Ques for Drs - Multiple sessions vs Mega sessions

[Guest dude1]

I have been wondering if there is a major drawback in having multiple surgeries of, say 1,000 grafts, as opposed to 1 or 2 mega sessions. I've read that 2nd and subsequent HTs do not grow as well as the 1st but I'd like to read a doctors opinion on this. I want to get up to around 5,000 grafts and having multiple surgeries over a period of time is not a problem (aside from possible shock loss).

How much does the growth fall off percentage-wise with the 2nd, 3rd, etc? I started from a NW 6, so there is considerable work to be done!

 

Thanks very much for your opinions.

[Guest dude1]

I have been wondering if there is a major drawback in having multiple surgeries of, say 1,000 grafts, as opposed to 1 or 2 mega sessions. I've read that 2nd and subsequent HTs do not grow as well as the 1st but I'd like to read a doctors opinion on this. I want to get up to around 5,000 grafts and having multiple surgeries over a period of time is not a problem (aside from possible shock loss).

How much does the growth fall off percentage-wise with the 2nd, 3rd, etc? I started from a NW 6, so there is considerable work to be done!

 

Thanks very much for your opinions.

[Guest]

Just my opinion but if I needed 5000 hair, I would go for one strip megasession (3000 hair or so), and finish up the rest using FUE. I don't think it's a good idea to have 5 strip surgeries, just think of the trauma your scalp will have to go through. You're saying multiple surgeries are not a problem - but have you had even one strip HT done yet? In my opinion get as much done at as possible in one session, not only will your results be more visible, but you will also spend less time under scalpel.

 

"Any sufficiently advanced technology is indistinguishable from magic''. Arthur C. Clarke

[Son of a Plug]

Get as many FUs as your scalp will permit each HT. Allow as much healing time between sessions in order to permit another large harvest with proper healing.

 

I think that having an over all goal for total number of FU transplanted is fine, but a good Dr is only going to cut out a strip that can be closed tightly each time rather than risk a wide scar.

 

Multiple small sessions sounds like Bosley = Trouble

[arfy]

If you were planning on 4500 grafts total, you are better off getting 3 sessions of 1500 each, or two sessions of 2250 each, than getting 9 sessions of 500 grafts (strip excision). Doing that many sessions is innefficient way to use your donor supply. Every time you remove a strip, there is "some" damage to surrounding hair from the incision, sutures etc. You don't want to maximize that by getting lots and lots of piddly little sessions.

 

However if you are transplanting FUE (non-strip) then small sessions are not problematic in that way. (You should still have enough hair loss to justify a transplant, even if you are doing small FUE session though).

[NW]

I would support the 2 HT sessions approach, with the 1st HT session being the larger one, the 2nd being the "add density" and "fine tuning" session.

 

Even though doc can do a 1 pass HT pretty well now days, its nice to have a chance to be able to evaluate and finish up with a 2nd HT.

 

NW

[Guest]

There are many ways to approach a case like yours.

I personally try to put a person through the surgical procedure as few times as possible. If the doctor has the capability to perform larger sessions (2000 fu's or greater) this would probably be the most successful and economical approach. It is a fact that the more incisions on the skin you make in the same area, the greater the chance of scar tissue formation. I attempt to remove all existing scar tissue formed from prior surgeries. When it is all said and done I would prefer to only have one thin line scar. So my suggestion is to have 1 or 2 larger sessions to start and then smaller sessions later if needed.

[Dr. Paul Rose]

I would agree with Glenn Charles assessment.It would be very reasonable to go for two sessions of about 2000-2500 grafts using the strip harvesting method. The ability to go for ove 2000 grafts in each session would depend on scalp laxity and donor density. As one takes more tissue form the donor area the density decreases and the laxity may diminish as well.

 

I would not try to obtain over 2000-2500 grafts because it would be very likely that the scar would be less than optimal.In removing the amount of tissue required there may be a great deal of tension on the wound, leading to poor scar formation.There can be people with incredible scalp laxity and very high donor densities but they are rare.

 

Like Dr Charles I would create one scar if a person wants to use strip harvesting.

 

If we were going to use the follicular isolation technique a linear scar would not be created. The down side of FIT would be the need to perform smaller sesions over 2-3 days to reach 2000 grafts.

 

There are no adequate studies examining the rate of graft survival after multiple sessions. The theory that the first session is the best session is based on conjecture and anecdotal experience.