How many grafts

[Graff]

Hi Everyone

 

Was wondering what everyone thinks about the amount of grafts on average a person has avialable for FUE. I have heard different figures thrown about and was wondering if you were to go on the side of caution how many would it be safe to allow for and not for it to show. I have been quoted that I would need approx 3000-3500 grafts for fue. It is very unlikely I would need many more after that as I am nearly 40 years old and still only have loss / thinning at the front. I know there is nothing to say that might not change in 10 years but I would imagine at the moment if I did need to touch up in the future the most I would need would be another 1500 or so. Would appreciate what you think in your experience is a conservative amount that most people would have to spare before getting that weird moth eaten look. My donor area by the way is very thick if that helps. Thanks

[Graff]

Hi Everyone

 

Was wondering what everyone thinks about the amount of grafts on average a person has avialable for FUE. I have heard different figures thrown about and was wondering if you were to go on the side of caution how many would it be safe to allow for and not for it to show. I have been quoted that I would need approx 3000-3500 grafts for fue. It is very unlikely I would need many more after that as I am nearly 40 years old and still only have loss / thinning at the front. I know there is nothing to say that might not change in 10 years but I would imagine at the moment if I did need to touch up in the future the most I would need would be another 1500 or so. Would appreciate what you think in your experience is a conservative amount that most people would have to spare before getting that weird moth eaten look. My donor area by the way is very thick if that helps. Thanks

[thanatopsis_awry]

I beleive Bill and Janna have said that FUE harvesting should theoretically be the same # for FUT in a given person. 3k-3.5k I wouldn't think would be anywhere near the # for you to get a "moth eaten" look.

 

I did see a lone example of Armani's once where a guy received well over 8k from FUE and one problem I saw -- besides rather poor growth -- was a poor looking donor.

 

FUE may very well be a great option for you, just be cautious as to who you go to and how you proceed as many of the "top" FUE docs are shrowded in various controversies.

[bverotti]

If you had asked the question how many FUE are available to the average person a couple of years ago the answer would look much different than today.

 

First of all today most top FUE docs are using smaller instruments than before. Obviously this has no impact on the total number of available follicles. However by using 0,7 mm or smaller instruments surrounding follicles remain untouched. This is very important for guys with high density.

Another factor is that FUE docs have picked up speed by performing it on a daily basis. I can not run a marathon, but if I practice for 12 months I am fairly sure I could pull it of (if I dont get a heart attack during the race). Give it 2 more years of practice and I am sure my time would improve tremendously. This is more or less what has happened the last couple of years in the FUE field.

So, instead of doing 3 consecutive days for 2100 grafts (like I did in 2003), experienced FUE docs pull it of within 1 day without having to stretch the limits.

 

Last year we really started doing a lot of 3k sessions (over 2 consecutive days). Most of the patients report us that their donor density is visible unchanged, can't even feel a difference when running fingertips through the hairs.

 

This year we are going to see more patients come back to add 1000-2000 grafts on top of what they already got. This means that some patients will go for 5000 grafts FUE only.

Obviously we tell those people that they should not expect an intact donor area when shaven to the bone. White spots with missing hairs will become visible at some point. However at 3 to 4 mm length it should be fine (we will provide more picture proof as soon as we got it).

 

We believe that today the average FUE patient will be able to transplant 4000 to 5000 grafts using FUE only with no worry about linear scarring, nerve damage, scar stretching, phantom pain.

[NW5a]

If u had 2 strips before with 6000 Grafts, how many fue grafts can u get than ? 5000, too ?

[chucky]

hi Bverotti

when you say by using smaller instruments the surrounding follicles remain untouched,does this mean that if a larger instrument is used the surrounding follicle may be damaged or worse case scenario killed.

[bverotti]

Originally posted by NW5a:

If u had 2 strips before with 6000 Grafts, how many fue grafts can u get than ? 5000, too ?

 

Hehe, you can't have it all !

No, I dont believe that it will be possible given the example you have given.

 

However, I managed to get 4000 FUE grafts after 1 strip session. According to our docs I still have 1000 or a bit more FUE in my donor area without risk of thinning. I must say I had an over average donor supply to start with.

[bverotti]

Originally posted by chucky:

hi Bverotti

when you say by using smaller instruments the surrounding follicles remain untouched,does this mean that if a larger instrument is used the surrounding follicle may be damaged or worse case scenario killed.

 

Indeed, when FU as very close to one another a large punch (anything greater than 0,8 mm I consider to be a large punch) surrounding follicles could be damaged in the process of extracting.

I believe dr. Bisange once presented a study about this.

 

Of course you would think transection rates would go up when smaller instruments are used.

 

But look at it this way.

 

A major leage pitcher can throw fast balls inside the pitching area all night long with almost no misses. I doubt most non proffesionals could pull this off.

These pitchers have developed a feeling for the ball, the distance, the pitching window. It took them many years to develop this Jedi like feeling.

Give them a smaller ball and I am sure that after a short while they would get the same score. The learning curve would not start from zero.

Same goes for FUE docs. Most start by using 1 mm instruments until they get the feeling in their fingertips. Give them smaller tools and they will adapt quickly.

 

I can not explain it better, I do not perform myselve ... that is how the docs describe it to me.

[Bill - Seemiller]

Graff,

 

The amount of available donor hair via FUT (strip) is dependent both on donor hair density and scalp elasticity. The amount of available donor hair via FUE/FIT is dependent on donor hair density.

 

In theory, on the average, one should have approximately as much donor hair available for either procedure. In other words, if a strip patient has approximately 6000 follicular unit grafts, the number will most likely be close for FUE.

 

However, those with extremely poor scalp elasticity may have more available donor via FUE.

 

The problem to date, however, is that FUE is seemingly less reilable than FUT in terms of percentages of successful hair growth. This is true because of the additional pulling, twisting, and squeezing forces that are imposed on the hair follicle as they are being extracted and the greater risk for damage as they are being inserted into recipient sites due to the lack of supporting tissue and fat around the graft.

 

Though Bart is correct in saying that those hair transplant surgeons that have improved this technique have been able to increase the speed of the extraction, I also worry that some have sacrificed proper graft care for speed which will ultimately impact hair growth percentages of the transplanted hair.

 

In my opinion, those clinics that deny or ignore the potential risks of follicular transection with FUE/FIT are putting their patients at risk for an unsuccessful hair transplant due to low hair growth yield

 

From what I have seen so far, Bart's clinic does appear to be producing some impressive follicular unit extraction hair transplantation.

 

Many of our Coalition physicians also have improved this technique significantly.

 

Best wishes,

 

Bill