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A Guide to High Density Hair Transplantation


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    High density hair transplantation involves implanting grafts at a density between 50-60 grafts per cm2 to achieve a result that almost mimics natural hair density.

    In most hair transplant surgeries, hair is re-implanted at a density between 35-45 grafts per cm2. This tends to give a natural result that blends with existing hair styles. Sometimes, a patient and Surgeon may choose to plan a high density hair transplant but the choice isn’t so simple. In this guide we explain what is high density hair transplant surgery and the main considerations Surgeons will make when counselling patients to see if they are eligible for the technique.

    high density hair transplant before and after
    High density hair transplant before and after picture. This gentleman had his receding hairline operated on with grafts implanted at 55 grafts per cm2

    High density hair transplants can give some amazing results but this can’t be achieved for everyone and a good part of my consultations involves what should be the goal and outcome for patients and their level of hair loss and hair transplant expectations

    Dr Roshan Vara, Hair Transplant Surgeon and Director at The Treatment Rooms London

    Hair Transplant Surgery

    Hair transplant surgery involves transplanting grafts (hair) from the back and sides of the scalp to an area of thinning or balding. There are 2 main techniques for extracting the hair:

    1. FUE Hair Transplant Surgery– this involves cutting each hair individually out, leaving small dot-like scars where they have been taken out, spread across the back and sides of the scalp that are concealed easily with shorter hair cuts
    2. FUT Hair Transplant Surgery- this involves cutting a strip of skin from the back of the head, leaving a long- line scar that will need to longer hair to conceal
    Video explaining FUE hair transplant surgery

    Medium hair density and hair transplant surgery- 35-45 grafts per cm2

    Hair density refers to how many hairs or hair grafts you have per cm2. There is a physical limitation to how close hair can be implanted to each other in hair transplant surgery with the majority of patients receiving 35-45 grafts per cm2. This will tend reflect 50-60% of the natural hair density in the scalp. Although it is not 100% of the natural hair density, it doesn’t need to be. The end result will often blend well with the natural hair and the end result will often depend on a number of other variables, such as:

    • Hair shaft diameter
    • Hair texture
    • Hair curl
    • Hair and skin colour contrast
    • Ongoing hair loss
    medium density hair transplant
    This gentleman had his hairline operated on with grafts implanted at 40 per cm2. This gave a respectable outcome of medium density, blending in with his natural hair

    High density hair transplant surgery- 50-60 grafts per cm2

    Grafts can be implanted at a higher density. This tends to range between 50-60 grafts per cm2. At this level of density, the result often mimics 70-80% of natural hair density with almost undetectable difference between native hair and transplanted hair.

    Attempting to transplant beyond this density is risky and also pushes the limit on how close each hair can physically be implanted during hair transplant surgery.

    high density hair transplant before and after
    This gentleman had a high density hair transplant to his hairline. His grafts were implanted at a density of 50 per cm2. His result here is 1 year post surgery

    Having a high density hair transplant

    The choice to have a high density hair transplant should lie with a hair transplant surgeon. They will make a decision balancing how best to achieve your surgical plan and the risks of implanting hair at a high density.

    high density hair transplant
    Immediately after a high density hair transplant

    Normally those who require hairline or small crown hair transplant surgery and have stabilised their hair loss with medications are good candidates for high density hair transplant surgery. During surgery, the hair implanted right at the front of a hairline will be at a higher density than implanted hair behind. This is done to achieve a natural result.

    Risks of high density hair transplant surgery

    The majority of patients are not eligible for a high density hair transplant. By implanting hair too close to each other, you risk the newly implanted hairs attempting to grow too close to each other and “competing” for space. This will result in the hair not growing at all.

    There are other risks associated with undergoing such surgery. By implanting hairs very close to each other, you can risk over-traumatising the skin resulting in the skin not healing and becoming necrotic (skin death). This again results in the implanted grafts not growing.

    Smoking and high density hair transplant surgery

    Patients with a history of smoking are particularly at risk of skin death and should not have high density hair transplant surgery. Smoking cigarettes can impair wound healing and risk the skin and hair transplant not healing appropriately.

    How is a high density hair transplant achieved?

    At The Treatment Rooms London, we primarily achieve our high density hair transplants using implanter pens. This gives us greater precision and control over the direction, angulation and density of the hairs we are implanting.

    The implanter pens create a channel and insert the hair at the same time- direct hair implantation (DHI) method. Implanter pens can also insert the hair into a pre-made incision. Either technique can be used to achieve a high density hair transplant. Our Surgeons are experts in using either or both techniques for patients.

    The surgery is more laborious and uses more grafts than a normal, medium density hair transplant. Some patients may require 2 sessions of surgery spaced 6-12 months apart to achieve a high density hair transplant. This is often the case for large frontal hairlines or crown hair transplant surgeries.

    Book a high density hair transplant with The Treatment Rooms London

    The Treatment Rooms London is a renowned hair transplant clinic. If you are interested in surgery, book a consultation with one of our Surgeons – call 020 8706 0076 or contact the team via our website.

    high density hair transplant before and after
    Before and after a high density hair transplant with picture immediately after surgery

    References

    • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6371733/
    • https://pubmed.ncbi.nlm.nih.gov/25409994/
    • https://pubmed.ncbi.nlm.nih.gov/24981717/

    Authored by

    Hair Transplant Surgeon Dr Roshan Vara

    Dr Roshan Vara

    Full Medical Member of the British Association of Hair Restoration Surgery

    GMC Registered - 7458409

    Reviewed by

    Hair Transplant Surgeon Dr Dilan Fernando

    Dr Dilan Fernando

    Royal College of Surgeons

    Executive Committee Member & Treasurer of the British Association of Hair Restoration Surgery

    GMC Registered - 7458157

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