Focus on hair not grafts

[P.J]

To all,

 

I think over the years there has been a major focus on grafts per cm - when it should be hair per cm

 

Grafts don't really mean anything without the hair lets face it.

 

 

So let try and mention hairs per cm2 - which to me means alot more then jamming 80grafts per cm and half of them acually growing (see armani for this specilized technique)

 

My new focus is hair per square cm!

 

My experience

Strip = 4995 hairs (27cm long by 1.25 wide)

Fue = 2025 hairs

7020 hairs in 75cm2 frontal third with an average of 15 hairs per cm existing

Hair total= 105-110 hairs per cm on average

 

 

PJ

[P.J]

To all,

 

I think over the years there has been a major focus on grafts per cm - when it should be hair per cm

 

Grafts don't really mean anything without the hair lets face it.

 

 

So let try and mention hairs per cm2 - which to me means alot more then jamming 80grafts per cm and half of them acually growing (see armani for this specilized technique)

 

My new focus is hair per square cm!

 

My experience

Strip = 4995 hairs (27cm long by 1.25 wide)

Fue = 2025 hairs

7020 hairs in 75cm2 frontal third with an average of 15 hairs per cm existing

Hair total= 105-110 hairs per cm on average

 

 

PJ

[Bill - Seemiller]

PJ,

 

Great point. This is why in Pat's signature, it says "Count hairs, not grafts".

 

Of course, not every patient will have the same average number of hairs per follicular unit graft. But I think surgeons who provide hair counts provide a valuable service since in addition to the placement and hair characteristics, the number of hairs will significantly contribute to the final illusion of hair density.

 

Best wishes,

 

Bill

[Dewayne]

.

 

 

 

My experience

Strip = 4995 hairs (27cm long by 1.25 wide)

Fue = 2025 hairs

7020 hairs in 75cm2 frontal third with an average of 15 hairs per cm existing

Hair total= 105-110 hairs per cm on average

 

PJ

 

How many grafts was that?

 

[the B spot]

I disagree.

 

In my opinion, you need BOTH numbers grafts AND hairs to accurately judge a hair transplant.

 

If we just get hairs, how do we know if the grafts are refined, and not simply mini-grafts?

 

If we just get grafts, how can we accurately describe density, or whether additional grafts are sub-divided?

 

No, the only way to truly quantify this is use both factors.

 

For example, (using PJ's#'s) his strip of 27cm X 1.25 should yield approx 2868 grafts using average density (85 fu's cm/2)

 

1.25 X 27 X 85 = 2868

 

4995(# of hairs) divided by 2868 (# of grafts est.) = 1.74 hairs per graft.

 

Pretty low, considering average is 2.1-2.4 hairs per graft.

 

Now, we could assume that PJ has lower than average density, OR we could assume that the follicular units were subdivided, OR we could assume that large grafts were used without being refined.

 

These statements may or may not be true.

 

However, if we have both factors hairs/grafts coupled with a Doctor whose methods we know, we can accurately gauge the hairtransplant.

 

I think it is even more important for FUE--not just hair/graft but GRAFTS before attempted extraction. (ie. extracted 3 hair graft, got 2 hair graft, 1 transection)

 

Sorry if I put anyone off,

Jason

[Gorpy]

I agree with B Spot here. Both factors, hair count and grafts/cm2 play an important role.

 

More hair equals more density - that's obvious. However, sometimes there is reliance on "hair layering" to give coverage. In other words, it lays down upon itself to prevent seeing through to the scalp - kind of a shingling effect.

 

Sounds good in theory, but in reality there is always some part of the scalp that is visible. It might be where you part your hair or when the wind blows or when wet or even at the edge of the hairline. When looking at those parts of the scalp that are showing, grafts that are too far apart look bad. It looks much better to look down on 40-50 or more grafts/cm2 sprouting out of the scalp than 20-30.

 

At the same time you also need an adequate hair count per graft, otherwise your entire hair will tend to be "see through".

 

I think Dr. Feller discussed this once a long time ago.

 

Gorp

[P.J]

B-spot,

 

Your point it understood but we are talking about refined surgery on this forum. Yes my graft count was low because I used FUE first which in turn lowered my graft count substanually from 90-100 to 75-80( which is a whole nother topic).

 

Now, when we are talking about density I believe graft count means little in comparision to hair count - that is all I am talking about

 

No matter how you slice 10,000 hairs are 10,000 hairs - 5000 grafts could be 10,000 hairs or 5000 hairs .

 

 

I know you are referring to pricing - this really isnt what I am talking about - though if one just paid for the total strip area that would be solved

 

 

To properly judge someones outcome what do you see hairs or grafts?

 

 

dewayne - 2512 grafts by strip

1000 grafts by fue - bad first choice for a nw4

 

PJ

[Pat - Community Publisher]

PJ,

 

Thanks for bringing up this topic. As you might imagine from my signature, I couldn't agree more. Thanks to everyone else for adding their illumination to this issue.

 

In my opinion, simply presenting graft counts is outdated and makes no distinction between follicular unit grafting in which the native 1, 2, 3 and 4 hair grafts are kept intact and sub follicular unit grafting in which these native follicular units are sub divided. In addition, some clinics use a limited amount grafts that contain two follicular units that are so close together that they are referred to as "follicular families" or "double follicular units". These clinics believe that such follicular family grafts create a better illusion of density.

 

I believe arguments can be made in favor of doing sub follicular unit grafting, follicular unit grafting, and for some patients the use of a limited amount of follicular unit families.

 

The final choice is up to the clinic and patient. But the patient deserves to know exactly what they are getting.

 

Consumers get to read the ingredients and nutrition info on food labels. Patients should also get detailed information so that they can make apples to apples comparisons.

 

Better information is more empowerment. All clinics can provide graft counts and even donor strip measurements if the patient based community demands it.

 

It's up to you to ask for it and ask why its not provided in clinic photo albums when it's missing.

[Dewayne]

Originally posted by Pat - Publisher of this Community:

PJ,

 

The final choice is up to the clinic and patient. But the patient deserves to know exactly what they are getting.

 

Consumers get to read the ingredients and nutrition info on food labels. Patients should also get detailed information so that they can make apples to apples comparisons.

 

Better information is more empowerment. All clinics can provide graft counts and even donor strip measurements if the patient based community demands it.

 

It's up to you to ask for it and ask why its not provided in clinic photo albums when it's missing.

 

I certainly agree with this. Speaking of nutritional labels, in 1993 I was a Quality Control manager for a large food processing operation when it was mandated by the government that the industry put the nutritional information on products. It was a huge undertaking, and I can tell you most all food companies would never have done it on their own. You would've thought it would bankrupt the whole industry! Now, people take it for granted and probably can't remember when it wasn't available.

 

So yeah, the patient should demand full and honest transparency in this and everything else. If your clinic doesn't comply, threaten them with a few internet posts and I'll bet they have a change of heart....

 

Rant over.

[the B spot]

I wasn't speaking of pricing at all PJ-- I am talking about actually quantifying the total result.

 

Certainly, total hairs moved is a great way to quantify the "bulk" of a HT, but it isn't descriptive enough, IMO.

 

However, to accurately judge what was moved, in conjunction with density in an area, and overall approach, you need both factors.

 

The patient SHOULD know what they are getting whether they ask or not, imo, however, I understand going to a top clinic and taking whatever they give you--some people do not get caught up with the fine details.

 

Since you brought up pricing, this is yet another point that requires detail. This is why at SMG we list every graft 1,2,3,4 hairs and total them up so the patient knows what they are paying for...we have long established ourselves as a trustworthy clinic, but again, patients should know what they pay for.

 

Anyway, I do appreciate your bringing this up--we laid out a couple of different areas where this is important which is great education IMO.

 

Take Care,

Jason

[P.J]

Pat - thanks for the help - you got me interested in this topic

 

B-spot

 

I wholeheartly agree with you that you need to know exact #s on everything with your transplant - that is not what I am trying to take away - this all should be included in your knowledge/descriptions

 

What I was trying to point out is everyone refers to grafts not hairs when talking about their surgery - which in my opinion is not as important as hairs - in the hands of equally skilled surgeons

 

The reason is, in the pictures a guy might see 3000 grafts a go holy crap that amazing but what might be missing is the 9000 hairs the guy recieved with an irregular amount of three and fours or DFUs - not that anyone is hiding anything its that most people focus on graft count instead of hair count.

 

Hair Density = hair per cm2

 

Illusion of hair density = hair caliber, contrast and charateristics per cm2

 

PS -I do appreciate all the input you have shared and it has guided me greatly

 

 

 

PJ