Having Enough Hair for a Transplant

Needing to cover a large balding area with a small supply of good, healthy donor hair can make the hair transplant option a “no-go.” Obviously, the larger your balding areas, the less donor hair you have. But you don’t need to restore your hair all the way to its original density to develop the appearance of fullness.

For example, uniformly pulling out every other hair (50 percent) from the head of a person with black, medium-weight hair and white skin won’t change the person’s appearance much at all. At 75 percent uniform hair loss, this person will start to show significant hair thinning, but it’s still disguisable with good styling techniques that layer the hair. In contrast, a blond with 75 percent hair loss may show no thinning because of the uniform color of the hair and the light-colored scalp.

At 90 percent loss, the black-haired, whiteskinned person will show severe thinning, whereas the blondhaired person with light skin color may lose up to 90 percent of his hair and still look reasonably full-haired. It’s not fair, we know! There’s an art as well as a science to the hair transplant process. A good surgeon can achieve the illusion of fullness even when the need for hair follicles exceeds the supply.

For example, it’s not unusual for the hair restoration surgeon to restore just one area of the bald scalp in a very bald person; putting hair in the front and leaving the crown thin or bald creates a natural-looking variation of a typical balding man who has only crown balding. Viewed from the front, the hair looks normal, whereas from the back the balding crown is visible.

People are born with varying numbers of hair on their heads, ranging from 60,000 to 150,000 hairs. If a man is born with 60,000 hairs and loses 70 percent of them, he would only have 15,000 hairs left, most of which would be needed to cover the areas around the side and back of the head where all of the good donor hair is found.

At the other extreme, a man born with 150,000 hairs who loses 75 percent would have 37,500 hairs on the side and back of his head. Redistributing 20,000 hairs may be enough to cover the entire balding head of a very bald man and make him appear as if he has a full head of hair.