Since the introduction of FUE in the early part of the century, there have many refinements to the technique. Though patients of African descent are believed to be among the best candidates for hair restoration surgery, because of the low colour contrast between their skin and hair, and the excellent coverage provided by its curl or kink, the results with FUE have been very poor .The main reason being that the quality of grafts extracted have been of a poor quality due to the unpredictable nature of the curl of the hair. Understanding the unique hair qualities of African hair enables the surgeon to help the African/African American patient achieve the best possible results.

The hair shaft of African hair is oval on cross section (in contrast the round shafts of Caucasians and Asians). This configuration allows the hair shaft to twist on itself and form the characteristic kinky or curly hair. This hair type provides excellent local coverage since each hair covers a large area around it. However, a limitation of this hair type is that the tight curl doesn't allow the hair to be easily combed back to cover thin or bald areas that are some distance behind it. To compensate for this, the surgeon should place at least a small amount of hair in all of the areas that need coverage.

African hair can be divided into two distinct, but overlapping types; one that is wiry and tightly kinked and other that has a looser, more wavy kink with a softer feel. The surgery in each case must observe slight differences.

 

African patient with density of 1.6 hairs/mm2 and tightly kinky hair African patient with density of 1.6 hairs/mm2 and curly-kinky hair

African hair is also unique in that the density of naturally occurring follicular units is relatively low (they are spaced farther apart). Africans have an average density of about 0.65 follicular units/mm2, in contrast to Caucasians with an average density of 1.0 follicular unit/mm2. During the transplant, the surgeon must account for this by spacing the grafts in African/African American patients slightly further apart to insure that there will be adequate coverage of the areas to be treated. Technically this works well, since the slightly larger grafts cannot be placed quite so close together.

The following table compares some easily measurable aspects of the follicular units in Africans/African Americans and Caucasians.

 

  Caucasians Africans
Follicular Unit Density (mm2) 1.0 0.6
Average Hair Density (hairs/mm2) 2.1 1.6
Predominant Hair Grouping Two Three

Another important consideration when transplanting those of African descent is the characteristics of the donor scalp. Their scalps tend to be thicker, more fibrotic and less distensible.

A final issue in transplanting Africans/African Americans is their increased risk of hypertrophic scarring and keloids. Although the incidence of keloid formation is rare in the back of the scalp, the formation of hypertrophic scarring is quite common. It is of paramount importance to identify that a condition called Acne Keloidalis that commonly occurs among African community. This presents as small bumps on the back of the scalp and this needs to be identified and addressed by the surgeon.

We at Cosmetic Medical Group understand the unique nature of African hair and have had consistently good results with the H+ technique. We can safely say that, due to the unique nature of this procedure, we are confident of achieving highly natural and satisfying results and hence back it up with a written guarantee.

We at Cosmetic Medical Group understand the unique nature of african hair and have had consistently good results with the H+ trechnique . We can safely say that ,due to the unique nature of this procedure , we are confident of acheiving highly natural and satisfying results and hence back it up with a written guarantee.