The donated hair follicles, surrounding tissue and skin are called grafts . Each graft contains one or more hair follicles with accompanying hair, tissue, and skin.
The art of hair transplantation is as important as the mechanics of this medical technique.
It is important to remember that no two heads are alike, and each procedure should be looked at on an individual basis.
Hair density is the number of hair follicles per squared centimeter of scalp.
Scalp laxity constitutes the flexibility or looseness of the scalp, the more flexible your scalp, the easier it is to harvest donor follicles . Conversely, the tighter the scalp the more difficult it is not only to harvest donor hair, but also to close the donor area after excision. More hair can be transplanted if the scalp is loose and the density is high.
Hair grows in several different directions from the scalp ; forward at the top and front, down or away from the middle and the sides of the head, and back or down in the rear.
Coarse Hair has naturally greater bulk, therefore covering more surface area and can be transplanted using fewer grafts.
Fine hair obviously has less bulk, consequently providing less coverage on the scalp than coarser hair . More grafts will be required to create a fuller appearance.
Curly and wavy hair usually gives superior results more easily in hair transplantation because a single curly hair has a tendency to curl on itself and covers more scalp than straight hair be it fine or course.
Straight hair tends to lie against the scalp, thus providing a less dense appearance than curly or wavy hair.
The closer the hair color is to the skin color, the better the appearance of coverage . For example, African hair is dark and very curly and provides the least contrast against various shades of dark skin. This will produce the best hair transplant results visually. Fair-haired men (blondes) with a light complexion also have a low contrast between hair and skin shades. This too can produce excellent results. Asian men however, with dark straight hair and light or beige complexions have a higher contrast between hair and skin, and usually pose the most challenges in hair transplantation. However, excellent results can be achieved by a highly skilled surgeon and team
It is imperative that the doctor considers the patient's future hair loss pattern and rate of change while designing the hair transplant procedure.
It is important to remember that a natural hairline will vary from person to person. When a doctor chooses the recipient sites for hairline placement, several things should be taken into account - the shape of the face, the age of the patient, and the prognoses of future hair loss.
The crown of the head should never be transplanted unless the patient is older with stabilized hair loss (which is difficult to gauge). The front and the top of the head should be the areas considered in a hair transplant. This is the area that frames the face and makes the most dramatic change in one's appearance.
Reviewed by Paul J. McAndrews, MD