Designing a new hairline in front of existing.

[Coopman]

When designing a new hairline in a patient, for a realistic approach you would need to densely pack the frontal 1cm around the entire hairline before reducing the number of grafts per cm2 as you go backwards.
But for this frontal area what is a realistic number of grafts per cm2 to achieve a satisfactory result. I have read that 35cm2 is adequate on hair graft calculators but this seems a bit light. Would I be correct in assuming 50-60 grafts per cm2 would be preferable assuming average individual hair thickness and reasonable donor availability.
Thankyou for anyones help.

 

[Hattingen Hair]

Coopman wrote:

When designing a new hairline in a patient, for a realistic approach you would need to densely pack the frontal 1cm around the entire hairline before reducing the number of grafts per cm2 as you go backwards.
But for this frontal area what is a realistic number of grafts per cm2 to achieve a satisfactory result. I have read that 35cm2 is adequate on hair graft calculators but this seems a bit light. Would I be correct in assuming 50-60 grafts per cm2 would be preferable assuming average individual hair thickness and reasonable donor availability.
Thankyou for anyones help.

Hi Coopman,

As you say it will depend on the person ´s hair characteristics, curl, hair to scalp colour etc but...

You need to start with single hair units, they are not placed in a uniform pattern so you do not end up with basically a straight line. The single units may take up the first few mm ´s of the hair line and then larger groups are placed behind, 2, maybe 3 hair units, the number of single can reach between 600-1000 hairs.

Donor availability is obviously an issue but if you cannot make a natural looking hair line then probably you should not even be looking for a hair transplant, as it needs to be a certain thickness to achieve an natural looking result.

It ´s probably fair to say that around 40-60 is reasonable if you took into account all the hair characteristics variables; but obviously for yourself you want to ensure the number suits your characteristics. For example curly hair a little less can be placed, especially if the hair is going to worn a little longer as the curl comes back on itself giving the illusion of more fullness.

Hope this helps a little

 

[Coopman]

Hattingen

Many thanks for your reply. Your response is very helpful to me and anyone else reading this.
Its amazing been researching hair transplants for nearly 18months and I'm still learning.
Just out of interest I notice your Clinic is based in Switzerland, do you get many English patients or are most of your clients Swiss/German/Italian?

 

[sl]

As said well by hattingen, the first few mms need fine single haired grafts and therefore at a higher density and then one drops to a lower density as larger hairs per graft units are deployed behind the initial rows of singles.

Patients often ask what density is used in the hair line and this as said depends also on native densities present and we will use the density in the sides of the scalp and above ear measurements to correlate to hair lines and not for example higher density areas such as the occipital area to determine hair line density.

Hair lines take a lot of grafts due to smaller units initially used and then do drop as said well already and then it really is about creating an illusion and not matching native densities.

A lot of skill is needed and this is the shop window for a transplant, it is the first thing seen and needs to look natural and an understanding of graft deployment is needed to obtain this.

All the best with your research and I can say I am still learning after many surgeries and some years in the industry.

 

[Hattingen Hair]

Hi Coopman,

It can take time to research, there are so many considerations and in some respects you can only learn by the information you are given, keep an open mind and hopefully you will find the best planning for you.

The majority of our patients are from the Germanic countries but we attract many from Europe in general, UK, Poland, Spain , France etc. I guess because of our position it is normal.

As most of the time we have patient referrals we restrict ourselves a little, but I am sure if you wished to speak with someone in English for example it would not be a problem.

 

[SADbutTRUE]

great topic, any pics to show graft placement in forming a hairline? it would be nice to see some,

 

[Coopman]

Stephen

Thanks for your response as well. I was unaware that the density in the occipital area was denser than the areas above the ears. I assumed incorrectly that it was relatively uniform throughout the donor regions. Bit of a bonus for me though as i naturally assumed my density was of a below average standard as the sides never quite felt as full as the back areas.

 

[topccat29]

My own personal opinion through my own experience is that the hairline is actually part of the face. I have found some do not agree with this statement and they consider hair separate from the face. I believe if you asked most who have had very bad hairline work that includes plugs, cobblestoning, pitting, ridging, inappropriate hairline location, hairs placed that were too thick in caliber, etc, etc, etc. they will in fact tell you that the hardest part to deal with is the psychological stress one now needs to endure because they have come to the realization that they have disfigured their face. It either makes you or breaks you and in most cases it breaks the person.

 

[Hattingen Hair]

Hi TC,

You make a very good point, the framing of your face is vital, as you said especially if you have suffered from a poor HT and having to either remove or camouflage older work.

Our facial structure differs from side to side and a hair line has to be designed and placed according to the individual, not simply one design suits all, a broader forehead compared to a narrow long face will require a different approach. As our face is not symmetrical and the design is adjusted accordingly when the hair line is initially placed it is not uncommon that the post op appearance seems a little off from one side to the other. This can be due to a little swelling and also simply because initially the placement creates a solid looking line. As the redness diminishes and swelling subsides the hair line although still not exactly symmetrical takes on a natural look to frame the face.

 

[Alex1]

SADbutTRUE wrote:

great topic, any pics to show graft placement in forming a hairline? it would be nice to see some,

Hi SADbutTRUE,



I agree that is a very good topic and all comments made are valid and of great importance in fact it is one of the questions that the majority of people I consult ask.



I agree with the rest that the exact density of the hairline depends on the hair characteristics of the individual as mentioned however it also depends on the donor density and graft availability and I will explain. At high Norwood cases a plan should be created according to realistic patient expectations and as to what can be achieved. The total number of grafts that can be harvested over several sessions will determine the density of the hair restoration including the hairline.



Below there is a photo showing 60 grafts per cm2 density at a hairline.



Regards

Alex

 

[SADbutTRUE]

great pic. in general how many grafts are needed to create a hairline from scratch,i always wondered about that,thanks for responding

 

[Hattingen Hair]

Hi SadbutTrue,

I did mention this in this thread earlier, maybe I wasn ´t too clear; I said 600-1000 hairs, I should of said grafts/FU ´s.

The immediate hair line is made solely of single hairs, this can easily reach 600 plus single hair FU ´s in the first couple of mm ´s, if the temple points are recreated more. Behind to give the thickness so you can ´t see up and over the hair line 2 hair units are then placed, then 3, 4 hairs accordingly to increase density.

 

[SADbutTRUE]

thanks for the info,sorry i must of missed it eariler in the thread'''ss''

 

[Alex1]

Hi SADbutTRUE,





For a very good density hairline with width of 1.25cm and normal length and design approximately 1300 grafts are required with approximately 600-700 of them being single hair ones.

Regards

Alex

 

[SADbutTRUE]

thanks for the info.

 

[Coopman]

Thats interesting 1300 grafts for the creation of a new hairline. Some great information here.