I have been recommended 600 to 1000 grafts to the front. I would like to know what is the highest density and graft count with more aggressive density on the front hairline. I would like to have the front hairline to be suitable for a 36yo that is not on meds.
You can go with the maximal density, but I’ve seen many patients from physicians who claim to place 70 to 100 grafts per sq cm that are growing 20 grafts per sq cm. One of two things occurred. One is that the patients received 20 grafts per sq cm, which is not likely. The other is that they received 60 to 70 grafts per sq cm and they lost 50 grafts per sq cm because the placed density was much higher than their scalp could tolerate. There are studies out there showing that densities of 40 per sq cm grow only 73%. I like to keep my maximal density between 40 and 50 per sq cm because I have seen consistent growth rates above 90% in my hands. The other problem with poor growth from an attempt to achieve maximal density is that it may poison the scalp for future surgery and nothing may grow subsequently. It is best to stick with a safe density of 45 per sq cm on the hair line and in the rest of the scalp. This seems to work best for my patients. It’s not as if 70 per sq cm will not grow in some patients. The problem is that you cannot tell which patients it will grow in and which patients it will not grow in. The only way to tell is to try it and if it does not work, the patient is in real trouble.
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I am NW VII at 57years, i have had just one strip procedure as usual it was insufficient and I would like to FUE only from my nape to my bald area i am not concerned about my crown and I believe that the total amount should be 6500 FUE to get a conservative nw3. I would like to ask you is this possible?
A NW VII typically looses 70% or more of their original scalp hair. This means that they maintain 30% of their original hair or less. In my opinion, this makes them a poor candidate for hair restoration surgery. The best you can hope for is what some call a frontal forelock that is isolated from the sides of your scalp. In other words, it is hair that sits on top of your head with a bald rim on the sides above the ears before you see hair again.
It does occur in nature, but it is quite uncommon. It can help to frame your face, but you must recognize that it can also look a little unusual to have hair on the top of your head, a bald fringe, and then hair again above the ears.
A typical donor area will have a maximum of 16000 follicular units. I think that a NW VII will have less. Of this donor area, you can expect to remove 50% or a little more in those with outstanding donor area characteristics such as a high density and coarse caliber hair.
In your instance, you can probably expect to remove no more than 5000 grafts in total. Of course, you may be able to move slightly more, but 5000 is a safe number to anticipate. This may leave you looking a little thin on the sides between the top of the head and the fringe of hair that normally remains in the NW VII.
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When can I resume exercise after a hair transplant?
After a strip surgery, it is recommended that you refrain from exercise for several weeks after the procedure to limit the widening of the strip scar. One advantage to CIT or FUE is that you can resume exercise the same day as the procedure. The reason is that you do not need to worry about increasing the width of a strip scar. You should avoid any exercise that might rub on the grafts, however such as standing on your head or martial arts.
With any hair transplant procedure, however, you must be careful with the grafted area. Anything that disturbs this area may result in the potential for a lost graft. Therefore, we recommend that you do not scrub the top of your scalp or pick at the grafts for the first 6 days after a procedure. I let my patients resume washing their scalp the following morning after the day of their procedure, but I recommend they use Hair Cycle shampoo, which has less lather and is easier to get out. I tell them to avoid letting the shower water hit directly on the scalp. I encourage them to use a 
cup of water on the scalp to remove the shampoo.
It is quite common, for some reason, for patients to hit the top of their scalp on the car, while getting into the car. For some reason they tend to do this right after a procedure only because they are being so careful not to do it.
Of course after 6 days the grafts are in place and you will not disturb them so you can resume normal shampooing and all physical activities.
How long after an FUE hair transplant before a person can – A, shave his head with a razor and B, shave his head with a number 1 or 2 setting? Also, how does HGH affect hair growth and hair loss?
Often times the head is shaved in preparation for an FUE procedure. It is possible to shave the head immediately after a procedure, but it is probably best to wait about 3 weeks. The appearance of the shaved donor area will depend on the total number of FUE grafts obtained in a procedure. FUE removes intact follicular units from the donor area. This will result in fewer follicular units. If 25% of the follicular units are removed from the donor area, this will leave gaps in the donor area where follicular units were removed in an effort to relocate them to the top. A number 1 guard will conceal these gaps, however. It is possible to clip to a number one at any tim
e after a FUE procedure. If you are concerned about gaps in the donor area, one way to minimize these is to add body hair into the FUE extractions at the same time that grafts are removed.
There is no scientifically documented relationship between human growth hormone and hair loss or hair growth. There are anecdotal reports of grey hair regaining color and an increased rate of growth with HGH.
I’m told by various strip physicians that the strip scar is a thin as a pencil mark. Is this true?
This is completely dishonest. The average strip scar is 2 to 3 mm wide and it can stretch from ear to ear. If you plan to cut your hair short, this can be a problem for you as it is obviously a man made scar. It is an obvious sign that you had a hair transplant. No one wants anyone to know they’ve had a hair transplant, however. No one wants anyone to know they had hair loss or that they ever considered hair restoration surgery. Even shorter hair styles can expose the strip hair transplant scar. Frequently we are told that a hair cut of a number 3 or shorter exposes the strip scar form a strip hair transplant.
There is a new fallacy you are hearing from strip surgeons, as well. They claim that their new trichophytic closure technique produces pencil thin scars that are invisible. We’ve seen 5mm wide scars produced by this technique. Five millimeters is ¼ inch wide. It is a huge gap with no hair in it. When the trichophytic closure works, it rarely works in the rear of the scalp. You will not see an advantage along the sides of the scalp usually. Furthermore, the tighter you make the scalp by performing successive strip procedures, the more likely it is that your scar will widen and stretch out. Furthermore, these strip scars can turn whiter than the surrounding skin or bright pink. This produces further contrast to the scars should they be exposed by a short hair cut or by a medical illness that causes thinning or loss of your hair.
One other problem you will never hear about from your strip surgeon is t
hat strip procedure causes irreversible changes in your donor area hair growth angles. A strip is nothing more than a scalp reduction in the donor area. It alters hair growth angles for the rest of your life.
There is no reason to have a strip procedure. It really is up to the patient to demand the alternative, which is far better. Patients should begin to demand CIT, which is an advancement over our older FIT procedure. There is CIT and no quite CIT. Many physicians will tell you they perform FUE. This FUE procedure does not meet the quality of CIT. CIT is a proprietary procedure with quality instrumentation. Only CIT has proven results day in and day out with all types of hair including wiry, kinky hair seen in men of African decent.
