I was asked to post this on it's own as I had this in another post, I know doctors who would do real mega sessions (4000+ grafts) like Dr. Rahal or H&W but I asked another HT surgeon and he was saying that mega sessions of 4000+ usually are possible only when splitting up 2 and 3 hair grafts into 1 hair grafts, so if there are 2500 grafts to give, surgeons usually would split these up these into a majority 1 hair grafts to give more grafts (4000+) for more coverage but with less density, is this right? I know there are people who have gotten HT's with large number of grafts not split up into single hair grafts (as a majority) but this is what he said:

"It is also well know that the average head has about 10-15% one hair grafts. Therefore in a person who gets a 4326 grafts transplant, they should get about 436 to 649 single hair grafts. They quote a total of 2129 single hair grafts!! The only way to do this is to cut the two and three hair grafts into one hair grafts. Most doctors think that this is not a good way to go since you will lose density. Single hair grafts produce less density than doubles or triples. However, some doctors claim that at least the patient has some hair there even if it is only a one hair graft. Furthermore, most doctors charge by the graft so the cost is significantly higher. For example, typically 2500 follicular units will have about 250 singles and about 2250 double and triples in equal ratios. If we cut up all the doubles and triple into singles we will get about 3375 ( 2250x0.5x3) + 2250(2250x0.5x2) + 250= 5875 single hair grafts. YOU do not have 4326 real follicular units to give in one sitting ??“ no one does"

Please comment, thanks!

True FUs should never be spilt unless extra are needed for the hairline.

Some docs may split grafts. Who knows for sure? But for a doc to suggest nobody has over 4000 real FUs in one session is just plain wrong. He's most likely behind the times.

Which doctor are splitting grafts. In my opinion doctor accuse other doctor of splitting grafts because in the majority of the time they are not able to perform large session. If this is what other doctor were telling you them there results of 2500 would look the same as a doctors with 4000. Take a look at these results with around 4000 or so grafts and then look at the doctor that are telling you grafts are being split and look at there results of around 2500 and see if they look the same because according to what they are saying they should be.

http://www.hassonandwong.com/patient_gallery/photo_view...ansplant_type=normal

http://www.hassonandwong.com/patient_gallery/photo_view...ansplant_type=normal

http://www.hassonandwong.com/patient_gallery/photo_view...ansplant_type=normal

http://www.hassonandwong.com/patient_gallery/photo_view...ansplant_type=normal

http://www.hassonandwong.com/patient_gallery/photo_view...ansplant_type=normal

http://www.hassonandwong.com/patient_gallery/photo_view...ansplant_type=normal

__________________
My Hair Loss Website - Hair Transplant with Dr. Hasson

I assist H&W with translation when needed and available.I am not a rep, I am a full time real estate agent. My comments and opinions are 100% mine.

Hi lorenzo,
actually the HT doctor I'm referring to told me that the 2500 grafts aren't the same as 4000+ because he said the 2500 are being cut into a majority of 1 hair grafts to give more coverage but of course that takes away density, he said he'd be happy to do 4000 grafts for me for more coverage but then it will be really thin, otherwise take the 2500 grafts for a more fuller look but with less coverage. But when I check myself I see doctors such as H&W and Rahal performing large true 4000+ sessions with multiple hair grafts and then believe that the HT doctor I'm referring to probably can't do true mega sessions.

I do not know of any real way to check the number of grafts received so I think we have to take the doctors word for it after a procedure. Its not like going to buy tuna salad where you actually see them weigh the tuna salad before putting a price on it. Hopefully reputable doctors are honest with the grafts counts.

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4374 grafts-7/2/2008-Dr Rahal
485 singles
2336 doubles
1526 triples
16 quads
9809 total hairs

I'm convinced that this whole graft terminology is not consistent with every doctor. I'm not suggesting that doctors are being dishonest, but rather have different definitions as to what actually constitutes a graft. Is a graft a slit in the recipient sit? I've heard that a couple follicular units can fit into one slit. But then I thought follicular units were grafts. So I take the graft count of these photos with a grain a salt.

I remember when I went in for my consult with Dr. Gencheff. He initially said I needed about 1,000 grafts. Members of this board told me that that would not be enough. I called the offices and they said that 1,000 grafts would yield about 1,500-2,000 follicular units. Well, what the hell is the difference? I ended up with 2,100 follicular units and when I spoke with the doctor he assured me that the follicular units consisted of 1,2,3, and 4 hairs. We then had a conversation about the whole situation. He said that a numbers of doctors are working to come up with a uniform method of counting grafts, follicular units, etc. I really think that's Pat quote his the nail on the head. Count hairs not grafts. Maybe we should apply this to the photos.

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2008 Dr. G – presumably 1,000 grafts / 2,142 hairs
2009 Dr. Paul Shapiro – 2,348 grafts / 4,258 hairs
2011 Dr. Paul Shapiro – 1,999 grafts / 3,624 hairs

My Hair Transplant Journey with Shapiro Medical Group

Hi aaron1234 I also think that hair count would be better then a graft count because at the end that's all that matter is how many hairs you are getting. If 2500 grafts split up into a majority of 1 hair grafts then you might be getting 4000 hair and grafts but with a majority of them being 1 hair grafts. I like Dr. Rahal's table as you can see below where he put 5800-6300 hairs for 2500 grafts which leads me to believe that there will be a lot of 2 hair grafts. So the hair counting way is good as you get more of a general idea as below:

HAIR COUNT GRAFTS COST GST TOTAL
2300 ??“ 2500 hairs 1000 $4000 $240 $4240
2800 ??“ 3000 hairs 1200 $4800 $288 $5088
3500 ??“ 4000 hairs 1500 $6000 $360 $6360
4200 ??“ 4800 hairs 1800 $7200 $432 $7632
4800 ??“ 5300 hairs 2000 $8000 $480 $8480
5300 ??“ 5800 hairs 2200 $8600 $516 $9116
5800 ??“ 6300 hairs 2500 $9500 $570 $10,070
6300 ??“ 6800 hairs 2700 $10,100 $606 $10,706
7000 ??“ 7500 hairs 3000 $11,000 $660 $11,660
7400 ??“ 8000 hairs 3200 $11,600 $696 $12,296
8050 ??“ 8700 hairs 3500 $12,500 $750 $13,250
8625 ??“ 9400 hairs 3750 $13,250 $795 $14,045
9200 ??“ 9700 hairs 4000 $14,000 $840 $14,840
9660 ??“ 10200 hairs 4200 $14,600 $876 $15,476
10350 ??“ 11000 hairs 4500 $15,500 $930 $16,430
11500 ??“ 12000 hairs 5000 $17,000 $1,020 $18,020

I feel compelled to reply to this thread as I think too many of us are or have been misled by incompetent Dr's in the subject of graft splitting.

When I first started the hair transplant journey two years ago I talked to different Dr's who I shall not name here. I was a NWD 6 I needed a large procedure and more. I was told the same thing. "These huge graft numbers are achieved by grafts being split." I settled for Dr. Epstein who said the biggest result he could do was about 2900 grafts on someone with my laxity. He seemed like a nice guy, dedicated to his profession and close by to where I live and very financially reasonable. I went ahead and did it, and although I look better now , I now have mixed feelings about the results for reasons I shall show with pictures and evidence later on.

Knowing I desperatly needed a second procedure and with Dr. Eptein saying he could only get about 2400, I looked for second opinions. After looking at the website of Hasson and Wong repeatedly, actually 100's of times and comparing it to others, Their results just seemed to look far superior to almost any other Dr's results I had seen. Their single pass 5000 + graft results really looked at least twice as good as other Dr's 2500 graft results. Their Single 6000 graft results looked twice as good as other dr's 3000 graft results. Although they are thousands of miles from me and more expensive than some, I went ahead and had an online consult where Dr. Hasson told me to expect about 4000 grafts. I told him I wanted the largest possible procedure. The morning I arrived and met him for the first time he said I had good laxity and a dense donor area. I said specificaly, "MONEY IS NO OBJECT, TAKE AS MANY GRAFTS AS POSSIBLE" at the end of the day he got 3600 grafts which is less than what I hoped but all he could do with what donor I had. Most of them were multiples and I think about 600 were singles. he could have easily cut up the multiples into sigles and charged me for 6000 grafts which I would have paid without blinking and still left happy not knowing the difference. I felt like I was treated very honestly. I even got up at one point and looked through the microscope and did not see any evidence of graft splitting. This procedure had many differences from my first procedure. The staff were very diligent and paying alot of attention to what they were doing. i did not notice any idle gossip, but only 1000 % attention to detail. I had no itching, less pain afterwards and far less swelling than the first time I did this. Also the time it took to do strip removal and stitching was far longer than my first procedure and "apeared" to be more meticulous........

I can go on and on and on singing praise about Dr.Hasson. You have all heard it a 1000 times before by others and I now know why this company has such a stellar reputation.

Bottom line is, I do not believe from anything I saw or experienced that guys like Dr. Hasson do any unneccesary graft splitting,especially when I was begging to throw money at them to extract more grafts and he said that 3600 was the best he could do for my natural characteristics although the bummer was he told me he could have probably done 6000+ the first time around. i friggin wish I went to Dr. Hasson the first time.

Thanks for the response wanthairs, was it a big difference that you saw between 2800 and 3600 grafts? I know doctors like H&W and Rahal are the elite and ethical ones. I just wanted to gain all the experience and knowledge of people who have gone through this and might know a little about possible graft splitting.
Thanks!

Hi reptile,

It is hard to say as both Dr's did different densities and attacked different areas. Epstein did the frontal third and Hasson did the crown and some of the middle and beefed up my hairline. I would have to wait over a year to see how it turns out to be more accurate with my answer. I did look better with the first prcedure but there has definately been issues of lack of growth for which I intend to talk about in another thread with pics, soon.

Ive only heard good things about both Docs you mentioned, Rahal, and Dr. Hasson. I chose Dr. Hasson because I have just been blown away by his results on a consistent basis. I think even though the prices may be a little higher than some of the US Dr's its crazy not to use guys like this.

Knowing what I know now, in retrospect, I would have gone to Dr. Hasson the first time around if he charged three times what he does and had his clinic in the South Pole.