Manny Marritt’s Density Numbers and the Implications
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Manny Merit was a very famous hair surgeon from the 1980s. And he came up with a very interesting idea which was that we lose about 50 percent of our hairs before we begin to actually notice hair loss. So, we’re not talking about losing 50% of your hair is you look totally bald, we’re talking about you lose 50% percent of your hairs and then you begin to see that you may have some early thinning. So, if you have some early thinning, you’ve really lost 50% of your hairs according to the Merritt’s idea. And so we’re born with about eighty to a hundred twenty thousand hairs on our head, on average, less a hundred thousand hairs on our head. By the time we actually see thinning or balding thinning, we have to have lost about fifty thousand hairs on our head. So, the numbers that I need to do is actually to try to accomplish full density is to not get two hundred thousand hairs on the head, but to get the fifty thousand hairs on the head. So how do I do that? What’s interesting is, if you look at the donor area, if the donor area doesn’t get any thinning, then we should have a hundred percent on the back. So, in other words, let’s say on the front of your scalp, these numbers are not entirely realistic, because honestly, you’re probably not going to be this level. But let’s say you’re at a hundred thousand a hundred follicular per square centimeter for you to begin to start seeing density loss. You have to be at 50 follicular per square centimeter, to be honest with you, you should be even lower than that. But let’s just use these round to make it a little bit clearer to understand. So, for me to get you back toward full visual density, I have to accomplish getting to 50 follicular per square centimeter, not a hundred. How do I do that? Well, here’s the good news on the back of your head. If there’s no thinning, and you have a high density like a hundred follicular per square centimeter, I have now a higher density hundred pairs per squares, a hundred follicular units per square centimeter to try to get the front back to 50. So let’s say the front was only at 20 or 25. In that case, the gap is now 25 for the units from a density in the back that starts at a hundred. So, this is the way that I can cheat to get the numbers to make sense. Now, when you’re looking at, for example, a strip procedure where I take a centimeter of tissue out from the back of the head, that often times iz very compacted Zone, I can have enough hairs to cover the whole scalp. With FUE, you have to be a little more careful. Now, if you use merits numbers, You could argue that on the back of the scalp, If you had a certain number of follicular units per square centimeter, I could take out half of the units on the back of the head and not see the area start to become thin. That’s the theory behind merits numbers. Well, the dangerous thing is that Merritt came up with his numbers, way before FUE. It was during a time of strip procedures. And he was really talking about the recipient area. What’s interesting with the donor area is that things are not exactly the same, Because when you do FUE, you actually create some micro scarring throughout the entire back of the scalp, and that can actually cause a sheen and a shine on the backside. You can miniaturize or thin adjacent hairs that are areas of harvesting so that you’re not necessarily able to accomplish a fifty fifty percent reduction of the donor area to be able to transplant the front. Sometimes that’s overharvesting. In fact, most often times is overharvesting. For me, most of the times I can only get no farther past about 25% of the backside, Sometimes 30 percent, without having the risk of getting visible thinning and the back. And that’s really the crime against humanity that I see almost every single week that comes through my door. I’ve seen two to three every week of overharvested FUE, which is really such a disaster, because there’s almost no way to Fix it. You can do some scalp micropigmentation, but it’s not easy to fix it. So this is just a sort of an esoteric discussion. But it has practical ramifications of understanding what Manny Marritt talked about in terms of numbers when it comes to hair restoration.