Estimating the Number of Lifetime Follicular Units: A Survey and Comments of Experienced Hair Transplant Surgeons

January 2013 in “ Dermatologic Surgery ”

Walter Unger, Robin Unger, C Wesley

follicular units hair transplant male pattern baldness Follicular Unit Extraction strip harvesting cherry picking Safe Donor Area FUs MPB FUE SDA

TLDR Experienced hair transplant surgeons suggest a limited number of hair follicles can be used for transplants, and recommend conservative methods to avoid scarring and depletion.

In 2013, a survey of 39 experienced hair transplant surgeons estimated the number of follicular units (FUs) available for transplantation in 30-year-old males with different hair densities and a potential for developing Type V or VI male pattern baldness (MPB). For Type V MPB, average hair density could yield approximately 6,404 FUs, below-average density could yield 4,963 FUs, and above-average density could yield 7,904 FUs. For Type VI MPB, the yields were 5,393 FUs for average density, 4,204 FUs for below-average density, and 6,661 FUs for above-average density. The study concluded that the number of FUs containing permanent hairs is finite and should be considered when planning hair transplants to avoid overly aggressive procedures. Additionally, the document discusses the practice of combining Follicular Unit Extraction (FUE) with strip harvesting and "cherry picking" FUs, acknowledging the risks such as increased sparseness and visible scarring. The conclusion emphasizes the limitations of the Safe Donor Area (SDA) and the importance of conservative approaches in hair restoration surgery to prevent future aesthetic and legal issues.

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Research cited in this study

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research Distribution of Human Hair in Follicular Units

83 citations , April 1999 in “Dermatologic Surgery”

The research found that for a typical hair density, about 11 square centimeters of donor scalp is needed to get 800 hair grafts for transplantation.

research The Density Issue in Hair Transplantation

32 citations , September 1997 in “Dermatologic Surgery”

Mini-micrografting in hair transplants can give similar density to older methods with fewer sessions.

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