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Basic Principles of Hair Transplantation

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Basic Principles of Hair Transplantation

Basic Hair Transplantation

Hair transplantation is a technique, which has become popular over the years, because of sound scientific logic and consistency in results. Understanding the pattern of hair distribution, and the sequence of balding, helps us learn the limitations of this technique and give the best possible results to the patient.

Hair Transplantation is a seemingly illogical process wherein we are using a small number of hairs to cover a large area of baldness.

If one looks at it this way one may have the following questions; will the hair transplantation work, will I have enough density, can you cover my entire bald.

Below are the basic principles of Hair Transplantation

Smaller donor for the bigger recipient

One of the fundamental principles of Hair Transplantation is that of using a small area of donor hair to cover a much larger recipient site by creating an illusion or impression of fullness. Fullness or volume is achieved because of a combination of factors, such as number of hairs, thickness of hairs, length, color, and curliness of hairs.

This is so because the necessary density for the perfect results can be provided using only 50% of actual density during a hair transplant to provide fullness and density. A density of 35-40 cm2 is adequate. This answers the question of how many grafts per cm2 are will be placed in my balding area.

Follicular unit

A follicular unit can have 1–4 hairs with the arrectores muscle, sebaceous gland, per follicular collagen, and nerves and vessels supplying the unit.

The more the number of hairs and thickness of hair per unit, the better the appearance, this means that with patients that have 3 or 4 hairs in their unit its equivalent to hitting the jackpot.


Two variables to the above scenario, which make FUE process liable for transection or damage to hairs, are as follows:

As the level of attachment of arrectores is not the same in all hairs, in all units, in all areas, and in all patients, and also because FUE process is blind, precise depth of the introduction of punch is variable.

The amount of collagen and hence the tightness of the hold may vary from area to area and person to person.

Hair distribution

Transplantation density is one of the key factors for a successful hair transplant procedure. Today, the experienced and skilled hair transplant surgeons can achieve great looking hair thanks to the few techniques that lead to high transplantation density. A scalp is usually 500cm2 (50,000mm2) in area, with a follicular unit distribution of 1/mm2. Each follicular unit has on average two hairs. This leads to a total hair count of 100,000.

It is important to differentiate follicular unit density from hair density; hair density is a function of the number of hairs per follicular unit rather than follicular unit density which is the total number of follicular units.

Process of balding

It should be noted that a donor area with a lower hair density will need more number of follicular units than a donor with a higher hair density to achieve the same result.

While performing transplantation from the unaffected donor area, a follicular unit density of 0.5/mm2 is required in the frontal hairline to achieve a hair density of 1/mm2 and appear normal. In areas behind the hairline, where layering and weighting can add value, less than 50% of the original density may be enough to achieve fullness.

Donor site

The donor area mathematically has around 6000 follicular units that can be harvested safely in an average individual. This number of follicular units increases with any increase in hair density.

Logic of FUE

FUE harvest reduces the donor density, which has to be kept in mind to avoid thinning of the donor site. It is also important to keep this in mind for the sake of future transplants.

To harvest without causing thinning, no two consecutive hair units can be taken, so that the maximum gap between two follicular units after harvest will not be more than 2mm.

Recipient site

Calculating the number of grafts required for the recipient site is a vital stage for a surgeon during hair transplantation.

Planning hair transplantation

It is important to plan for the future and not for just one surgery. Hence to achieve fullness, we need to use our precious supply of follicular units judiciously. The most important component of this is long-term planning.

Body Hair Transplant

Body hair when transplanted to scalp hair can grow longer and thicker over successive cycles, thus gradually acquiring the characteristics of scalp hair. However, body hair occurs mostly as single hair units that an anagen phase of few weeks (6–10 weeks). Even after transplantation to scalp, though some prolongation of the anagen phase may occur, it is unlikely to match the scalp hair.

For these reasons, body hair cannot be a first choice for hair transplantation to the scalp and when transplanted, should be carried out amid scalp hairs.

Medical tourism in Turkey is increasing. People dealing with hair loss mainly keep flocking to the country to get a hair transplant treatment. This is because hair transplant clinics in Turkey charge unbelievably less for a hair transplant procedure than any other clinic in Europe and the US, without compromising the quality of the procedure.

Civas Hair Transplant is best hair restoration center in Turkey. In Civas Hair Transplant, all hair transplant procedures could be performed by Board Certified Hair Transplant Surgeon (doctor). If you’re interested in hair transplant in Turkey or have any additional questions about the procedure, feel free to contact us. Schedule your consultation, and we’ll help you make an informed decision regarding your hair transplant.

Update Date: 19.08.2023
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