More importantly to the mm-wave discussion, it's not the physical size of the antenna that drives the efficiency but the electrical size. Keep the enclosure design the same and increase the frequency and the antenna gets electrically larger and efficiency goes up-- so it should be easier to make an efficient mm-wave antenna than LTE antenna.
Actually no, loading antennas to make them electrically longer exactly results in loss. There is a relationship with the physical size, the well-known Chu limit:
Chu–Harrington limit - Wikipedia
The design is basically maximize physical size you have, then try to get as close to the Chu limit as you can.
The second unique problem with mm-wave and 60 GHz is cost. All of the academic and military systems tend to use substrates particularly PTFE-based RT/duroid, which is very expensive. I know there's a lot of work in alternate low-loss substrates like LCP. The challenge with Apple and Qualcomm will be to see what the best technology they can get for their budget with their huge volumes.
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