" The 2 Questions

Before I accept anyone for a hair transplant, the first question I always ask is: “Why does he or she want the procedure right now?” The second is: “Can I realistically meet this patient’s expectations?”

In some cases, such as clients who frequently appear on stage, the demand is for a youthful, energetic look. These patients often request a low hairline with high-density coverage, including restoration of the temporal hairline. That approach is valid — but it’s not for everyone.

Expectation Must Be Reasonable

Ricky, in contrast, is an interior designer. Our goal with him was to enhance his professional image, not chase youthful extremes. His donor density was also relatively low, with a large number of single-hair follicular units (as shown in his chart). With this in mind, we had to plan carefully to ensure his results will remain natural and age-appropriate well into his 60s and 70s.

We also anticipate progressive thinning at the crown in the coming years. That’s why we agreed to take a conservative approach and reserve some good-quality grafts for future sessions if needed.

In Hair Transplant, Density Is King

Anything less than 35 grafts per square centimeter is often perceived as thin. To achieve a natural appearance — especially at the hairline — we typically aim for 50–55 grafts per cm².

It's important to remember that the hairline is the outer arc of a circle. Lowering it by just 1 cm can consume up to 600 grafts. For Ricky, we deliberately set the hairline slightly higher to reduce the area that needed dense packing. This allowed us to focus density where it counts, and realistically convert his classification from Class V to Class III — not an overambitious Class II.

With just 2,104 grafts, I believe we achieved a very respectable and natural result.

The key wasn't just graft count — it was placement, angle, and direction. Even his hairdresser couldn’t tell he had undergone a transplant. That, to me, is the highest compliment. In the end, naturalness is always more important than numbers. "

Dr Bertram Ng