How to determine the Donor Supply

If you use a Macro-lens on your cell phone (https://www.amazon.com/gp/product/B07S5YPPQX?pf_rd_p=ab873d20-a0ca-439b-ac45-cd78f07a84d8&pf_rd_r=CCSSMZGDS79G6AG31TT9) or purchase a digital hand microscope from Amazon (https://www.amazon.com/Microscope-Magnification-microscope-Compatible-Microscope/dp/B08HX42NCB/ref=sr_1_6?dchild=1&keywords=hand+microscope&qid=1634397365&sr=8-6), you can take a look at your donor area and calculate your donor density and your total available grafts or hairs for hair transplants for your lifetime. The key to getting photos like the ones shown below, is to closely cut an area (doesn’t have to be large) but the size of the lens you are using.  These hairs were cut almost to a shaved level.   I have counted the hairs in the  field for you in two of the three photos shown here. Each number reflects the hair count per follicular unit (or graft).

In this example (photo #1), the total count is 140 hairs found in 56 Follicular units (or grafts) which means that this person averages 2.5 hairs/follicular unit (or graft).  As the average Caucasian hair count is 2.2 hairs/follicular unit, this means that this man has 20% more hair in his donor area than an average Caucasian man. This will translate into more than 20% more grafts (logic will be presented another time) available in the donor area. With significantly more hair per graft, it means that over his lifetime, he will have more harvestable grafts to use for hair transplants. More grafts leads to a fuller look. You need to do this calculation for your donor area  (the back and sides of your scalp). If your donor area has 1.7. hairs per follicular unit (or graft) as shown in the second patient photo, then it would mean that your donor supply is not capable of producing a lot of grafts for treating an advanced balding pattern.  These patients run the risk of a see-through donor area if they get FUE performed with any significant numbers, especially if they have a medium-fine or fine hair.

The total number of Follicular Units on the entire hair baring scalp is 50,000 for an average head size.  To calculate the total number of hairs that you were born with and using Follicular Unit Density from the back of the head (permanent zone) just multiply the average number of hairs per follicular unit times 50,000 and that will give you a total birth hair count.  Example, if your average donor density is 2.2 hairs/Follicular unit, then the total hairs on the hair baring scalp is 2.2 * 50,000 = 110,000 hairs (which happens to be the average hair count for a Caucasian Male). From that calculation, the surgeon can determine your lifetime GRAFTS availability of the donor area.  The donor area has 12,500 grafts (26,000 hairs), which is 25% of the 50,000 total follicular units on the head.  Usually, the surgeon limits his harvest to leave enough donor grafts for (1) future use as balding progresses and (2) for increasing the fullness of the hair transplant with further hair transplants.  Enough hair has to be left behind in the donor area so that it doesn’t become visibly depleted (see-through).  In men with medium weight hair, between 3000-3600 grafts can usually be safely harvested, but with fine hair, harvesting 3000-3600 grafts with FUE produces a see-through donor area so the number of FUE grafts that are safe is usually substantially less than 3600 grafts and that is where the experience of your surgeon comes into plan.  When a person has a coarser hair, the number of grafts that can be transplanted goes higher than the 3000-3600 graft limit of the 50,000 total follicular units. This illustration shows how the individual hair thickness impacts the overall look one gets with a hair transplant: https://baldingblog.com/hair-thickness-vs-density/

There is a warning here for those of you going for FUE. If your hair is fine in character, harvesting a lot of grafts from the donor area will produce a see-through donor area that appears to be balding.  This is not a concern for a man with a coarser hair.

I will tell you that doctors opinions vary considerably on this limit of harvestable graft numbers.  Some doctor increase the number, extending the donor area above the 3 inch height limit, possibly harvesting 5000 or more grafts of the 50,000 follicular units, but those who do that, are going to harvest grafts that may not last the lifetime of the patient because they were taken outside of the safe donor area zone.  If the patient develops an advanced balding pattern (like a Class 7 pattern of balding), harvesting outside of the true donor area will show significant scarring of the scalp left behind from the FUE punch.  A competent doctor will put this into perspective for your Personalized Master Plan.  Every balding man who things that some day he may get a hair transplant, must understand how to do these very simple calculations and understand what I have said in this post.

 

 

 

High Donor density

 

 

 

 

 

 

 

 

 

 

Here are two different patients with low donor density, one with my counted numbers and the other without numbers at all. Both of these two lower photos reflect lower than average donor densities.