Afro, curly and wavy hair gives better coverage than straight Caucasian type of hair for various reasons.
In some cases there may still a good density of hair, however, the reflection of light on the scalp through the thin miniaturised hair may make the person look bald even though he/she is not. When this is the case we talk about a loss in calibre not in density.
Hence, the main challenge of a successful hair transplant lies in creating an optical illusion of good coverage in the recipient area.
Understanding the difference between density and calibre is important when deciding on the number of grafts transplanted per cm2. The quality of hair to be transplanted is key here. Someone with hair of less calibre may need more grafts to be transplanted than someone with hair of a better calibre.
Therefore, in order to receive a satisfactory result, Dr. Lupanzula decides on the number of grafts to be transplanted based on various factors, such as the diameter of the grafts, the contrast between the skin and the hair, as well as hair texture.
Think of two fields of the exact same size: 100m2. Now we plant exactly 100 tress on each of them, however, the crowns of the trees vary in diameter. On field A, the treetops will be 1m in diameter, whilst on field B the treetops are much smaller, say 50cm. Despite all tress having the same stem height, when looking from above, field A, with the trees that have a larger diameter, will appear to be fuller than field B.
The same applies to follicular units and their diameter. The more hairs per follicular unit, the better the coverage. Ideally we would have enough FUs of 2-4 hairs available, however, realistically this is not the case. Hence, in order to create the optimal optical illusion we mix follicular units of 1-4 hairs to create a natural look with maximum coverage.
To stick to the same example, let’s once again think of two fields of the same size. However, this time all trees are exactly the same in diameter and size. The only difference is their positioning. Whilst on the one field the trees are all lined up, on the other field they are staggered.
Whilst density may be exactly equal, the second field with staggered planting appears more bushy.
The same principle is applied when transplanting hair. Naturally our hairs are not aligned in perfect rows. Hence, to create a better illusion of coverage the follicular units are staggered rather than lined up. Furthermore, this technique makes it imperceptible to the eye that the hair has been transplanted, once grown.
Someone of darker skin with dark hair, or someone with light hair and skin may appear to have a better coverage than someone with very dark hair and light skin. The bigger the contrast between skin and hair color, the more obvious it becomes when hair is thinning and the higher the number of grafts needed in order to create a satisfactory result.
Hair texture varies from person to person. Some people have straight hair, others wavy or curly hair and countless variations in-between.
Generally speaking, the curlier the hair, the better the coverage it gives. Curly hair creates the illusion of better density, which is just that: an optical illusion. However, the contrast between hair and skin color also plays an important role here.