December 20 2011, 12:46 pm PT | Posted in: Density + Hair Transplantation
Dr Rassman,
I’m a Caucasian 27-year-old male with zero known family history of MPB. However, I’ve lost some hair on the front of my head, and crown miniaturization was detected — meaning that down the road, I could have a serious (Norwood 6?) pattern. I started taking Propecia and hope it can hold onto my hair for 5+ years.
That said, I already need a transplant. (A “conservative” well-regarded doctor recommended 1400 FUT.) I understand the need for a Master Plan and to not run out of donor hair too early. However, it’s very important to me to not be viewed as balding as a young man (I’m single and haven’t firmly established a career.)
I have fair skin and dark brown hair. Luckily, I’m blessed with wavy hair, donor density 2.3, that people commonly describe as coarse and thick. So, I’m wondering, how big of a transplant could I do now for the front of my head, and still leave enough donor hair for future loss? Could I transplant 2000-2500 grafts without worry? I imagine other patients might be in a similar situation to me.
Thanks so much.
Everyone is different. A 2.3 density suggests you have more hair in the donor area than many people, and with coarse hair you may be able to cover an extensive pattern. But for those with fine hair, it may not be enough to cover a class 6 or 7 balding pattern. I have many patients who have had more that 6500 grafts and most of them get quite depleted. A few of these patients have gone to 10,000+ grafts like this man, and although he could have passed the 10,000 graft number, he got realistically what he needed.

I’m sure the donor impact of follicular unit extraction (FUE) is rarely a subject discussed by many of the doctors doing this procedure. When the donor area has a below average density, the impact on the donor area is very significant and it may appear to look like Swiss cheese. When the density is high, this is not a problem.
A hair density of 30-50% can produce a good look depending upon the coarseness of your hair and the color contrast of your skin and hair color. I have never believed that a hair transplant should bring you to 70% of your original density. The difference between people, based upon color/contrast and the coarseness of the hair, can be dramatic. A return of 50% of the original density in a person with fine hair will have a more see-through look than a return of 25% of the original density if the hair is coarse. So you see how difficult it is for me to understand your situation as the blanks (color/contrast and coarseness) are not filled in for me to include in the assessment.
First I though you were describing