We have gathered a list of the Frequently Asked Questions with respect to Hair Transplants. Please feel free to call or email if you have any other questions or concerns.

What are follicular units?
Over time, researchers in hair transplantation have discovered that hair grows in groupings of 1 to 4 hairs. These are called follicular units. During the hair transplant procedure the donor hair is dissected into the naturally occurring follicular units. These follicular units are then placed into the recipient sites to achieve natural looking results.

How many hairs are in the average follicular unit?
There is an average of 2.3 hairs in each follicular unit. We use the follicular units containing just a single hair to restore and sculpt the hairline. We use follicular units containing 2 or more hairs to achieve density away from the hairline.

Will my hair transplant look natural?
Yes, the proper use of follicular units, hair line design, hair angle, and depth of graft placement is what makes hair transplantation look completely natural. Done properly, transplanted hairs are completely undetectable. Not even on close examination will you or anyone else be able to distinguish a transplanted hair from a naturally growing one. The only way other people will know you’ve had a transplant is if you choose to tell them.

Why does the hair on top of my head fall out but not in the back?
In certain areas of the scalp (frontal and top) cells around the hair shaft have more 5-alpha reductase. This is the enzyme that converts testosterone to DHT (dihydrotestosterone). As a result, these areas with more DHT result in greater hair loss.

Why does hair transplant work?
The hair in the donor area at the back of the head is genetically programmed (less 5 alpha reductase) to last a lifetime. When these donor hairs are moved to the recipient site they retain this genetic predisposition to last!

How many hairs do I have?
A person has an average of 100,000 hairs. Most people must lose 50% of their hair in an area before they begin to notice hair loss. If you are completely bald on the top of your head, you have likely lost approximately 60,000 hairs.

How much hair can be transplanted?
There is a limited supply of donor hair. The average person has approximately 7,000 to 9,000 follicular units that can be utilized for transplantation. This cannot all be transplanted at once as it would be difficult to close the donor area.

How can I achieve density?
Density is achieved by number of hairs transplanted into a given area, not the number of grafts. For example, transplanting 10 single hair grafts in a 1 cm2 area (10 hairs) will not give the same density as transplanting 10 grafts with 2.3 hairs in 1 cm2 area (23 hairs). It is the total number of hairs transplanted that will improve the density in the area we transplant. Density is also affected by the thickness of individual hairs. Hair with a larger diameter will give the appearance of greater density.

Will I keep losing hair after a transplant?
Hair loss is a continual process. Hair follicles naturally cycle between growth and resting phases so it is normal to lose approximately 100 hairs daily, and hair that is high in the enzyme that results in DHT will continue to be a factor affecting future hair loss. In planning for a procedure we try to anticipate future loss and plan accordingly.

How many procedures will I need?
It depends on the amount of hair loss and expectations. Our goal at surgery is to achieve 25-35% density at each session. 50% density will generally satisfy most patients having the procedure. Most patients require 2 procedures.

How many follicular units do I have in my donor area?
There are approximately 100 follicular units per square centimeter. To achieve 35% coverage, 35 follicular units are placed in a 1 square centimeter area.

How long does it take before the transplanted hair grows out?
Following the transplant the hair follicles will go into a dormant phase and lay resting for approximately 6-12 weeks. In most cases the follicles will begin to wake up between 3 to 6 months and begin to grow a new hair. Hair growth will initially be fine but will thicken as time goes on. You should expect to see the full effect in 1 year. Hair on average grows 1¼ centimeters or ½ inch per month.

Can other people donate their hair to me?
No! Your body would reject it just like a kidney transplanted from a non cross-matched donor.

I use a hair-piece. Can you just do a frontal hair line, I don’t have much donor hair, but I would like a more natural hair line?
Yes! This will give a more natural look to the coverage achieved by your hair piece. We can work with you and your hair system counselor.

Questions and Answers by Dr. Goertz

RealSelf Q&A with Brian Goertz, MD