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Topic Title: Can you explain hair transplant math?
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Created On: 09/27/2017 04:48 AM
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 09/27/2017 04:48 AM
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topcat
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Can you explain hair transplant math? I would like your opinion here in this thread from those that have had a hair transplant and from those considering one.

My math from over 30 years of experience and observation is as such. Approximately 40,000 fu on the average male head. For those balding approximately a 50% loss over time leaving 20,000. The 20,000 donor that is left will also thin over time so taking 50% of it is not an option. Taking about 25% seems to be safe but it can't be guaranteed. Maybe slightly more can be taken but that increases the risk long term.


25% equals 5000 fu which will cover a 4" square at about 50% density. Overall this will give you 25% coverage over the whole balding pattern. If the numbers are raised slightly then the square can be a little larger and the coverage maybe closer to 30%
The real risk is long term as the donor area thins out. We see that with many long time patients trying to now address their scars. Their donor area has thinned and growing the hair longer to cover it all is not an option. As the donor area thins the hair becomes fly away hair and this is in fact why most older people in general go with a shorter cut. Just look around and make observations The volume is no longer there for longer styles to work.


There is a thread on HTN which really illustrates the point. "Permanent Shock loss after 3 years" What it shows is the same principle. When the donor thins in this case due to another cause the issue becomes the same. How do you hide the scars with thin fly away hair? You can't grow it long and the shorter you cut it the more it exposes the scar. This is in fact why for most guys 5000 fu is probably going to be the limit long term regardless of what the industry puts out there and for some even that number is not possible.


One can easily view any hair transplant doctor in the world that has had a procedure and the reality becomes easier to understand. There are no dense results.............. absolutely zero. Doesn't mean they are not happy but what it does mean is the numbers are very, very limited. This presents a problem for most younger guys. What they are hoping for does not exist long term for most and those that are older are not as eager to have a procedure which creates a problem for the industry. Where does the revenue come from? What do you say and/or do to generate it so that everyone can make money?


So what are your numbers? What do you believe to be true?

Please no responses from marketers...........no one believes what you have to say any more.

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Stay away from doctors who perform mega sessions, have posts deleted, attack posters, sue patients & forum owners, use power drills or robots. I recommend fue with hand punches in the .70-.85 range. I consulted with dozens of clinics over the years and there was a recurring theme regarding FUE among some employees of those other clinics. I was told Bisanga was the man my research told me the same and my experience validated my own research.

Edited: 09/27/2017 at 11:29 AM by topcat
 09/27/2017 02:03 PM
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Skywalker
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Sounds about right Topcat, of course there are a ton of variables including degree of loss; degree of further loss over time (which is uncertain); hair calibre, follicular density, average size of follicular units, hair contrast to scalp, degree of potential donor miniaturisation (if any & again uncertain) that affect the cosmetic acceptability of the result.
This also assumes you get a top doctor who doesn't f*** up your grafts during extraction & implantation. Even then there are no guarantees...

As a NW7 I'm somebody that is at the rough end of most of these variables - due to donor miniaturisation over time I doubt I could now get a 1,000 grafts out of my virgin scalp (I am not exaggerating).

I'm not trying to put people off - but you need to be well informed after much research (at least a year in my opinion) before embarking on hair transplantation because you really can screw the look of your head forever if you are cavalier about it and are stupid enough to just trust your HT doctor wouldn't put you in harms way. Some are really ethical, but some are not & this is ultimately a business for them...

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A 'Government Study' is not necessarily proof - "Garbage In, Garbage Out".

Have not had an HT, turned down by 3 clinics, sadly they were right, my donor area has miniaturised.
Now here to look for any advances and give newbies another opinion.

The guy in the centre of my icon doing the inspection of scars is the ideal potential HT candidate:- Doubting Thomas
 09/28/2017 04:20 AM
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topcat
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Sounds about right Topcat, of course there are a ton of variables including degree of loss; degree of further loss over time (which is uncertain); hair calibre, follicular density, average size of follicular units, hair contrast to scalp, degree of potential donor miniaturisation (if any & again uncertain) that affect the cosmetic acceptability of the result. This also assumes you get a top doctor who doesn't f*** up your grafts during extraction & implantation. Even then there are no guarantees...



Yes I agree and I think the most important starting point for most young guys is to understand the math most especially in percentages. On average most experiencing hairloss long term can achieve 25%-30% coverage with hair transplantation. When stated in these terms the limitations become a little clearer. One then understands if they are going to take 50% of their donor and use it on a small area or start at the crown for example they are setting themselves up for disaster. It's important to know because very often those pimping online don't state it in these terms they state it as 5000 for example which sounds like a very large number when in fact in reality that is not the case.

The bigger issue for many of the younger guys is they are too desperate which puts them in a very weak position. All it takes is for someone to throw something out there like large numbers, tattooing, PRP or even plucking for example. People were actually believing you could bring back to life a dead hair shaft. Yes very odd indeed but all that is needed is for it to be thrown out there. Put it out there and they will come the desperation is that great. The predators lie in wait and when I say predators it's not in a masculine way but in a weirdo kind of way, it's absolutely bizarre to me. Even with names of doctors being touted as best in the world. All that is needed for those pimping is to keep throwing the name out there often enough and many buy into it all.

What also works against many of these young guys is the marketers work to be their friend. So if they can meet a need for the patient they will throw it out there which is all part of the confidence game.


Would love to hear how others perceive the math.

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Stay away from doctors who perform mega sessions, have posts deleted, attack posters, sue patients & forum owners, use power drills or robots. I recommend fue with hand punches in the .70-.85 range. I consulted with dozens of clinics over the years and there was a recurring theme regarding FUE among some employees of those other clinics. I was told Bisanga was the man my research told me the same and my experience validated my own research.

Edited: 09/28/2017 at 06:34 PM by topcat
 10/17/2017 02:39 AM
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topcat
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Understand hair transplant math before ever considering a procedure.

5000 grafts if you are very lucky represents 25% of the total hairloss most will experience over a lifetime. How do you cover an area with 25% and make it work long term? Give it thought and formulate a plan on paper first.

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Stay away from doctors who perform mega sessions, have posts deleted, attack posters, sue patients & forum owners, use power drills or robots. I recommend fue with hand punches in the .70-.85 range. I consulted with dozens of clinics over the years and there was a recurring theme regarding FUE among some employees of those other clinics. I was told Bisanga was the man my research told me the same and my experience validated my own research.
 10/27/2017 09:04 AM
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pidda
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The moral of the story is that the doctors don't care about the math. They will lie to you and say you have 10,000 donor. But when after extracting the grafts the patient will come to the conclusion that they only have 1,000 to use total.
 11/11/2017 04:25 PM
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topcat
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Yes I would have to agree Pidda. The majority in this business unfortunately are not honest/ethical and the worst of the bunch are the marketers working the forums. Of course this is all easy to see after 32 years of watching it all so all one can do is pass down some of the lessons to others. One can easily look towards some of the news coming out of Hollywood. Bill Cosby, C.K. Louis, Kevin Spacey, etc all really good guys. All smiles this bunch and many of them can make others feel at ease and laugh a bit. It's all part of the gimmick and the same applies to much of the HT industry. This is in fact why so many in the business have not had a procedure like many of the doctors..........they just sell them. The obvious needs to be pointed out every so often so those researching can start asking themselves the same questions.

It's skin grafting with hair attached with a very limited amount of donor available and most will only achieve 25-30% of the lost hair simply due to the math. For some the caliber in the donor will simply be too thick when taken from the wrong area and that can easily be seen with some of the showcase results posted online let alone in person where it really starts to stand out and surely draws uncomfortable stares. It's a limited procedure with only a handful possessing the skill to pull it all off which means it's a giant risk for most. When things go wrong the same marketers work the side hustle...........tattooing, PRP, etc often digging those that feel even more desperate a deeper hole.

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Stay away from doctors who perform mega sessions, have posts deleted, attack posters, sue patients & forum owners, use power drills or robots. I recommend fue with hand punches in the .70-.85 range. I consulted with dozens of clinics over the years and there was a recurring theme regarding FUE among some employees of those other clinics. I was told Bisanga was the man my research told me the same and my experience validated my own research.
 11/13/2017 01:56 PM
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topcat
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To understand skill and math one can easily take a look at some of the current results posted to Hairsite. One result is a Turkish clinic using 4623 grafts and the other is a Cole result using 3690 grafts. Note the hairline position and whether temple points were rebuilt or not. How about the caliber of hairs that were used in the recipient area? If you had to determine if the math is going to hold up long term which result would have a better chance? Now compare what you are seeing with much of what is posted on the various forums and the amount of those postings. The online hustle is all a game so observe for long periods of time to understand it all. If a medical procedure requires a hustle and a game then what exactly does that mean? Be careful..............information is about programming the mind. Where is the information coming from and what is the agenda?

What do you do if the wrong hairs were used or the math was wrong? There is not much you can do. For the most part the procedure is irreversible making the room for error zero and the biggest red flag of all.............marketers working forums.

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Stay away from doctors who perform mega sessions, have posts deleted, attack posters, sue patients & forum owners, use power drills or robots. I recommend fue with hand punches in the .70-.85 range. I consulted with dozens of clinics over the years and there was a recurring theme regarding FUE among some employees of those other clinics. I was told Bisanga was the man my research told me the same and my experience validated my own research.

Edited: 11/13/2017 at 04:11 PM by topcat
 11/18/2017 06:32 AM
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topcat
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At the bottom of this post is a very recent comment from another forum. Let it sink in because what that person is feeling represents probably hundreds of thousands of men that suffer in silence. They went into all of this not understanding the seriousness and that it is irreversible for the most part. Many of them drawn in by marketers that work online forums. You will not hear from the majority of them just like you don't hear from guys who experience erectile dysfunction...........they feel shame.

Understand the math and understand only a few can perform this procedure and achieve a result that does not draw stares. I waited 10 years before I attempted a repair and I had to travel to Brussels and regardless of the circumstance that is where I was going or it was nothing. Even with that I only wanted the smallest procedure possible regardless of cost. Why did I have to travel half way around the world...........because I had no choice.


When you see these young guys working the forums especially the ones trying to drive traffic to Turkey. I would suggest you be very careful............it's all a game for these guys.

The math limits you to one shot. I have hundreds of comments like the one below gathered over years. It only represents the tip of the iceberg and what you can see. The rest is hidden.


I'm SICK & TIRED of this shit, I'm sorry for my language but this has cause me so much pain and suffering & embarrassment. Can't go anywhere without wearing a F hat. Cant go to parties, Cant go to Weddings, Cant go to Church without people looking at me. And when they are talking to me, they are staring at my head and wondering.
Just simply tired of it!!!


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Stay away from doctors who perform mega sessions, have posts deleted, attack posters, sue patients & forum owners, use power drills or robots. I recommend fue with hand punches in the .70-.85 range. I consulted with dozens of clinics over the years and there was a recurring theme regarding FUE among some employees of those other clinics. I was told Bisanga was the man my research told me the same and my experience validated my own research.

Edited: 11/18/2017 at 09:06 AM by topcat
 12/07/2017 02:08 AM
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topcat
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Take a good look at the doctors pictured on the hairlossdocs.com ad on the side bar of the main page. The picture is telling you something about the math and the limitations of the procedure. Many will not be candidates' long term and even more will only be candidates if the procedure is performed ethically where the hairline is high enough and very often leaving the crown bald. This is perfectly acceptable and can turn out to be a blessing for many.

What you can learn from this is that when you see clinic's focusing on young patients with denser/lower hairlines it's a form of enticement for the sweet spot of those most desperate to jump. It's a red flag so go over to Dr. Bernstein page and look at the results. Note the age of the patient by looking at the pictures and note the numbers of grafts. Now contrast that with the low/denser hairlines in young guys and ask yourself will that hold up long term? What about this 8000-10,000 grafts promised in places like Turkey? Does it make sense when the numbers are pointed out to you?

Many will be enticed by pictures that don't represent reality even repair patients so be careful and understand the numbers. They are in fact very limited and if you are young there is a good chance even if you are losing your hair you are probably too young to start with surgery.

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Stay away from doctors who perform mega sessions, have posts deleted, attack posters, sue patients & forum owners, use power drills or robots. I recommend fue with hand punches in the .70-.85 range. I consulted with dozens of clinics over the years and there was a recurring theme regarding FUE among some employees of those other clinics. I was told Bisanga was the man my research told me the same and my experience validated my own research.
 01/09/2018 05:10 AM
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topcat
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Most will have 5000 grafts to draw from long term if they are lucky. In most cases it will give them 25% of their hair back if their hair loss is going to be substantial.You get one chance with that 5000 number and if you mess up you are pretty much done. In some cases even 5000 grafts are not available long term.

If you observe many of those going to Turkey for example some are being promised 8,000-10,000 grafts. They are being lied to most especially in the long term when the donor starts to thin naturally and the area becomes balder then the transplanted area 10+ years down the line when it's too late. They will then be asking themselves now what do I do.

Take a look a Dr. Berstein's work as an example and look at the numbers as they appear over decades. Where are the mega session cases? They don't exist because it does not apply to a finite resource. I'm not a fan of the robot but I am a fan of being ethical and working within the numbers.

David Gest did not have enough donor long term but he was not given good advice and chances are he didn't understand the math. Thin hair all over your head does not look better than being bald in my opinion. Most especially when the lateral humps (sides) drop. It immediately catches your eye. You have to understand the math when you consult so ask for all those numbers in detail. Write them down for your records and you want all the numbers.

Yes we can laugh that David got his advice from Michael Jackson. Just like we can laugh at many of these young guys who believe what they read with online forums and the marketers/posters that create much of it.

David Gest speaks about his cosmetic surgery

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Stay away from doctors who perform mega sessions, have posts deleted, attack posters, sue patients & forum owners, use power drills or robots. I recommend fue with hand punches in the .70-.85 range. I consulted with dozens of clinics over the years and there was a recurring theme regarding FUE among some employees of those other clinics. I was told Bisanga was the man my research told me the same and my experience validated my own research.

Edited: 01/09/2018 at 12:03 PM by topcat
 01/09/2018 05:05 PM
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Wolverine
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I think the transplant math only works for people that have mild to moderate hair loss and that are low risk to have significant loss. And I'm not sure that anyone can safely guarantee that last part.
So let's say you made it to 40 years old and are still a NW4 or better. You might be a good candidate.

Also I don't know how many doctors practice in this industry, but my general impression is that most of them must not be very good. And the skill of the doctor seems like it would be the most important variable of all for this type of procedure.
 01/09/2018 08:12 PM
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dodgePT
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Hi topcat, I've been a follower since I first read your story, and man, I really respect you.

My opinion on this, after being a NW5 and after my first procedure, being a NW2 with thinning, I believe that, being lucky with transplants is the answer. Unfortunately, it all comes down to pure and sheer luck.
Even great surgeons fail once in a while, and results are subpar.

My first transplant (in Turkey, with one of the best surgeons in my opinion) took 3700 grafts from my donor area, and according to him, I should have 2500 to 3000 for my second procedure.

3700 grafts had a huge impact in my looks. I mean, I have a hairline now, and well done, exclusively made of one hair grafts. You can all see my story well documented here: http://www.hairlosshelp.com/fo...d=99758&enterthread=y

Now, I think we can't rule out beard and leg hair, by using it wisely, intertwined with head hair in certain areas. I mean, why not?
When you've exhausted your donor hair, if you've previously taken care of the more exposed areas like the hairline, I think they're valid alternatives. What do you think? I know you've been through all that, and you've transplanted a great deal of beard hair as a last resort, so what do you advise to most of us, when we exhaust most of our donor area?

Cheers and thanks for your insight.

-------------------------
Regimen:
[5mg finasteride] 04-18-2012
[keto 2% shampoo]
[FUE 3700 FU] 11-04-2013



for($hair=0; $hair<100000; $hair++) {
echo $hair;
}
 01/10/2018 05:01 AM
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topcat
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Hey Dodge

I think maybe you would have been better off following a hairline pattern you show in photo 19-08-2007. Just filling in that frontal forelock as opposed to the straight hairline. You would have saved grafts. Then I would of filled in behind up to maybe the midpoint of the top of the lateral humps just adding a little density and definitely leaving the crown bald. Then if the sides were to start to drop I would be able to address it with the grafts I had left.

5000 grafts represents approximately a 4" square of 50% density that's not really a large area so one needs to position it so that it is going to look normal long term and that's the key. What is going to look normal long term.

Sure you might be able to get 7000 grafts from your donor but as that area too begins to naturally thin you could be presented with thin fly away hair that needs to be cut short. Most older men maintain this type of style because of that very issue and it also applies to females. If they were to grow it long it becomes straggly. If you need to cut it short and have extracted too many grafts do you now have visible spaces because too much is missing? Something to think about as you might be creating future issues.

I'm sure you are familiar with Jimmy Saville kind of a UK flim flam man, good talker I guess. Take a look at his hair it's a good representation of a naturally thinning donor area when grown long. He didn't have a procedure but none the less the donor area thins and would look better cut short.

You should post a picture of what you hair looks like now. Why do you feel you need more work? Is it too thin and see through or something else. You might be better off doing nothing. It's easy to fall into the trap of online marketers offering up advice to have more work when it might not make sense.

You don't want to end up like David Gest or any of the other billionaires/millionaires that decided to have a procedure.

Sometimes a lighter hair color is the right answer as it reduces contrast all depends on your situation.

I would also add that in my opinion it's not luck but mostly math. Yes one has to find someone that can perform a skin grafting operation that includes hair follicles requiring thousands and thousands of grafts but in the end it's math. The number of billionaires/millions and celebrities that have what can be described as pathetic results are numerous. The amount of ht doctors that have their own personal showcase result is zero. This means if this is what we see then the underbelly has literally hundreds of thousands of cases that can only be described as victims.


Jimmy Saville

David Gest

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Stay away from doctors who perform mega sessions, have posts deleted, attack posters, sue patients & forum owners, use power drills or robots. I recommend fue with hand punches in the .70-.85 range. I consulted with dozens of clinics over the years and there was a recurring theme regarding FUE among some employees of those other clinics. I was told Bisanga was the man my research told me the same and my experience validated my own research.

Edited: 01/12/2018 at 04:50 AM by topcat
 01/11/2018 06:03 AM
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pidda
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I'm amazed people get 3000+ FUE extracted from their scalp. I already feel over-harvested from 1000... Come on guys, some of these clinics are happy that someone was gullible and naive enough to walk into the door.
 01/12/2018 04:54 AM
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topcat
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Dodge I would have started with something like this it's probably 4" sqaure approximately maybe less. This would give me the option of having donor left if the sides were to drop further. I probably could have filled in the area with 2500 maybe less and I feel it would keep me safe. Of course this does not apply to me but I can try to help others with my opinion. For most that have not had a procedure I would advise against mainly became all the marketing fraud that goes on. It's a red flag.

That is how I would approach a hair transplant and of course as wolverine has stated yes skill matters too. It usually goes hand in hand. Highly skilled in most cases advise for the long term but when it comes down to money every prospective patient needs to know the math for themselves as it keeps people honest.

Just like anything else in life if I know about cars, carpentry, plumbing, etc it becomes harder to get screwed over. It's sad that this is the case but it's part of how the system operates.

In fact I would have gone with even less than 2500 maybe 1200. See the effect and it would give me a better option to stop before too much damage was done. The problem with Turkey is I don't think they can make money unless they are doing volume but I don't know their numbers. The procedure is very limited and every person I have spoken to I tell them to avoid it............too risky. And these clinics showing off lower/thick hairlines.................it's not sustainable. I know it and they know but does the patient know it?

Just my opinion here and I'm not trying to make you feel bad for your choice but other young guys might be reading this and they need to consider rolling back their expectations.

Keep in mind with the picture below even that small triangle that connects the temple area might be a bad idea as the area on each side of it could very well drop and recede further back leaving a gap. You have to be able to see the future pattern and work with that not what you see in the mirror before a procedure.




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Stay away from doctors who perform mega sessions, have posts deleted, attack posters, sue patients & forum owners, use power drills or robots. I recommend fue with hand punches in the .70-.85 range. I consulted with dozens of clinics over the years and there was a recurring theme regarding FUE among some employees of those other clinics. I was told Bisanga was the man my research told me the same and my experience validated my own research.

Edited: 01/12/2018 at 03:09 PM by topcat
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