What is the Maximum Hair Density Possible with Hair Transplant Surgery?

This question comes from a member of our hair loss social community and discussion forums:

I recently began investigating hair transplantation and have a question: what is the maximum hair density possible with modern hair restoration surgery? How many follicular unit grafts can really be transplanted per square centimeter of scalp?

Although it seems like this question should possess a fairly straightforward answer, maximum density is variable and determined by several different factors. In my opinion, the factors or variables that affect post-operative density break down into three categories: patient physiology, current hair restoration regimen, and physician preference.

First, the maximum hair density possible after hair transplant surgery is highly dependent upon patient physiology. If a patient possesses thick, coarse, or curly donor hair, compared to fine, straight hair, coverage with a smaller number of grafts is possible and less grafts per square centimeter is required. Additionally, other factors like the difference in tone between hair color and scalp color (a starker contrast between dark hair and light scalp would require more grafts for adequate coverage) and donor laxity would influence density possible and grafts needed during hair transplant surgery.

Second, a hair loss sufferer’s current hair restoration regimen greatly influences the density possible and necessary with hair transplant surgery. For example, if a patient is currently utilizing a proven hair loss regimen of medications like Propecia (finasteride) and Rogaine (minoxidil), it’s likely that coverage in the vertex and midscalp region isn’t a concern and a greater number of grafts can be utilized in the frontal scalp and hairline to implant at a greater density.

Third, the hair transplant surgeon’s preference and patient treatment plan plays a big role in the density possible with surgery. Some physicians are comfortable transplanting a large number of follicular unit grafts per square centimeter; other physicians like to transplant at lower densities and reserve supply for future procedures, or believe “over packing” grafts can overwhelm scalp blood supply and sacrifice overall outcome.

Having said that, some general figures for maximum number of grafts per square centimeter implanted or “maximum density” possible in hair transplant surgery do exist. In general, most experts agree: the maximum density ethically possible with hair transplant surgery is around 50 – 60 grafts per square centimeter. To put this into perspective, density unaffected by hair loss normally measures around 90-100 units per square centimeter, and some physicians report results as high as 70-90 grafts per square centimeter during dense packing cases.

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Blake Bloxham – formerly “Future_HT_Doc”

Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum

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