Ever-evolving hair transplantation techniques have been a boon to many who worry about thin hair, hair fall, or bald spots. With modern advanced techniques, the surgeons can renew the patients’ hair as per their desire. Before starting the procedure, the hair transplant surgeon will decide the technique, number of hair grafts, number of sessions needed etc. Hair density is crucial for getting natural-looking results. The patient would come with an expectation that he would get back the same dense and thick lost natural hair. The doctor should set the patient’s expectations realistically. 

Hair Transplantation Procedure and Hair Density

Hair density is defined as the ratio of follicular units on the head per square centimetre. Hair density varies based on ethnicity, genes and climatic conditions of the place the person is living. Normal hair density is between 80-100 follicular units per square centimetre of the scalp with no hair loss. Thinning is visible when around 50% of the natural density has been lost. 

There are some measures which the surgeon can take during the procedure itself for achieving maximum hair density, such as the direction of the placement of hair follicle, number of grafts, pattern of placement based on the patient’s combing style. If genetics is the reason for baldness, planning for a hair transplant at a younger age is not recommended since the natural hair will fall out. So in a younger patient with reasonable thinning, the look will be excellent for a few years after transplant, but after the natural hair falls out, it will appear thinner as only the transplanted hair will remain. 

How is optimum hair density achieved after Hair Transplantation

In the early teens, the body hair is around 100,000 follicles. A successful harvest of donor’s hair from back of scalp is usually between 2500-4000 hair follicles. So with approximately 2500-4000 hairs, a balded area that lost 50,000 hairs has to be covered. This means a small donor area with a large recipient site. So it is evident that in just one session, the original density cannot be achieved. Transplanting around 45-55 follicular units per square centimetre should be sufficient in one hair restoration session. But to achieve pre-hair loss density, the transplantation should be around 80-100 follicular units per square centimetre. Surgeons do not do this for reasons such as:-

• Such dense implantation causes overwhelming blood supply, resulting in shock loss in the surrounding natural hair.
• Severe diversion of the scalp blood supply can potentially cause serious issues such as necrosis.
• It is unnecessary and a waste of finite grafts.
• Transplanted hair comprises the shaft, entire follicular unit, dermal papilla and other soft tissue. The follicular unit can survive and grow if there is space on the scalp and healthy blood and nutrient supply from the body. Too much crowding of grafts results in the poor growth of the implanted follicles.
• Hair restoration cost is determined by the number of grafts transplanted. Hence, such a high rate of graft transfer also increases the cost of the procedure.

Considering all the above-discussed factors, usually, 45-65 grafts per square centimetre are the optimum value.

How does “Desired Hair Density” affect hair restoration procedures?

It’s expected that patients would want greater density and more grafts, which leads to a compromise on both the doctors and patients. Although using more grafts sounds ideal, they won’t survive. Some surgeons suggest “mega sessions” to make the patients happy. In these mega sessions, around 10,000 grafts are implanted. Later research has shown that up to 90% of grafts from mega sessions are eventually lost. This will create huge dissatisfaction in the patient since as many grafts die before growing significantly. Exceeding the limit of a safe number of grafts in one transplant session sets off hair loss of the nearby original hair due to trauma. Surgeons plan second or multiple transplant sessions to achieve natural-looking density.

Hence, it is evident from the above discussion that it is essential to choose a competent surgeon who can maintain a balance between achieving maximum density and keeping the heath of hair follicles intact. We at HairSure Clinic have years of expertise in handling all types of hair thinning across all age groups. You can book a consultation with us for a detailed discussion at, 83 31 02 02 02, cyberhairsure@gmail.com.