What's a safe density to pack follicular units into the hairline so that shock loss to existing hair is minimized, maximum graft yield will be achieved, and decent coverage will be attained where it will be cosmetically noticeable/acceptable?

I hear 40-50 grafts per square centimeter is all that's needed; however, will this result in acceptable density such that one can go outside during daylight and have the hairline look strong?

For those that have had work into the hairline, what are some of your densities in terms of grafts per square centimeter?

beanz,

You are asking some good questions, and one that's heavily debated even among the world's leading hair transplant surgeons.

Pat Hennessey and I recently attended the annual ISHRS (International Society of Hair Restoration Surgery) and one of the hot topics of discussion was appropriate hairline density. To read more about this topic among other important ones, see our Highlights of the Annual 2008 ISHRS Scientific Meeting in Montreal.

A few important issues that was not raised at this meeting in relationship to appropriate hairline density was hair characteristics and lighting. Certain lighting will make lower density hair transplants (hairline and beyond) appear thinner than others. Additionally, thin hair will appear less dense than hairs with thicker hair shaft diameter.

Best wishes,

Bill (Falc)

Fal comments good points and good reference.

Florecent lighting shows less density and direct sunlight sometimes.
Also donor hair character-- how big diameter, dense course the hair shaft per FU makes a difference.
On the hairline you do not want dense packing and 50-60fu/cm is good-- you want that natural "zone fading look" rather than a blunt dense packing hairline.
Ron Shapiro has some articles about Natural Hairline characteristics, ect.

SMOOTHY
Dr. Shapiro
Propecia/Rogain xtra
MSM/ZINC/Saw Palmett
3 oz Zrii Daily

The correct hairline density is determined by hair quality and overall scalp density in non balding areas. This can range from 40 graft cm2 up to 75 cm2. Everyone is different.

This is a good question? what are most averages? i still find it difficult to believe that a surgeon can fit 50+ graphs in a square centimeter.

The key to recreating a "good" hairline is in accurately evaluating, from an artistic point of view, the patient's donor hair characteristics, facial features, age, degree of current hair loss and anticipated future loss and integrating these findings into a surgical plan or design that will therefore necessarily involve choosing the "correct" density, degree of variability of that density (both along the length of the hairline as well as from the anterior to posterior hairline direction) and contour of the line itself, so that the result will appear perfectly (or, more accurately, imperfectly ) natural. Numbers are good for ballpark estimates, but in practice there is no real "one size fits all".
That said, there is necessarily a limit (a one procedure or "one pass" max limit, usually around 40- 45 grafts/cm) that can be obtained initially. (Assuming little to no pre-existing hair.)
While some patients may be satisfied with this (e.g., it may not be appropriate in an older patient to have more density given a more receded hairline), a slightly larger majority of men will want a second session to fill in density, especially in the midline.

As Dr. Carman says, there are many variables involved. 40-50 grafts per cm2 will generally give you a good hairline. I have probably fewer than that in mine. However, what is key is that the central core behind the hairline is not see-through. In other words, there must be enough hair (not just grafts) behind the hairline to prevent light from passing through.

This way, anyone looking at you might see into your hairline, but not through it (if you know what I mean). Your hairline just blends into a dark thicket of hair.

My hair is not see-through even in bright light.

Gorpy -

For a density of fewer than 40 grafts per cm2, your results are impressive.

Things really took off after the second procedure. The hairline is natural. Were the graft incisions made using the lateral slit technique? What is your current regimen to maintain the hair that you currently have?

Also, could this have been achieved in 1 session instead of 2 sessions?

Thanks beanz.
The hairline itself is less than 40. The hair behind it is estimated to be around 45 per cm2.

Lateral slit was used in some areas, but was not the primary technique.

My regimen is just finasteride - 1/4 tablet of Proscar a day. And staying fit and lots of sex .

Could it have been acheived in one session? Each person is unique in their laxity and donor density. In my case of 3700 grafts, or more importantly 8400 hairs, I don't think so.

You would have to consult with some doctors that could estimate the possibilities for you.