Certain hair types may be more common in certain human groups. Understanding these characteristics may be critical in anticipating the results one can expect. African hair is very curly. This single characteristic makes African hair produce some of the best results in hair transplantation, but the dissection must be performed with extreme care to avoid damage to the curved follicles.
Most Asian hair is black, coarse and straight, making this hair type the most difficult when striving for good reconstruction results with traditional hair transplant techniques, especially when the skin is fair. Korean hair, for example, requires very small grafts (usually one to two hairs per graft) to produce a natural look. In fair-haired Caucasians with a low contrast between hair and skin tones, hair transplant results can be spectacular, as the fair skin and blonde hair color match closely. Using only naturally occurring individual follicular units will produce natural results with all hair and skin types.
In addition to the variation of size and character of the terminal hairs in different areas of the head, hair grows in different directions in different parts of the scalp. Hair in back of the head grows backward and downward; hair in the front and top grows forward; hair on the sides of the head grows away from the middle of the head. The place where they meet in the crown is reflected in the “cowlick.” The art of your surgeon should reflect knowledge of your natural growth patterns, your hairstyle preferences, and how you want your hair to look when groomed or un-groomed. To create a natural looking head of hair, the grafts that go into the recipient area should produce hair that is as close as possible in consistency and direction to the original hair and should reflect the various characteristics of both your hair and heritage.
A working knowledge of the nuances of different hair characteristics is essential in producing an ideal result. Fine techniques are necessary to make perfect donor grafts that are exactly parallel to the direction of the hair shafts of the original hair in the transplanted area. Artistry is required to design a hairline that is appropriate to the size and shape of the patient’s head. Precision must be employed for the proper placement of the many small grafts.