Graft Quantity

[Agio]

Hi Rambler-I too am 46. It may be helpful for you to look at my weblog as the surgeon who did mine trained with H&W.

As I never attempted any type of camouflaging, just combed my hair as I always had through 13 years of thinning it may or may not look worse than it actually is but it looks like I have a lot less hair than you. Keep in mind that when they are dense packing anywhere from 40-80 grafts per sq cm to achieve optimum results it doesn't take many grafts to reach 900. Nakatsui covered approximately 120 sq cm with 4312 grafts and he isn't a 'dense packing fanatic' as I doubt H & W are. They put the hairs where they are needed to obtain optimum results, no more, no less. I've attached a photo of an area near the front showing 1 sq cm with 59 grafts. Lot of grafts in a small area.

It's all about what you want and expect and in truth an electronic consult is at best an educated quess. Best of luck to you.

[Rambler]

Agio, I've read about your doctor and his work is very impressive. He seems to have very good artistry skills. I can't wait to see how yours looks in a few months. Thanks for the photo too. I can see how little tiny dots add up real quick. Strangely, to me some of the slits look longer than I would expect them too.

 

I'm still running abound like a mad scientist doing comparisons, and it "is" a bit confusing still. I understand everything everyone has said so far and agree. but..

 

Here's a couple more. Let's take Hasson&Wong for example because that is where I was given an estimate of 3500 grafts. This assessment did not come from the doctor mind you, but from a consultant that has my photos that I posted earlier. Another reason for H&W examples is I believe they represent "actual" results ( lighting/photography )

 

I'm looking mainly for those who's condition is similar to mine and comparing the amount of grafts of their procedure...

 

Patient 26

Now this guy is definitely further thinning than I am and his result is not what I would call ultra-densle packed but it is pretty nice considering it was 2100 grafts. He got a whole hairline constructed plus filler for a significant receding area.

 

Patient 48

Look at all the forehead on the before photos. That's a lot of recipient area. 1900 grafts. Again, not really dense-packed but pretty good coverage considering the area/grafts inserted.

 

Patient 59

Once again, a lot of recipient area to be covered. A lot more than I need for sure. 2699 grafts.

 

Are these photos deceiving in some way? or are they planning to pack me like a rabid wolfman? I definitely would like more density than these examples, but the math just doesn't add up.

 

Jotronic,

Is it possible to get more densely packed results than these in a single procedure? Even if part of the procedure is building a hairline in an area where there are no hairs?

 

Rambler

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[Bill - Seemiller]

Rambler,

 

What kind of hair density are you looking for?

 

The patient galleries you have presented are quite impressive.

 

I imagine that most highly skilled physicians such as Hasson and Wong can achieve great hair densities, even up to 80 Follicular units per square cm in a single session, but whether or not this is in the patient's best interest is a case by case situation.

 

Age, current level of hair loss, and future possibility of hair loss must be considered. Additionally, a hairline should be feathered in order to achieve a "soft" and natural look which means the hairline in itself will be less dense than immediately behind it.

 

These are just some things to consider.

 

Bill

[Rambler]

Bill,

 

Well, density per say isn't the main question here. It directly relates but ... It's the amount of proposed grafts for my procedure. I am making comparisons of those similar to me and the amount of grafts they received. So far I am finding individuals with more thinning and less grafts with pretty decent results. So why 3500 for me?

 

The first comparisons I posted were from a site that uses flash on hairlines, therefore not really an accurate visual of the result. So I compared with H&W's photos because their photos, I believe, are more an accurate representation of density/coverage. Also because it was H&W that proposed 3500 for mine.

 

Like I said, from looking at the results of others and their thinning/grafts of procedure, the math just doesn't add up for me. So this leads me to believe a procedure of 3500 with my area to be filled would be more dense?

 

Rambler

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[Bill - Seemiller]

Rambler,

 

I understand. That makes sense.

 

It's hard to tell from your current photo set how many grafts you may need because your hair is combed forward. It does appear however, that you have a pretty good head of hair.

 

Obviously, the more hair that is transplanted, the greater the overall density. 3500 grafts will certainly give you a nice looking thicker head of hair than 2500 for example.

 

But much of this depends on your hair restoration goals and proper planning for the long term leaving a strong available donor supply for future work if needed.

 

Bill

[Rambler]

Ok, here are some more photos with wet hair. I love modern technology :-)

 

Front

Left

Right

 

The right side is the worst. It has a vacant area that the left doesn't. Well it does, but not as much. The entire frontal area isn't as dense as the, what do you call it? the "helmet area" of the head where the donor stems from but I've been thinning for 20 years so I'm pretty sure I won't lose much more.

 

My goal is to camaouflage the 900 graft pitted hairline. It's pretty roughly outlined with 2-3-4 hair grafts too so will need a new transition zone. Also to fill in the more vacant areas on the right/left just behind the hairline. I imagine some beefing up of the entire area would be needed as well.

 

Now compare this "canvas" with the others and you will see what I mean.

 

So If the 3500 would make the entire frontal area as dense as the helmet area then I can see, but I'm not sure this is a realistic goal or not.

 

Rambler

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[Agio]

Rambler

It is indeed confusing and I've been there. All a person can do is sift through it patiently because regardless what a person feels, their hair isn't falling out so fast that they need to rush before being comfortable.

For me I used the electronic consults I had done (inc one form H&W) as a broad approximation because it is essentially an unanswerable question.

In my opinion, until you are actually at the surgeons and he or she is looking at your head judging hair coarseness & thickness, donor site and scalp laxity determining how many grafts you actually need is pretty tough. Of course, in the end, everything depends on the results you want and what the surgeon can give you. I'm sure that whoever you choose will be top notch and they won't be hustling you for extra grafts. It's your head afterall, if you want 900 or 1500 or 4000 grafts then that's what you'll get.

 

There are some interesting posts and information on surgeons sites about dense packing. More isn't always better it seems.

 

P.S. Just looked at the pics you posted. You aren't being unrealistic in your goals but if you want to fill in that hairline it's going to take a fair amount of grafts I think. I know we ate up a lot doing mine because you can't hide anything.

We appear to have a quite similar pattern in hair loss given that you had 900 grafts done previously. A ton on the sides and not so good on top, lol. I think yours is thicker though and probably not as advanced as mine.

[Rambler]

Agio,

 

Today's your 2 week mark? I think your going to be happy, that was a serious session and it looks good.

 

Agree, the hairline will take up considerable if it is to be done right. You have links to those dense pack articles?

 

Rambler

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[Agio]

Rambler-After waiting this long I certainly hope I'll be pleased and yeah, it was a serious session. I'm pleased I found a quality surgeon literally 10 minutes away from me. Lucky, unless the results suck, lol.

I don't have links, if I recall Rahal, Shapiro and Feller give interesting comments and you can also google "dense packing hair transplants"

I think that's what I did. Frankly, it's all a haze now. I've bought companies with less research, man...

[flyby]

Hi Rambler,

 

Interesting thread. From looking at your pictures you do look like you have a pretty decent head of hair and I do agree that 3500 may be a little high depending on your goals. I do think H&W is one of the best and most ethical HT centers in the world and with 3500 you would probably be an HT posterboy with almost perfect density (which you may not want). I'm sure they would also be happy to do less as long as both side were in agreement of your expectations.

 

A question I have for you is are you OK with buzzing your recipient area down for the HT? Which, I would imagine HW would require with 3500 grafts. I know buzzing down creates a perfect work envorinment for the Dr. & Techs but unless you have the ability to hide under a hat for a while buzzing down seems to create a very akward 2 months after the HT (IMO). With your existing hair it appears like you would be a perfect candidate to have excellent results with an HT of about 2000-2500 without buzzing down which would allow your existing hair to conceal the HT and you'de be back to your pre HT life much sooner without noticible results of the HT. I'm not sure If H&W will do an HT without buzzing down but I know Dr. Shapiro and Dr. Alexander do as long as graft counts are below 3000. Hope this doesn't add any confusion to your existing questions but something to think about. Also, great to see someone actively doing their homework like you are.

[Rambler]

flyby,

 

No problems with the buzzing, I figured I'd arrive with a 4 all over and let them finish me off from there. Here are the most important things.

 

1) Quality, artistic, natural looking hair transplant(non-pitted). Donor scar quality. I know there will be one, but the quality of it matters considerably.

2) Density

3) Cost

 

To me, if number one isn't a realistic outcome, there's no sense even doing it. I'd rather be bald, honestly. If it is, and number 2 is a realistic agreed upon amount, all the rest is colored bubbles.

 

Rambler

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[Agio]

Rambler-Have you actually had a consult be it electronic or face to face with a Doctor on this yet? In this case either Hasson or Wong? I emailed pics to H&W and then spoke to H on the phone about 6 months back when I was serious about having one done. I ask because these seem to be questions only the Doctor should attempt to answer and as important, that you will be satisfied with.

I mean no offense to any consultants but they aren't the ones doing the surgery nor can they possibly have the knowledge the doctor has, especially if they are looking at pictures.