From Pat's visit to H&W:
"Many of the other leading clinics I have visited keep detailed count sheets which enable a person to see not only the final graft count but the number of hairs in each graft. I find such detailed information useful, since the trimming of grafts is rather subjective and the average number of hairs per graft can vary from clinic to clinic.
Upon closely examining the multi haired grafts I found that the vast majority contained two hairs each, while three hair grafts were very rare. I found no four hair grafts. However, the number of hairs in a typical follicular unit does vary from patient to patient. Perhaps this particular patient had a disproportionately high number of single and double hair follicular units than the average patient. According to a published study the typical distribution of hairs in follicular units is ??“ 14% one hair, 51% two hairs, 29% three hairs, 6% four hairs.
When I asked two of the technicians about the lack of 3 and 4 hair grafts they told me that three hair grafts are the largest size they cut. Thus while the average number of hairs per graft does vary from patient to patient, the often quoted average number of hairs per follicular unit in the average patient is 2.3 hairs per follicular unit. Without a final hair count per graft I had no way of knowing if this patient's follicular units had more or less than the average 2.3 hairs per follicular unit or not.
Comparing "Apples to Apples" by comparing total hairs transplanted
Perhaps I'm splitting the proverbial hairs. But I believe that physicians and their patients should ideally provide not only their final graft count but also the amount of hairs moved so that patients and potential patients can compare "apples to apples". After all, ultimately it is the amount of hairs and how they are distributed in the recipient area that determines what a patient achieves.
Some clinics cut grafts that contain "follicular unit families" (follicular units that are so close together that they are trimmed into one multi hair graft). Thus the amount of hairs such grafts transplant to the recipient area is high. Yet such multi haired grafts count as only one graft.
Patients and physicians can debate the aesthetic, practical and economic merit of different graft sizes and excellent points can be made by advocates of both large and small grafts. But in my opinion detailed information about the hair composition of the various grafts should be available to all parties in the debate. Information about the size of size of the donor strip removed would also be useful.
Personally I'm biased in favor of sessions that provide large numbers of refined follicular unit grafts rather than large multi haired grafts. But in fairness to all I think hair counts should be provided in addition to graft counts."
Puzzling how there's a lot of smaller grafts and no 4 hair grafts. Good work but.....