Natural density varies in the range of 70-120 follicles/cm2. Density is usually higher in Caucasians and lower in Blacks and Asians. The cosmetic perception of fullness, volume or density is greatly influenced by the diameter of the individual hair shaft which varies between 0.06-0.15 mm.
Asians and Blacks tend to have thicker hair (greater diameter) while Caucasians have thinner and finer hair. In the initial stages of hair loss the patient or surroundings don’t see any cosmetic difference. When the hair loss reaches around 50% the thinning becomes noticeable.
This has two important implications for hair transplantation in general:
In many cases Dr. Hussain would recommend 20-40 grafts/cm2 for the first operation. The specific recommendation depends on age, stage and maturity of hair loss, patient’s expectations and other factors. If required more density can be added later. Again age is an important consideration: A 25 year old male with high temples and initial thinning in the crown may be recommended to wait for 5-8 years. On the other hand Dr. Hussain may suggest 3500 graft to a 45 year old male with the very same pattern of hair loss, please see age considerations for further information.
Dr. Hussain would advice against density-shopping commonly seen among young patients trying to restore their teenage-hair. A restoration of very high density in the hairline may look just fantastic at age 22 year, but the patient may run out of donor-hair few years later after another 1-2 operations. A dense front and a thinning or bald vertex may be less fantastic aged 28.
High density hair transplantation (in one or more sessions) is a luxury that not all patients can or should avail as it’s highly expensive and graft-consuming. And the patient may run out of both.