A must read! In this blog we will deal with questions such as: how many grafts are needed and how to calculate this, whether the entire head can be covered with hair, and what determines what result can be achieved. Enjoy reading!
Can I get full coverage with a hair transplant?
Often patients say "I want it fully covered" or ‘’I want allot of density’’. But to what extent is that possible?
With a hair transplant, two aspects are mainly important, namely, the coverage: area that can be covered, and density: the number of hairs per cm². These two aspects, however, work against each other, because with a fixed number of grafts, you can choose more density with less coverage or more coverage with less density. This of course depends entirely on the person and the degree of hair loss, the doctor can best advise on this with his experience.
A normal person has a follicle density of 75-85 follicles per cm², since each hair follicle can contain 1-4 hairs, this corresponds on average to 190-230 hairs per cm². Unfortunately, the same density cannot be achieved with a hair transplant, often a hair density of around 50% can be achieved, but the result is very similar. How can it be? This has to do with the fact that when it becomes apparent that there is hair loss and the scalp can be seen through the hairs, often more than 55-65% of the hairs have already fallen out corresponding to a hair density of under 100 hairs per cm². This means that there is a threshold after which baldness becomes apparent and that in the average person the difference in range between 50-100% of the original hair density looks somewhat similar. So if a hair density of 50% is reached during a hair transplant, results can be achieved which are very similar to the original hair density. The reason that there is a maximum in hair density is because the grafts have a specific diameter, and a certain distance must be kept between the grafts themselves and the natural hairs. This can to a certain extent be solved by multiple treatments and the use of certain techniques such as the DHI method.
So to come back to the question of how much can be covered, it is necessary to look at the number of available grafts, the desired hair density and the size of the surface to be covered.
How many grafts do I need? Calculate the number of grafts
Most people have between 5,500 to 6,500 donor grafts available. However, this does not mean that the full amount of donor grafts can be transplanted in one session because this may be at the expense of the result. The best looking results are achieved when the grafts are divided over multiple sessions (example: 3500 grafts over 2 sessions). This has mainly to do with the fact that more hair density can be achieved this way. The second and/or third sessions usually serve to obtain more hair density, as there must be a certain distance between the implanted grafts, and only after the first hair transplant has fully healed the intervening gaps can be ''filled up’’. Therefore, it should be taken into account that the desired result for some can only be achieved after several treatments and this unfortunately takes time.
The amount of grafts needed depends on the size of the surface to be covered and the desired hair density. To paint a better picture, we use a scale that classifies the degree of hair loss called the Nordwood scale.
Below we see an overview from which an indication can be obtained about the total number of grafts needed for a '' complete '' hair restoration/recovery.
Calculate the number of grafts needed
()* Incl. crown
III Vertex: 1800-2600 (2600-3200)*
IV: 2200-3400 (3400-3800)*
V: 2600-3800 (3800-4500)*
VI: 3000-4600 (4600-5600)*
VII: 3200-5000 (5000-6400)*
What determines the result that can be achieved?
The final result that can be achieved depends on a combination of several factors including:
Age and genetic predisposition: In younger patients it is more difficult to determine the extent to which hair will fall out in the future. Often an indication can be obtained by looking at family members. As a result, certain young people will have to undergo a hair transplant again in the future to maintain the result (Note: the transplanted hairs do not fall out, the original hairs may fall out further).
The degree of baldness: The more hair loss there is, the more grafts are needed. Unfortunately, it is not always possible to achieve the desired result with severe baldness.
Quality and quantity of donor hairs: The average patient has between 5500 and 6500 donor follicles (grafts) available, but some patients only have 4000 grafts available or more than 7000. The greater the hair density and quality of the donor follicles, the greater the possibilities become.
Size of the head: Some patients have larger heads than others. The bigger the head, the more grafts are needed and vice versa.
Hair properties: The hair properties also play a role in the achievable result. This includes hair colour, hair thickness and hair shape. For example, hair colour that more closely matches the skin colour allows for better blending of the two hereby creating the perception of ''more hair''. Similarly, thick and curly hair also cause a more dense and voluminous result.
Skin Elasticity: This only applies to a FUT treatment (Removal of a strip of tissue). If the scalp is elastic, a larger piece of tissue can be removed, corresponding to a greater amount of grafts being harvested.
Medication: Better results can be achieved with the use of certain medications. Medicines such as Propecia/Finasteride and Rogaine prevent or reduce future hair loss. However, it should be taken into account that some of these drugs need to be used for a long time and can have side effects that can be experienced as worse than hair loss itself. So do your research beforehand and consult a doctor about the possible side effects and interactions with your current medications.
Expertise: The result also depends to a large extent on the expertise of the healthcare provider. After all, it is up to the surgeon to perform a hair restoration that is as best looking and natural as possible with the given quality and quantity of grafts. This often involves more than one thinks, such as weighing up hair coverage and density, the number of grafts, the use of different techniques and the number of sessions. Additionally, the surgeon and the team themselves must also be competent enough to perform the actions correctly and to deploy and use the correct resources.
Aftercare: It is important that good aftercare takes place and that the instructions given are followed correctly. Good aftercare keeps the vitality of the grafts as high as possible and stimulates the recovery.
In conclusion, the final result depends on several factors, if you are a good match, it may work in your favour. If you are a bad match, then there is no need to worry, as good results can still be achieved, provided that you call in good expertise.
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