin crown but I still think that's better than being slick bald.

Of course you do hear about people with around 10,000 available by strip and then another 1500-2000 by FUE. I'm looking at you Joe you lucky sod. 9500 with another strip of 1500-2000 and then another 1500 FUE left. It's good to have good donor.

As Dr. Feller says you can have all the money in the world but if you don't have the donor there's only so much the doctors can do. For the real freaks out there, 50% density restoration all over is just about possible. FDR out.

[Follicle Death Row]

Imagine someone was norwood 6 or 7 and pulled out a 30cm strip and then cut out a strip of scalp on top and placed in the donor strip, plus a bit of FUE for the donor scar, for the mister T native density mowhawk.

[StressedToTheBald]

I still feel very much puzzled with donor hair mystery.. essentially, we all should have plenty of side hairs to be moved to bald spots..

[topcat]

Every 20 something that has hardly any hairloss should look at that picture and understand that the clinics that do give them that unethical low hairline or do not plan responsibly by front loading too much density are in reality screwing them over and taking their money for some very temporary happiness that will come at a very painful price.

Same goes for the clinics that just use up grafts to load the crown because what the heck the patient is paying.

Responsible clinics explain the numbers and advise the patient on what is sensible because the clinic is in a position of greater knowledge, or at least we would hope so.

Great visual on the reality of donor and hair transplants.

[25 going on 65]

Every 20 something that has hardly any hairloss should look at that picture and understand that the clinics that do give them that unethical low hairline or do not plan responsibly by front loading too much density are in reality screwing them over and taking their money for some very temporary happiness that will come at a very painful price.

I agree.

I have looked at Alvi Armani's website and the results they show; the young men look quite good, but I'd hate to see them in another five years. Using up all of someone's donor for a dense NW1 hairline before they're even my age seems like a terrible thing to do.

[Tracy C]

I still feel very much puzzled with donor hair mystery...

You are puzzled by everything associated with resolving hereditary hair loss.

[Follicle Death Row]

Alvi Armani are a disgrace. Disgusting unethical marketing. They seem to cake all their patients with makeup to make them slightly more tan and to be honest I'm not even entirely sure that they're not putting some dermmatch in the hair.

Their long term strategy for a norwood 6 is as follows (I copied this from another site):

Take someone such as yourself who has never had a procedure before, and Dr. Armani asses that he can harvest 8,000 grafts from your donor area over time.

You eventually need coverage from front to back, here is how it would be managed roughly:

Here is what is recomended to the patient
-----------------------------------------------------
Zone - 1: 2500 follicular units at 80% density
-----------------------------------------------------
-----------------------------------------------------
Zone - 2: 2000 follicular units at 40% density
-----------------------------------------------------
-----------------------------------------------------
Zone - 3: 1240 follicular units at 30% density
--------------------------------------------------
-----------------------------------------------------
Zone - 4: 2030 follicular units at 20% density
-----------------------------------------------------
Total grafts 7,770

This strategy gives a high density front with a full dense hairline with many styling options and a lower density crown with great coverage.

[2020]

what will happen when replicel and histogen will be able to revive dead follicles.... all you people with hair transplants will look ridiculous

[Follicle Death Row]

Zone 3 and 4 are going to look pretty odd relative to the front. By all means if a patient is norwood 6 and strip out with say 55 or 60 up front which may be possible and they have nice coverage in the crown. They could always decide to add another 1000 FUE to the crown to boost density there by 10 FU/cm2 and they may even have some more for the front. However transplanting at 80% native pre mpb density without knowing how bad future hairloss will be is madness.

Dr. Rahal seems to be slightly more aggressive than most and he did work with the Alvi Armani outfit for a short time but the highest I've seen him go up front is 65% native density so the Alvi Armani approach is by far the most aggressive. At 75 or 80FU/cm2 I can't imagine the yield being very good. Such a waste.

Unfortunately there's some Armani patients out there that had work done back around '05 thinking that HM would be here now to take care of their future loss. Oh dear. They're in trouble now.

[ejj]

Great post !

the shape of zone 4 is an ` egg shape ` this shape should be put in zones 2 and 3 and grafted via fue ,with a side weighting to create the illusion of density , further down the line you can expand on this , donor and finances allowing , or retain the option to shave down and look ` normal ` .

There are a couple of Drs grafting with beard hair ,this is another source of donor ,that I think will come more to the forefront in the future , more so than , replicell etc ...

ejj

[DepressedByHairLoss]

If you are bald hair restoration surgery will NEVER restore a full head of hair. For a dose of reality, check out the following image. I have used my pitiful Photoshop skills to show what a donor strip with approximately 4800 grafts would look like if it was just laid on top of a bald scalp. This is assuming a donor strip of approximately 30cm X 2cm and full density of about 80 FU per cm2. If this doesn't make the reality of this procedure clear, nothing will.

This is actually what I suspected all along and is precisely the reason that I'm so against hair transplantation. I mean, if transplantation could give us a full head of hair back, I'd easily shell out $20,000, no questions asked. But to pay thousands of dollars for something that can't even give you close to a full head of hair, leaves permanent head scarring, and requires a lifelong commitment to Propecia and most likely more than one hair transplant, is something that I would never do. This really illustrates the absolute need for much better methods to regrow and preserve hair, and it's really inexcusable to me that we don't have better hair regrowth options today. But I give Jotronic lots of credit for being an honest person and posting this. Plenty of doctors and their representatives would never be this honest and admit to the limitations of hair transplantation and would blatantly lie about what transplantation methods can achieve.