A Publication co-authored by Carlos K. Wesley, M.D.in the peer-reviewed Dermatologic Surgery Journal. All of the improvements in our field over the past two decades have allowed for a younger patient population to benefit from surgical hair restoration. The great determiner in treating young patients, however, is not what wecan do, but what we should do with the limited number of follicular units (FUs) containing “permanent” hair that every patient has. This publication serves as a cautionary tail in order to help clarify the limits of the finite supply of “permanent” donor area hair used in treating young patients. Together with hair transplant pioneer Dr. Walter Unger and his daughter, Dr. Robin Unger, Dr. Carlos K. Wesley conducted a survey of the world’s most experienced HT surgeons with nearly 1000 years of combined experience in which they were asked the following:
“Keeping in mind that over the years the hairs closest to the upper, lower, and anterior borders of the fringe will be lost, how many FUs containing very likely permanent hairs can be harvested from a 30-year-old patient who you believe is destined to develop Type V or VI male pattern baldness (MPB) and has either higher than average, average, or below average donor hair density?”
The survey determined that patients with an average hair density and destined to develop Type V MPB were estimated to yield and average of 6,404 FUs, 4,963 FUs with below-average density, and 7,904 FUs with above-average density. When Type VI MPB is anticipated, estimated mean harvest yields are 5,393 FUs with an average density, 4,204 FUs with below-average density, and 6,661 FUs with above-average density.
While not serving as absolute dogma, these findings can serve as useful guideline numbers for patients and physicians alike to help choose appropriate surgical goals.