Measuring the Balding Surface for Hair Transplant Surgery Assessment

Do you have any idea as to what the average surface area is for level 5, 6, and 7 on the Norwood scale of hair loss?   I was measuring my scalp and found that even if I progress to a Norwood scale level 7, I will only have about 175 cm2 of bald area. That would only take 7,000 grafts to fill in the entire area with 40cm2, a density that I believe is more than adequate to give an illusion of fullness and hair density. I realize there are variables such as color, hair shaft diameter, texture, etc. that come into play, but shouldn’t any hair restoration physician that transplants 1,000 grafts per Norwood level fill in the entire area with good density?

This hair loss question was answered on our hair restoration forum by Dr. Paul Shapiro  of Bloomington, MN who is a member of the Coalition of Independent Hair Restoration Physicians.   His professional answer is below.

In my experience, the average patient’s head can be divided into two areas.  

The frontal 2/3 of the scalp on average measures 100 sq.cm. On average the crown loss is 80 to 100 sq.cm. The area of the crown will vary by how low and wide the crown loss is. On average I would say that to cover the total bald area in most men who are type 6 or 7 on the Norwood scale, I cover an area of 200 sq. cm. But there are men with very large balding scalps in which the area is more like 250 to 300 sq.cm and men with smaller areas. A total area of 170sq.cm.is in the realm of a normal area to cover.

Since the area of scalp I am transplanting is not a box, it is hard to get a measurement by measuring just the length and width of the area of hair loss. So your measurements may not accurately estimate the area balding in your scalp.

The way I measure the recipient area is as follows. I went to Kinko’s and had them copy some one sq.cm. graph paper onto clear plastic overhead sheets. To measure the recipient site area I place this clear plastic sheet on the scalp and draw the recipient site with wax pencil. Then I count the number of intersections inside this drawing on the square cm. grid. The number of intersections counted should closely approximate the area inside the tracing. This method is mentioned in some of the textbooks on hair transplant surgery. Try this method and see what area you get for your recipient area.

I hope you find  this is helpful.

Paul Shapiro, MD

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Bill Seemiller
Associate Publisher/Editor

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